Cardiovascular pathology is often accompanied by changes in relative content and/or ratios of structural extracellular matrix (ECM)
proteins within the heart and elastic vessels. Three of these
proteins,
collagen-I,
collagen-III, and
elastin, make up the bulk of the ECM
proteins in these tissues, forming a microenvironment that strongly dictates the tissue biomechanical properties and effectiveness of cardiac and vascular function. In this review, we aim to elucidate how the ratios of
collagen-I to
collagen-III and
elastin to
collagen are altered in
cardiovascular diseases and the aged individuum. We elaborate on these major cardiovascular ECM
proteins in terms of structure, tissue localization, turnover, and physiological function and address how their ratios change in aging,
dilated cardiomyopathy,
coronary artery disease with myocardial infarction,
atrial fibrillation,
aortic aneurysms,
atherosclerosis, and
hypertension. To the end of guiding in vitro modeling approaches, we focus our review on the human heart and aorta, discuss limitations in ECM
protein quantification methodology, examine comparability between studies, and highlight potential in vitro applications. In summary, we found
collagen-I relative concentration to increase or stay the same in
cardiovascular disease, resulting in a tendency for increased
collagen-I/
collagen-III and decreased
elastin/
collagen ratios. These ratios were found to fall on a continuous scale with ranges defining distinct pathological states as well as a significant difference between the human heart and aortic ECM
protein ratios.