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Immunometabolism in heart failure.
Ioanna Andreadou1, Alessandra Ghigo2, Panagiota-Efstathia Nikolaou1
1Laboratory of Pharmacology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece.
Nature Reviews. Cardiology
|June 21, 2025
Summary
Heart failure involves complex interactions between inflammation and metabolism (immunometabolism). Understanding these pathways is key to developing new therapies that promote healing and improve patient outcomes.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Metabolic Science
Background:
- Inflammation and metabolism (immunometabolism) are central to heart failure pathophysiology, regardless of origin (ischemia or metabolic disorders) or ejection fraction.
- Immune cell infiltration and polarization in the myocardium are driven by metabolic shifts, influencing cardiac and systemic metabolism.
- This immune-metabolic crosstalk contributes to adverse cardiac remodeling and chronic inflammation, perpetuating heart failure progression.
Purpose of the Study:
- To provide a comprehensive overview of the cellular and molecular mechanisms governing immunometabolism in heart failure.
- To discuss current and potential therapeutic strategies targeting immunometabolism in heart failure.
- To explore non-invasive monitoring and treatment approaches for heart failure patients.
Main Methods:
- Review of existing literature on immunometabolism in heart failure.
- Analysis of cellular and molecular pathways involved in immune cell infiltration and metabolic shifts.
- Discussion of pharmacological and immunomodulatory interventions.
Main Results:
- Identified bidirectional metabolic crosstalk between immune cells and cardiac cells contributing to adverse remodeling.
- Highlighted the role of metabolic shifts in immune cell polarization (pro-inflammatory vs. anti-inflammatory).
- Emphasized the perpetuation of chronic inflammation through myelopoiesis driven by injury and metabolic dysregulation.
Conclusions:
- Understanding immunometabolism is crucial for developing novel heart failure therapies.
- Targeting metabolic pathways and immune responses offers potential for improved patient outcomes.
- Further research is needed to overcome challenges in immunomodulatory approaches and develop effective monitoring strategies.
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