A narrative review of potential therapies for the treatment of myocardial tissue in relation to heart failure.

Abstract

Heart failure (HF) is not a disease but a combination of signs and symptoms caused by the failure of the heart to pump blood to support the circulatory system at rest or during activity. HF is the potential end stage of all heart diseases in which cardiomyopathies are a diverse group of cardiac disorders with distinct phenotypes, depending on the protein and pathways affected. Cardiomyopathies represent major causes of morbidity and mortality at all ages in humans in which hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM), are the most common. Among the different common diagnostic tests for heart failure such as physical examination, blood tests, chest X-rays, electrocardiogram (ECG), etc. ultrasound has also been used not only for diagnosis such as echocardiography but also for therapeutic purposes. The development of therapeutic strategies for HF aiming to improve the heart's function, delay progression of HF, and treat HF symptoms as well as to stimulate the capacity to regenerate cardiomyocytes via stem cell therapy have been under intensive research interest. This narrative review aims to present the current understanding of the pathogenesis, diagnosis, and treatment of HF. Furthermore, as a perspective, this review navigates emerging therapies for HF by emphasizing on the use of low-intensity pulsed ultrasound (LIPUS) as a noninvasive therapy for (1) stimulation of the myocardial tissue reconstruction mechanisms; and (2) exploration of the molecular mechanisms behind the mechanotransduction from the muscle LIM protein (MLP), which is believed to be involved in human HF, using its expression vector via glycosylphosphatidylinositol, GPI, anchor.