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Endothelial to Mesenchymal Transition in Cardiovascular Disease: Key Mechanisms and Clinical Translation Opportunities

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  • Jason C. Kovacic
  • Stefanie Dimmeler
  • Richard P Harvey
  • Toren Finkel
  • Elena Aikawa
  • Guido Krenning
  • Andrew Baker

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Original languageEnglish
Pages (from-to)190-209
JournalJournal of the American College of Cardiology
Issue number2
Early online date14 Jan 2019
Publication statusPublished - 22 Jan 2019


Endothelial to mesenchymal transition (EndMT) is a process whereby an endothelial cell undergoes a series of molecular events that lead to a change in phenotype toward a mesenchymal cell (e.g., myofibroblast, smooth muscle cell). EndMT plays a fundamental role during development, and mounting evidence indicates that EndMT is involved in adult cardiovascular diseases (CVDs), including atherosclerosis, pulmonary hypertension, valvular disease, and fibroelastosis. Therefore, the targeting of EndMT may hold therapeutic promise for treating CVD. However, the field faces a number of challenges, including the lack of a precise functional and molecular definition, a lack of understanding of the causative pathological role of EndMT in CVDs (versus being a “bystander-phenomenon”), and a lack of robust human data corroborating the extent and causality of EndMT in adult CVDs. Here, we review this emerging but exciting field, and propose a framework for its systematic advancement at the molecular and translational levels.

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