Physiology and homeostasis of extracellular matrix: cardiovascular adaptation and remodeling.

Tissue distensibility and extracellular matrix (ECM) including receptor integrins play significant role in the frequency of heart beat, contraction and relaxation. To meet the workload and during compensatory adaptive remodeling, the ECM restructures and transmits nuclear signals to convert fibroblasts to myofibroblasts. The matrix metalloproteinases (MMPs), a disintegrin and metalloproteinase (ADAM), and tissue inhibitor of metalloproteinases (TIMPs) control the activation of ECM remodeling and transmission of nuclear signals. This lead to the replacement of the injured muscle during wound healing in heart failure. The ECM degradation leads to apoptosis in cardiomyocytes.