While a limited number of studies have explored the role of Ang II in myocardial fibrosis, the role of Ang II has not been elucidated thoroughly, especially the relationship between Ang II and ACT A. Although recent studies have shown that angiotensin II upregulated activin A in peripheral blood mononuclear cells (PBMNC) via activation of NFkB in heart failure40, inhibition of NFkB does not completely suppress Ang II-mediated upregulation of activin A in bone marrow-derived mononuclear cells -derived conditioned medium (CM). This evidence concerns the gene SERPINA3 and Myocardial fibrosis.