High-density lipoprotein-mediated cardioprotection in heart failure

Area of Science:

• Cardiovascular Medicine
• Biochemistry
• Molecular Biology

Background:

• Global prevalence of heart failure (HF), encompassing both reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF), is rising.
• Current therapeutic strategies and patient outcomes for HF remain suboptimal.
• Emerging evidence suggests high-density lipoprotein (HDL) plays a significant role in cardiac repair mechanisms within the context of HF.

Purpose of the Study:

• To elucidate the precise roles and underlying mechanisms of HDL in the regulation and progression of heart failure.
• To review recent findings on HDL's influence on key cardiac functions and cellular components affected by HF.

Main Methods:

• Literature review and synthesis of recent scientific findings on HDL and heart failure.
• Discussion of HDL's impact on cardiac excitation-contraction coupling, energy metabolism, inflammation, neurohormonal balance, and microvascular function.
• Analysis of HDL's effects on cardiac endothelial cells (ECs), cardiomyocytes (CMs), and resident immune cells in HF.

Main Results:

• HDL influences critical pathways involved in HF progression, including energy homeostasis and inflammation.
• HDL modulates the function of essential cardiac cells like ECs and CMs.
• HDL impacts neurohormone activation and microvascular integrity in the failing heart.

Conclusions:

• HDL plays a multifaceted role in modulating cardiac function and repair during heart failure.
• A comprehensive understanding of HDL's cardioprotective mechanisms is essential.
• Targeting HDL pathways may offer novel therapeutic avenues for preventing and treating heart failure.