“…Furthermore, we were able to locate 16 trials reporting cardiac fibrosis as a result of Hcy-induced oxidative stress [ 41 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ]. Several mechanisms of action have been proposed for this effect, including increased reactive oxygen species, nitrotyrosine, matrix metalloproteinase, and decreased endothelial nitric oxide in response to antagonizing PPAR-gamma [ 82 ] and regulation of the Akt/FoxO3 pathway.…”