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Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Heart Failure Drugs: β-Blockers01:22

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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers01:26

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Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
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Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

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Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
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Tipifarnib Reduces Extracellular Vesicles and Protects From Heart Failure.

Vandana Mallaredy1, Rajika Roy2, Zhongjian Cheng1

  • 1Aging and Cardiovascular Discovery Center (V.M., Z.C., C.T., C.B., M.T., D.J., A.M., J.I., M.C., C.G., V.N.S.G., R.K.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA.

Circulation Research
|June 7, 2024
PubMed
Summary

In heart failure, exosomes worsen cardiac dysfunction and fibrosis. Inhibiting exosome biogenesis with tipifarnib improves heart function and reduces fibrosis by restoring miR 331-5p levels.

Keywords:
cell communicationfibrosisheart failureventricular remodeling

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Area of Science:

  • Cardiovascular Biology
  • Extracellular Vesicles
  • Molecular Medicine

Background:

  • Heart failure (HF) is a major global health concern.
  • Extracellular vesicles (EVs), including exosomes, play a role in cardiac disease communication.
  • The impact of systemic exosome biogenesis inhibition in HF models is not well understood.

Purpose of the Study:

  • Investigate the role of circulating exosomes in a mouse model of HF.
  • Evaluate tipifarnib, an exosome biogenesis inhibitor, for treating HF.
  • Determine if tipifarnib affects exosome cargo, specifically microRNAs.

Main Methods:

  • Utilized a mouse transverse aortic constriction (TAC) model of HF.
  • Administered tipifarnib to TAC mice and assessed cardiac function, histology, and plasma exosomes.
  • Analyzed exosome and cardiac tissue miRNA profiles, focusing on miR 331-5p.

Main Results:

  • TAC increased circulating exosomes, cardiac dysfunction, hypertrophy, and fibrosis.
  • Exosomes from TAC mice induced cardiac dysfunction and hypertrophy in naive mice.
  • Tipifarnib treatment reduced exosomes, improved cardiac function, and attenuated fibrosis.
  • Tipifarnib normalized miR 331-5p levels, which were downregulated in TAC exosomes and cardiac tissue.
  • miR 331-5p targets HOXC8, a fibrosis regulator, and its restoration by tipifarnib mitigated fibrosis.

Conclusions:

  • Systemic exosome biogenesis inhibition is a promising therapeutic strategy for HF.
  • Tipifarnib effectively reduces cardiac remodeling and fibrosis in HF by modulating exosome cargo.
  • Targeting exosome pathways offers a novel approach to managing pressure-induced heart failure.