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Basic mechanisms in heart failure: the cytokine hypothesis
1Department of Medicine, Veterans Administration Medical Center, Houston, Texas 77030, USA.
Insights
Heart failure progression involves more than just hemodynamics. Cytokines, like neurohormones, are increasingly recognized as key biological molecules contributing to heart failure development and worsening.
Area of Science:
- Cardiology
- Molecular Biology
- Pathophysiology
Background:
- Heart failure traditionally viewed as a hemodynamic disorder.
- Hemodynamic hypothesis insufficient to explain heart failure progression.
- Neurohormones implicated in heart failure progression.
Purpose of the Study:
- To review clinical and experimental evidence on the role of cytokines in heart failure.
- To explore cytokines as a class of biologically active molecules in heart failure.
- To compare the role of cytokines with neurohormones in heart failure pathogenesis.
Main Methods:
- Review of recent clinical studies.
- Analysis of experimental research findings.
- Synthesis of data on molecular mechanisms.
Main Results:
- Cytokines are expressed in heart failure.
- Evidence suggests cytokines contribute to heart failure development.
- Cytokines may play a role similar to neurohormones.
Conclusions:
- Heart failure pathogenesis involves more than hemodynamic factors.
- Cytokines represent a significant class of molecules in heart failure.
- Further research into cytokine pathways is warranted for heart failure treatment.
Abstract:
Although the development and progression of heart failure have traditionally been viewed as hemodynamic disorders, there is now an increasing awareness that the syndrome of heart failure cannot be simply and/or precisely defined solely in hemodynamic terms. The inability of the so-called hemodynamic hypothesis to explain the progression of heart failure has given rise to the notion that heart failure may progress as a result of the overexpression of an ensemble of biologically active molecules referred to generically as neurohormones. More recently, it has become apparent that in addition to neurohormones, another portfolio of biologically active molecules, termed cytokines, are also expressed in the setting of heart failure. This article reviews recent clinical and experimental material that suggests that the cytokines, much like the neurohormones, may represent another class of biologically active molecules that are responsible for the development and progression of heart failure.