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[Mechanisms of myocardial damage progression in heart failure]
1Instituto Nacional de Cardiología, Ignacio Chávez, INCICH, Juan Badiano No. 1, Col. Sección XVI, Tlalpan, 14080 México, D. F. martinrp02@yahoo.com.mx
Insights
Cardiac failure, a growing global health issue, is increasingly understood through complex mechanisms like gene regulation and neuroendocrine interactions. This review explores these pathways and highlights novel therapeutic strategies for improved patient outcomes.
Area of Science:
- Cardiology and Molecular Medicine
- Pathophysiology of Cardiac Failure
Context:
- Cardiac failure represents a significant and escalating global health concern.
- Increased patient survival from coronary heart disease and advancements in cardiac failure management contribute to its prevalence.
- Understanding the multifactorial nature of cardiac failure is crucial for effective treatment.
Purpose:
- To provide a comprehensive review of the proposed mechanisms underlying the epidemiological transition of cardiac failure.
- To analyze the influence of various biological systems and signaling pathways on cardiac cellular damage.
- To emphasize emerging therapeutic strategies for managing cardiac failure.
Summary:
- Cardiac failure pathogenesis involves intricate mechanisms including gene regulation, extracellular matrix dynamics, neuroendocrine signaling, inflammation, immune balance, intracellular cascades, and mechanical integrity.
- Key influencing factors include the endothelin system, sympathovagal balance, oxidative stress, and angiotensin and aldosterone receptor activity.
- Apoptosis is identified as a common terminal pathway in cardiac cellular damage.
Impact:
- This review facilitates a more rational and informed approach to cardiac failure management.
- It highlights the importance of understanding complex molecular and physiological pathways in disease progression.
- Emphasis on new therapeutic strategies offers potential for improved clinical interventions and patient care.
Abstract:
Cardiac Failure is an increasing health problem in the world. Several mechanisms have been proposed as the cause of this epidemiological transition. The main reason is the increase in the survival of patients with coronary heart disease and the improvement in the management of cardiac failure with new drugs. Knowledge of new mechanisms including gene regulation, extracelullar matrix function, intracardiac vessels, neuroendocrine interrelations, inflammatory activity, immune balance, signalling intracellular and extracellular cascade, and mechanical integrity, have permitted a better and rational approach. The influence of paradigms such as endothelin system, sympathovagal balance, oxidative system, angiotensin receptors, aldosterone receptors have been demonstrated on progression of the cellular damage's patients with cardiac failure. Apoptosis is recognized as a common final way. In this review all these topics are analyzed. Emphasis is made on the new therapeutics strategies of treatment.