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Published on: May 25, 2020
PCSK9: A emerging participant in heart failure
Qian Xu1, Yi-Meng Zhao1, Nai-Qi He1
1Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, Hunan International Scientific and Technological Cooperation Base of Arteriosclerotic Disease, Hengyang Medical College, University of South China, Hengyang, Hunan Province 421001, PR China.
Insights
Proprotein convertase subtilisin/kexin type 9 (PCSK9) is elevated in heart failure (HF) patients and may worsen outcomes. This review explores PCSK9
Area of Science:
- Cardiology
- Molecular Biology
- Biochemistry
Background:
- Heart failure (HF) is a complex syndrome with unsatisfactory treatment options.
- Current HF pathogenesis involves cardiomyocyte loss, metabolic disorders, and inflammation.
- Proprotein convertase subtilisin/kexin type 9 (PCSK9) is linked to lipid metabolism, apoptosis, and inflammation.
Purpose of the Study:
- To review the potential mechanisms of PCSK9 involvement in heart failure.
- To identify PCSK9 as a potential therapeutic target for heart failure.
Main Methods:
- Literature review of studies on PCSK9 and heart failure.
- Analysis of clinical data and animal models.
Main Results:
- Circulating PCSK9 levels are significantly increased in heart failure patients.
- Elevated PCSK9 correlates with poorer heart failure prognosis.
- PCSK9 is upregulated in infarct margins in myocardial infarction models.
Conclusions:
- PCSK9 may play a significant role in heart failure pathogenesis.
- Further research into PCSK9 mechanisms could reveal novel heart failure treatment strategies.
Abstract:
Heart failure (HF) is a complex clinical syndrome caused by various cardiovascular diseases. Its main pathogenesis includes cardiomyocyte loss, myocardial energy metabolism disorder, and activation of cardiac inflammation. Due to the clinically unsatisfactory treatment of heart failure, different mechanisms need to be explored to provide new targets for the treatment of this disease. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a gene mainly related to familial hypercholesterolemia, was discovered in 2003. Aside from regulating lipid metabolism, PCSK9 may be involved in other biological processes such as apoptosis, autophagy, pyroptosis, inflammation, and tumor immunity and related to diabetes and neurodegenerative diseases. Recently, clinical data have shown that the circulating PCSK9 level is significantly increased in patients with heart failure, and it is related to the prognosis for heart failure. Furthermore, in animal models and patients with myocardial infarction, PCSK9 in the infarct margin area was also found to be significantly increased, which further suggested that PCSK9 might be closely related to heart failure. However, the specific mechanism of how PCSK9 participates in heart failure remains to be further explored. The purpose of this review is to summarize the potential mechanism of PCSK9's involvement in heart failure, thereby providing a new treatment strategy for heart failure.
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