fig3

Figure 3. Feed-forward interactions between ECM remodeling and macrophage mechanotransduction in cardiac fibrosis. ECM stiffening modulates macrophage mechanosensing and functional reprogramming through mechanosensors and intracellular mechanotransduction pathways. Macrophages in turn promote ECM deposition, cross-linking, and fibroblast activation via inflammatory cytokines and matricellular signals, forming a self-amplifying loop that drives progressive myocardial fibrosis and stiffening.