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Rethinking Endothelial Dysfunction as a Crucial Target in Fighting Heart Failure
Courtney Premer1, Anthony J Kanelidis2, Joshua M Hare1
1Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL.
Mayo Clinic Proceedings. Innovations, Quality & Outcomes
|March 23, 2019
Summary
Endothelial dysfunction, marked by nitric oxide issues and oxidative stress, contributes to heart failure. Targeting this dysfunction may offer new therapeutic strategies for treating heart failure.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Pathophysiology
Background:
- Endothelial dysfunction involves nitric oxide dysregulation and altered redox state, promoting atherogenesis and hypertension.
- These factors are key risk factors in the development and progression of heart failure.
- There is renewed interest in endothelial dysfunction's role in failing circulation.
Purpose of the Study:
- To review the pathophysiology of endothelial dysfunction.
- To explore the mechanisms linking endothelial dysfunction and heart failure.
- To highlight therapeutic implications of targeting endothelial dysfunction in heart failure treatment.
Main Methods:
- Review of current literature on endothelial dysfunction and heart failure.
- Discussion of diagnostic methods for endothelial dysfunction, including flow-mediated vasodilation and endothelial progenitor cell measurements.
- Analysis of the relationship between endothelial dysfunction and cardiovascular disease.
Main Results:
- Endothelial dysfunction is characterized by oxidative stress and inflammation, contributing to heart failure.
- Various clinical methods assess endothelial dysfunction in heart failure patients.
- The direct therapeutic benefit of targeting endothelial dysfunction in heart failure remains under investigation.
Conclusions:
- Endothelial dysfunction is intricately linked to heart failure pathophysiology.
- Accurate diagnostic methods are available to assess endothelial function.
- Further research is needed to confirm if targeting endothelial dysfunction can effectively ameliorate heart failure progression.
Keywords:
Ach, acetylcholineCAD, coronary artery diseaseCVD, cardiovascular diseaseECFC, endothelial colony-forming cellEDHF, endothelium-derived hyperpolarizing factorEPC, endothelial progenitor cellEPC-CFU, EPC–colony-forming unitFMD, flow-mediated vasodilationH2O2, hydrogen peroxideHF, heart failureHFpEF, HF with preserved ejection fractionHFrEF, HF with reduced ejection fractionIVUS, intravascular ultrasoundLVEF, left ventricular ejection fractionNO, nitric oxideNOS, NO synthasePAT, peripheral arterial tonometryQCA, quantitative coronary angiographyROS, reactive oxygen speciescGMP, cyclic guanosine monophosphateeNOS, endothelial nitric oxide synthase
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