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Leveraging clinical epigenetics in heart failure with preserved ejection fraction: a call for individualized
Nazha Hamdani1,2,3,4, Sarah Costantino5, Andreas Mügge2,3
1Institute of Physiology, Ruhr University, Bochum, Germany.
European Heart Journal
|May 5, 2021
Summary
Heart failure with preserved ejection fraction (HFpEF) is a major unmet need. Epigenetic modifications offer novel, reversible biomarkers and therapeutic targets for personalized HFpEF management.
Area of Science:
- Cardiovascular Medicine
- Molecular Biology
- Genetics
Background:
- Heart failure with preserved ejection fraction (HFpEF) is a prevalent, untreatable cardiovascular disease, disproportionately affecting women and incurring high healthcare costs.
- The diverse phenotypes of HFpEF complicate diagnosis and treatment, highlighting the urgent need for novel therapeutic strategies.
- Epigenetic modifications, influenced by environmental factors, play a crucial role in the molecular pathways leading to HFpEF, including oxidative stress, inflammation, and cardiac remodeling.
Purpose of the Study:
- To explore the significance of clinical epigenetics in addressing the unmet need in heart failure with preserved ejection fraction (HFpEF).
- To highlight epigenetic modifications as potential diagnostic biomarkers and therapeutic targets for personalized HFpEF management.
- To review the role of epigenetics in environmental modulation of gene expression relevant to HFpEF pathogenesis.
Main Methods:
- Review of current literature on epigenetic mechanisms in HFpEF.
- Analysis of advances in high-throughput sequencing, computational epigenetics, and machine learning for biomarker discovery.
- Examination of existing and emerging epigenetic drugs ('epidrugs') targeting chromatin and non-coding RNAs.
Main Results:
- Epigenetic biomarkers reflect environmental and lifestyle influences and are reversible, offering dynamic monitoring capabilities.
- Epigenetic modifications are implicated in key pathological processes of HFpEF, such as left ventricular remodeling.
- Several FDA-approved 'epidrugs' demonstrate potential in preventing transcriptional alterations associated with HFpEF.
Conclusions:
- Clinical epigenetics presents a promising frontier for the personalized management of HFpEF.
- Epigenetic information holds significant potential for both diagnostic and therapeutic applications in HFpEF patients.
- The reversible nature of epigenetic changes offers a unique opportunity for monitoring disease progression and treatment response in HFpEF.
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