Kassner A, Oezpeker C, Gummert J, et al. - Given that mechanical unloading by ventricular assist devices (VADs) has become more and more essential for the therapy of end‐stage heart failure during the last decade, but VAD support was alleged to be related to partial reverse remodelling, whereas the literature reports the contradictory impacts of VAD systems on cardiac fibrosis, researchers investigated the impacts on cardiac fibrosis prior to as well as after mechanical unloading in 125 patients, to ultimately clarify these inconsistent findings. They examined left ventricular myocardial tissue collected from ischaemic or non‐ischaemic cardiomyopathy patients receiving VAD implantation and subsequent cardiac transplantation and non‐failing hearts of the control group, to determine 4‐hydroxyproline content as a marker for collagen protein. They also measured collagen cross‐linking as well as mRNAs of collagens I and III and transforming growth factor beta‐1. In this study of a comparably large patient cohort, a strong rise in cardiac fibrosis was evident in heart failure and it increased even following mechanical unloading. The mRNAs of collagens I and III were shown to be independently regulated from the collagen protein.