June 2025 Br J Cardiol 2025;32:72–6 doi:10.5837/bjc.2025.026
Ahmed Ali Kayyale, Peter Timms, Han B Xiao
Introduction Myocardial fibrosis plays a pivotal role in cardiac pathological processes and the development of complications. Preclinical studies demonstrate that angiotensin-converting enzyme inhibitors (ACEi) have inhibitory effects on fibrotic pathways and could reduce myocardial fibrosis.1 Myocardial fibrosis, triggered by various stimuli, increases morbidity and mortality.2 Azevedo et al. revealed that higher degrees of myocardial fibrosis were associated with worse long-term survival.3 Accumulation of myocardial fibrosis is associated with stiffening of the myocardium and failure to relax during diastole.4 Further, a higher degree of my
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