LncRNA GAS5 restrains ISO-induced cardiac fibrosis by modulating mir-217 regulation of SIRT1

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: April 1, 2024

Abstract Considering the effect of SIRT1 on improving myocardial fibrosis and GAS5 inhibiting occurrence development at cellular level, aim present study was to investigate whether LncRNA could attenuate cardiac through regulating mir-217/SIRT1, NLRP3 inflammasome activation involved in this process. Isoprenaline (ISO) given subcutaneously male C57BL/6 mice induce AAV9 vectors were randomly injected into left ventricle each mouse overexpress GAS5. Primary fibroblasts (MCFs) derived from neonatal TGF-β1 used fibrosis. And overexpressed MCFs treated with mir-217 mimics inhibitor respectively. Then assays expression levels NLRP3, Caspase-1, IL-1β conducted. The findings indicated that overexpression reduced collagen, Capase-1, ISO MCFs. However, significantly weakened after overexpression, but further enhanced knockdown mir-217. down-regulates SIRT1, leading increased subsequent pyroptosis. alleviates induced via mir-217/SIRT1 pathway.

Language: Английский

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Palliative Pharmacotherapy for Cardiovascular Disease: A Scientific Statement From the American Heart Association

Circulation Cardiovascular Quality and Outcomes, Journal Year: 2024, Volume and Issue: 17(8)

Published: Aug. 1, 2024

Cardiovascular disease exacts a heavy toll on health and quality of life is the leading cause death among people ≥65 years age. Although medical, surgical, device therapies can certainly prolong span, progression from chronic to advanced end stage temporally unpredictable, uncertain, marked by worsening symptoms that result in recurrent hospitalizations excessive care use. Compared with other serious illnesses, medication management incorporates palliative approach underused individuals cardiovascular disease. This scientific statement describes pharmacotherapy inclusive drugs essential medicines work synergistically control enhance life. We also summarize clarify available evidence utility guideline-directed evidence-based medical end-stage heart failure, pulmonary arterial hypertension, coronary disease, cardiomyopathies while providing clinical considerations for de-escalating or deprescribing. Shared decision-making goal-oriented are emphasized considered quintessential iterative process patient-centered across spectrum

Language: Английский

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Mediating Role of Blood Metabolites in the Relationship Between Immune Cell Traits and Heart Failure: A Mendelian Randomization and Mediation Analysis

Journal of the American Heart Association, Journal Year: 2025, Volume and Issue: unknown

Published: March 13, 2025

Background Observational studies have shown a significant association between immune cells and heart failure (HF). Nevertheless, the precise biological mechanisms underlying this remain unclear. Methods To investigate causative relationships cell traits adult HF, 3 main methods of Mendelian randomization were used: 2‐sample randomization, multivariable with controlling for several factors affecting mediation analysis. Results from inverse variance‐weighted model indicated that genetic predispositions human leukocyte antigen‐type DR (HLA DR) on CD33dim HLA DR+ CD11b+ (odds ratio, 0.967 [95% CI, 0.939–0.996]; P =0.028) may be associated reduced risk HF. Although HF CD33 dim did not withstand multiple‐testing correction, results ( IVW <0.05) decrease likelihood observational are due to chance. Our 2‐step analysis demonstrated ratio,1.085 1.020–1.155]; =0.010) was increased levels metabolite Octadecanedioate, while Octadecanedioate 0.917 0.849–0.991]; Moreover, our also possibly mediated by levels, proportion 21.4% 43.7 –0.998]. Conclusions These findings underscore importance in development acting as possible mediator pathway.

Language: Английский

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Management of ventricular tachycardia in patients with advanced heart failure

Progress in Cardiovascular Diseases, Journal Year: 2025, Volume and Issue: unknown

Published: May 1, 2025

Language: Английский

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Decongestion in acute heart failure: Is it time to change diuretic‐centred paradigm?

European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: 26(10), P. 2094 - 2106

Published: Aug. 21, 2024

Abstract Congestion is a common cause of clinical deterioration and the most presentation at admission in acute heart failure (HF). Therefore, finding effective sustainable ways to alleviate congestion has become crucial goal for treating HF patients. result complex underlying pathophysiology; therefore, it not direct disease but its consequence. Any therapy that directly promotes sodium/water removal only, thus targeting only symptoms, neither modifies natural course nor improves prognosis. This review aims provide comprehensive evaluation current decongestive therapies propose new (not diuretic‐centred) paradigm long‐term management attempts correct pathophysiology, improving congestion, preventing development, favourably altering rather than merely symptoms.

