Advances in pharmacological research on myocardial remodeling agents: A decade in review

Myocardial remodeling, a complex adaptive response to pathological stimuli, plays a pivotal role in the progression of various cardiovascular diseases, including arrhythmias and heart failure. Significant progress has been made in understanding the molecular mechanisms of myocardial remodeling and exploring the efficacy of single and multicomponent agents. Myocardial remodeling entails a complex signaling network that incorporates certain identified critical "bridge nodes," which are also significant drug targets in classical pharmacological approaches. Nonetheless, some multicomponent drugs that have undergone clinical trials, such as Qili Qiangxin capsules, may suggest the presence of a new and feasible drug development path. The potential of multicomponent agents lies in their ability to achieve a synergistic effect through the coordinated regulation of multiple up- and downstream molecules in signaling pathways involved in myocardial remodeling. However, the development of multicomponent agents presents several challenges, such as identifying active compounds, defining their mechanisms of action, and determining the optimal proportions of each component. Delving deeper into the synergistic, multitarget effects of multicomponent agents in the realm of future research holds the promise to chart a new course toward the development of more effective and safer therapeutic strategies for managing myocardial remodeling and its associated cardiovascular diseases.