Targeting interleukin-1 in heart failure and inflammatory heart disease

Heart failure (HF) is a clinical syndrome characterized by dyspnea, fatigue, and poor exercise capacity due to insufficient cardiac function. HF represents the leading cause of hospitalization among adult patients over 65 years of age. Neurohormonal blockade has improved clinical outcomes; however, HF incidence continues to rise, suggesting an urgent need to develop novel drugs that target a different pathophysiological paradigm. Inflammation plays a central role in many cardiovascular diseases. Interleukin-1 (IL-1), a prototypical proinflammatory cytokine, is upregulated in HF and associated with worse prognosis. Preclinical models suggest a beneficial effect of IL-1 blockade, and pilot clinical trials are currently underway to evaluate the role of IL-1 blockade to reduce inflammation, ameliorate ventricular remodeling, and improve exercise capacity in patients with HF.