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Postinfarction left ventricular remodeling: a pathophysiological and therapeutic review
Z R Yousef1, S R Redwood, M S Marber
1Department of Cardiology, Rayne Institute, Kings College London, UK.
Insights
Despite decades of research, heart failure prognosis remains poor. This review covers current and future therapeutic strategies for post-infarction left ventricular dysfunction, focusing on pathophysiology and drug development.
Area of Science:
- Cardiology
- Pathophysiology
- Pharmacology
Background:
- Left ventricular dysfunction significantly impacts heart failure prognosis, with high mortality rates despite extensive research.
- Current therapeutic strategies have limited long-term efficacy for patients with clinical heart failure.
Purpose of the Study:
- To review the pathophysiology of post-infarction left ventricular dysfunction.
- To provide a rationale for current, clinical trial, and pre-clinical drug development.
- To discuss intracellular signaling pathways in ventricular hypertrophy for future treatments.
Main Methods:
- Literature review of studies on left ventricular dysfunction pathogenesis.
- Analysis of current drug usage and clinical trial data.
- Exploration of pre-clinical compounds and intracellular signaling pathways.
Main Results:
- Numerous therapeutic targets and drug classes have been identified over 50 years.
- Despite advances, long-term prognosis for heart failure patients remains poor.
- Intracellular signaling pathways in ventricular hypertrophy present potential future treatment avenues.
Conclusions:
- Understanding the pathophysiology of left ventricular dysfunction is crucial for improving heart failure outcomes.
- A multi-faceted approach combining current therapies, ongoing trials, and novel pre-clinical research is necessary.
- Targeting intracellular signaling pathways offers promising future therapeutic strategies for heart failure.
Abstract:
Over the last 50 years, studies investigating the pathogenesis of left ventricular dysfunction have resulted in many potential therapeutic targets being identified and novel classes of drugs designed to treat this condition. Despite this, the long-term prognosis of patients with clinical heart failure remains poor with mortality rates equivalent to many terminal malignancies. This article reviews our present understanding of the pathophysiology of post-infarction left ventricular dysfunction and provides a rationale for current drug usage, drugs undergoing clinical trials and compounds still under pre-clinical development. In addition, the complexities involved in deciphering intra-cellular signalling pathways mediating ventricular hypertrophy which may form the basis of future treatments are also discussed.