Targeting myocardial remodelling to develop novel therapies for heart failure A position paper from the Working Group on Myocardial Function of the European Society of Cardiology

• Type: Another Publication in an International Scientific Journal
• Date: 2014

Authors

Tarone, G (Author) Other; Balligand, JL (Author) Other; Bauersachs, J (Author) Other; Clerk, A (Author) Other; De Windt, L (Author) Other; Heymans, S (Author) Other; Hilfiker Kleiner, D (Author) Other; Hirsch, E (Author) Other; Iaccarino, G (Author) Other; Knoell, R (Author) Other; Leite-Moreira AF (Author) FMUP; Andre P Lourenco (Author) FMUP; Mayr, M (Author) Other; Thum, T (Author) Other; Tocchetti, CG (Author) Other

Journal

Title: European Journal of Heart Failure

Vol. 16

Pages: 494-508

ISSN: 1388-9842

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 83 Citations

Scopus - 87 Citations

Other information

Authenticus ID: P-009-D3Q

DOI: 10.1002/ejhf.62

Abstract (EN): The failing heart is characterized by complex tissue remodelling involving increased cardiomyocyte death, and impairment of sarcomere function, metabolic activity, endothelial and vascular function, together with increased inflammation and interstitial fibrosis. For years, therapeutic approaches for heart failure (HF) relied on vasodilators and diuretics which relieve cardiac workload and HF symptoms. The introduction in the clinic of drugs interfering with beta-adrenergic and angiotensin signalling have ameliorated survival by interfering with the intimate mechanism of cardiac compensation. Current therapy, though, still has a limited capacity to restore muscle function fully, and the development of novel therapeutic targets is still an important medical need. Recent progress in understanding the molecular basis of myocardial dysfunction in HF is paving the way for development of new treatments capable of restoring muscle function and targeting specific pathological subsets of LV dysfunction. These include potentiating cardiomyocyte contractility, increasing cardiomyocyte survival and adaptive hypertrophy, increasing oxygen and nutrition supply by sustaining vessel formation, and reducing ventricular stiffness by favourable extracellular matrix remodelling. Here, we consider drugs such as omecamtiv mecarbil, nitroxyl donors, cyclosporin A, SERCA2a (sarcoplasmic/endoplasmic Ca2 + ATPase 2a), neuregulin, and bromocriptine, all of which are currently in clinical trials as potential HF therapies, and discuss novel molecular targets with potential therapeutic impact that are in the pre-clinical phases of investigation. Finally, we consider conceptual changes in basic science approaches to improve their translation into successful clinical applications.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 15