Language: Английский

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High-intensity care for GDMT titration

Heart Failure Reviews, Journal Year: 2024, Volume and Issue: 29(5), P. 1065 - 1077

Published: July 22, 2024

Heart failure (HF) is a systemic disease associated with high risk of morbidity, mortality, increased hospitalizations, and low quality life. Therefore, effective, treatment strategies are necessary to mitigate these risks. In this manuscript, we emphasize the concept high-intensity care optimize guideline-directed medical therapy (GDMT) in HF patients. The document highlights importance achieving optimal recommended doses GDMT medications, including beta-blockers, renin-angiotensin-aldosterone inhibitors, mineralocorticoid receptor antagonists, sodium-glucose cotransporter inhibitors improve patient outcomes, achieve sustainable decongestion, also discusses potential obstacles optimization, such as clinical inertia, physiological limitations, comorbidities, non-adherence, frailty. Lastly, it attempts provide possible future scenarios high-intensive that could outcomes.

Language: Английский

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Drug therapy and catheter ablation for management of arrhythmias in continuous flow left ventricular assist device's patients. A Clinical Consensus Statement of the European Heart Rhythm Association and the Heart Failure Association of the ESC

EP Europace, Journal Year: 2024, Volume and Issue: 26(11)

Published: Oct. 31, 2024

Abstract Left ventricular assist devices (LVADs) are an increasingly used strategy for the management of patients with advanced heart failure. Although these effectively improve survival, atrial and arrhythmias common a prevalence 20–50% at one year after LVAD implantation. Arrhythmias predispose to additional risk associated considerable morbidity from recurrent implantable cardioverter-defibrillator shocks, progressive failure unsupported right ventricle, herald increased mortality. Management differs in many aspects general population patients. These include ruling out reversible causes that may mechanical irritation inflow cannula suction events. For symptomatic refractory medical treatment, catheter ablation might be relevant. There specific technical procedural challenges perceived unique LVAD-related tachycardia (VT) such as vascular LV access, signal filtering, manoeuvrability within decompressed chambers, electroanatomic mapping system interference. In some patients, arrhythmogenic substrate not readily accessible by this regard, peri-implantation period offers opportunity surgically address suppress future VT recurrences. This document aims focusing on anti-arrhythmic drug therapy ablations.

Language: Английский

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New Challenges in Heart Failure with Reduced Ejection Fraction: Managing Worsening Events

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(22), P. 6956 - 6956

Published: Nov. 7, 2023

Patients with an established diagnosis of heart failure (HF) reduced ejection fraction (HFrEF) are prone to experience episodes worsening symptoms and signs despite continued therapy, termed “worsening failure” (WHF). Despite guideline-directed medical chronic accounts for almost 50% all hospital admissions HF, patients experiencing WHF carry a substantially higher risk death hospitalization than “stable” HF. New drugs emerging as arrows in the quiver clinicians address residual HF cardiovascular deaths WHF. This question-and-answer-based review will discuss definition light recent clinical consensus released by Heart Failure Association (HFA) European Society Cardiology (ESC), new therapeutic approaches treat then move on their timing safety concerns (i.e., renal profile).

Language: Английский

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Signaling Pathways in Inflammation and Cardiovascular Diseases: An Update of Therapeutic Strategies

Immuno, Journal Year: 2022, Volume and Issue: 2(4), P. 630 - 650

Published: Nov. 11, 2022

Inflammatory processes represent a pivotal element in the development and complications of cardiovascular diseases (CVDs). Targeting these can lead to alleviation cardiomyocyte (CM) injury increase reparative mechanisms. Loss CMs from inflammation-associated cardiac often results heart failure (HF). Evidence crosstalk between nuclear factor-kappa B (NF-κB), Hippo, mechanistic/mammalian target rapamycin (mTOR) has been reported manifold immune responses pathologies. Since signaling cascades regulate broad array biological tasks diverse cell types, their misregulation is responsible for pathogenesis many vascular disorders, including cardiomyopathies atherosclerosis. In response myriad proinflammatory cytokines, which induce reactive oxygen species (ROS) production, several molecular mechanisms are activated within inaugurate structural remodeling organ. This review provides global landscape intricate protein–protein interaction (PPI) networks key constituents NF-κB, mTOR pathways as quintessential targetable candidates therapy inflammation-related diseases.

Language: Английский

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Role of ejection fraction in patients at risk for advanced heart failure: insights from the HELP‐HF registry

ESC Heart Failure, Journal Year: 2023, Volume and Issue: 11(1), P. 136 - 146

Published: Oct. 16, 2023

Patients with heart failure (HF) reduced ejection fraction (EF) (HFrEF), mildly EF (HFmrEF), and preserved (HFpEF) may all progress to advanced HF, but the impact of in setting is not well established. Our aim was assess prognostic patients at least one 'I NEED HELP' marker for HF.

Language: Английский

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