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Heart failure as a metabolic problem
1Department of Cardiac Medicine, National Heart and Lung Institute, London, UK. s.anker@ic.ac.uk
Insights
Chronic heart failure (CHF) is a complex metabolic syndrome involving hemodynamic, neurohormonal, and immunological factors. Understanding these metabolic changes is crucial for developing new treatments to improve patient prognosis.
Area of Science:
- Cardiology
- Endocrinology
- Immunology
Background:
- Chronic heart failure (CHF) is a growing public health concern.
- CHF involves complex interactions between hemodynamic, neurohormonal, immunological, and endocrine systems.
- Initially adaptive, these secondary mechanisms can worsen CHF progression.
Purpose of the Study:
- To review the metabolic features of CHF patients.
- To discuss the immunological and neuroendocrine aspects contributing to CHF pathogenesis.
- To highlight CHF as a multifactorial metabolic syndrome.
Main Methods:
- Literature review focusing on metabolic, immunological, and neuroendocrine pathways in CHF.
- Analysis of current understanding of CHF pathogenesis.
- Synthesis of evidence linking metabolic dysfunction to CHF outcomes.
Main Results:
- CHF is characterized by significant metabolic disturbances.
- Immunological and neuroendocrine dysregulation plays a key role in CHF.
- Advanced CHF can manifest as cardiac cachexia, indicating a poor prognosis.
Conclusions:
- CHF is a multifactorial metabolic syndrome.
- Therapeutic strategies should target the metabolic status of CHF patients.
- Interdisciplinary collaboration among cardiologists, endocrinologists, and immunologists is essential for improved CHF management.
Abstract:
Chronic heart failure (CHF) remains an important and increasing public health care problem. Not until recently it has been recognised that CHF is a chronic progressive disorder affecting different physiological and metabolic pathways. Nowadays CHF is reviewed as the consequence of an interplay of haemodynamic, neurohormonal, immunological, and endocrine mechanisms, initially thought to have beneficial adaptive effects for the organism to compensate the heart's inability to pump properly. However, these secondary changes eventually contribute to further deterioration of CHF. This review focuses on metabolic features observed in patients with CHF and discusses immunological and neuroendocrine aspects and their potential contribution to the pathogenesis of CHF. The overall evidence suggests that advanced CHF is a multifactorial metabolic syndrome that can lead to cardiac cachexia and then carries a very poor prognosis. Joint efforts of cardiologists, endocrinologists, and immunologists are required to develop therapeutic strategies able to improve the metabolic status of CHF patients.