Cardiac remodeling: novel pathophysiological mechanisms and therapeutic strategies.

IF 2.1 4区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY
Motohiro Nishida, Xinya Mi, Yukina Ishii, Yuri Kato, Akiyuki Nishimura
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Abstract

Morphological and structural remodeling of the heart, including cardiac hypertrophy and fibrosis, has been considered as a therapeutic target for heart failure for approximately three decades. Groundbreaking heart failure medications demonstrating reverse remodeling effects have contributed significantly to medical advancements. However, nearly 50% of heart failure patients still exhibit drug resistance, posing a challenge to the healthcare system. Recently, characteristics of heart failure resistant to ARBs and β-blockers have been defined, highlighting preserved systolic function despite impaired diastolic function, leading to the classification of heart failure with preserved ejection fraction (HFpEF). The pathogenesis and aetiology of HFpEF may be related to metabolic abnormalities, as evidenced by its mimicry through endothelial dysfunction and excessive intake of high-fat diets. Our recent findings indicate a significant involvement of mitochondrial hyper-fission in the progression of heart failure. This mitochondrial pathological remodeling is associated with redox imbalance, especially hydrogen sulphide accumulation due to abnormal electron leak in myocardium. In this review, we also introduce a novel therapeutic strategy for heart failure from the current perspective of mitochondrial redox-metabolic remodeling.

心脏重塑:新的病理生理学机制和治疗策略
近三十年来,心脏的形态和结构重塑(包括心脏肥大和纤维化)一直被认为是心力衰竭的治疗目标。具有逆转重塑作用的开创性心衰药物为医学进步做出了巨大贡献。然而,近50%的心衰患者仍表现出耐药性,这给医疗系统带来了挑战。最近,对 ARB 和 β 受体阻滞剂耐药的心衰患者的特征已被确定,这些患者尽管舒张功能受损,但收缩功能仍得到保留,因此被归类为射血分数保留型心衰(HFpEF)。HFpEF 的发病机制和病因可能与新陈代谢异常有关,其通过内皮功能障碍和过量摄入高脂肪饮食而产生的模仿症状就是证明。我们最近的研究结果表明,线粒体过度分裂与心衰的进展有很大关系。这种线粒体病理重塑与氧化还原失衡有关,尤其是心肌中电子泄漏异常导致的硫化氢积累。在这篇综述中,我们还从线粒体氧化还原代谢重塑的角度介绍了一种治疗心衰的新策略。
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来源期刊
Journal of biochemistry
Journal of biochemistry 生物-生化与分子生物学
CiteScore
4.80
自引率
3.70%
发文量
101
审稿时长
4-8 weeks
期刊介绍: The Journal of Biochemistry founded in 1922 publishes the results of original research in the fields of Biochemistry, Molecular Biology, Cell, and Biotechnology written in English in the form of Regular Papers or Rapid Communications. A Rapid Communication is not a preliminary note, but it is, though brief, a complete and final publication. The materials described in Rapid Communications should not be included in a later paper. The Journal also publishes short reviews (JB Review) and papers solicited by the Editorial Board.
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