Obesity-Associated Cardiac Fibrosis: Mechanisms and Emerging Therapeutic Targets

Abstract: Obesity and cardiovascular disease are major, globally prevalent, and closely interrelated health challenges. Cardiac fibrosis represents the common pathological endpoint of multiple cardiac diseases. This review systematically synthesizes the mechanisms underlying obesity‑related cardiac fibrosis. It elaborates on how inflammatory factors, cytokines, and miRNAs, acting on adipose tissue and cardiac cells, drive a series of biological processes—including oxidative stress, activation of the renin‑angiotensin‑aldosterone system, autophagy dysregulation, and metabolic dysfunction—ultimately leading to obesity‑associated cardiomyopathy characterized by ventricular remodeling, heart failure, and atrial fibrillation. Potential therapeutic targets for this condition are also examined. Furthermore, this review discusses potential therapeutic targets for this condition, which will provide a critical theoretical foundation for the development of novel strategies aimed at preventing or even reversing obesity‑related fibrotic heart disease. Keywords: obesity, cardiac fibrosis, cardiac dysfunction, inflammation, cytokine, RAAS, autophagy