Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 58, Issue 18, Pages 1833-1843Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2011.06.058
Keywords
cardiomyocyte death; fibrosis; heart failure; inflammation; myocardial remodeling
Categories
Funding
- Foundation for Applied Medical Research and Union Temporal de Empresas
- Instituto de Salud Carlos III, Ministry of Science and Innovation, Spain [PS09/02234, PS09/02247]
- European Commission
- Metabolic Road to Diastolic Heart Failure, Brussels, Belgium [FP7-HEALTH-2010-261409]
- Ministry of Science and Innovation, Madrid, Spain [RYC-2010-05797]
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Classical therapy of heart failure is based on treatment of its pre-disposing/triggering factors and of the neurohumoral activation secondary to the deterioration of cardiac function. A new view is emerging that proposes the direct intervention on the pathological structural remodeling of the myocardium as part of heart failure therapy. In fact, in conditions of chronic injury, the cardiomyocytic and the noncardiomyocytic components of the myocardium undergo a series of structural lesions (i.e., cardiomyocyte growth and death, inflammation, alterations of collagen matrix, and microvascular rarefaction) that are governed by a complex interplay of mechanisms. Our increasing knowledge of the role of these mechanisms in remodeling enables us not only to better understand how our more successful therapies work but also to explore novel therapies for the future. In this paper, we will examine recent insights from experimental and pilot clinical studies that have provided new targets for interventions to prevent or reverse inflammation, alterations of collagen matrix, and cardiomyocyte death. (J Am Coll Cardiol 2011;58:1833-43) (C) 2011 by the American College of Cardiology Foundation
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