{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:32:16Z","timestamp":1791232336442,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Ministry of Education and Research (BMBF)"},{"name":"LEDUCQ"},{"name":"DZHK"},{"name":"the Else Kr\u00f6ner Fresenius Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Background: Dilated cardiomyopathy (DCM) involves myocardial remodeling, characterized by significant fibrosis and extracellular matrix expansion. These changes impair heart function, increasing the risk of heart failure and sudden cardiac death. This study investigates the prognostic value of circulating fibrosis biomarkers as a less invasive method in DCM patients. Methods: Plasma samples from 185 patients with confirmed DCM were analyzed to measure 13 circulating biomarkers using Luminex bead-based multiplex assays and ELISA. The prognostic value of these biomarkers was evaluated concerning heart failure-associated events and all-cause mortality. Results: Elevated MMP-2 levels (&gt;1519.3 ng\/mL) were linked to older age, higher diabetes prevalence, lower HDL, increased NT-proBNP and hs-TnT levels, and severe systolic dysfunction. High TIMP-1 levels (&gt;124.9 ng\/mL) correlated with elevated NT-proBNP, more atrial fibrillation, reduced exercise capacity, and larger right ventricles. Increased GDF-15 levels (&gt;1213.9 ng\/mL) were associated with older age, systemic inflammation, renal impairment, and poor exercise performance. Elevated OPN levels (&gt;81.7 ng\/mL) were linked to higher serum creatinine and NT-proBNP levels. Over a median follow-up of 32.4 months, higher levels of these biomarkers predicted worse outcomes, including increased risks of heart failure-related events and mortality. Conclusions: Circulating fibrosis biomarkers, particularly MMP-2, TIMP-1, GDF-15, and OPN, are valuable prognostic tools in DCM. They reflect the severity of myocardial remodeling and systemic disease burden, aiding in risk stratification and therapeutic intervention. Integrating these biomarkers into clinical practice could improve DCM management and patient prognosis.<\/jats:p>","DOI":"10.3390\/biom14091137","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T05:06:06Z","timestamp":1725858366000},"page":"1137","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prognostic Value of Circulating Fibrosis Biomarkers in Dilated Cardiomyopathy (DCM): Insights into Clinical Outcomes"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7285-2825","authenticated-orcid":false,"given":"Elham","family":"Kayvanpour","sequence":"first","affiliation":[{"name":"Department of Medicine III, University of Heidelberg, INF 410, 69120 Heidelberg, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3266-0527","authenticated-orcid":false,"given":"Farbod","family":"Sedaghat-Hamedani","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University of Heidelberg, INF 410, 69120 Heidelberg, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Tian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University of Heidelberg, INF 410, 69120 Heidelberg, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0453-0960","authenticated-orcid":false,"given":"Tobias","family":"Miersch","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University of Heidelberg, INF 410, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Weis","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University of Heidelberg, INF 410, 69120 Heidelberg, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imo","family":"Hoefer","sequence":"additional","affiliation":[{"name":"Experimental Cardiology Laboratory, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University of Heidelberg, INF 410, 69120 Heidelberg, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Meder","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University of Heidelberg, INF 410, 69120 Heidelberg, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), 69120 Heidelberg, Germany"},{"name":"Klaus Tschira Institute for Computational Cardiology, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1038\/nm1613","article-title":"Endothelial-to-mesenchymal transition contributes to cardiac fibrosis","volume":"13","author":"Zeisberg","year":"2007","journal-title":"Nat. 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