Targeting Mitochondrial Dysfunction in Chronic Heart Failure: Current Evidence and Potential Approaches

2016 ◽  
Vol 22 (31) ◽  
pp. 4807-4822 ◽  
Author(s):  
Alberto Aimo ◽  
Chiara Borrelli ◽  
Giuseppe Vergaro ◽  
Massimo F. Piepoli ◽  
Alberto R. De Caterina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Mitochondrial Dysfunction ◽  
Current Evidence

scholarly journals Comparative Efficacy of Medical Treatments for Chronic Heart Failure: A Network Meta-Analysis

2022 ◽  
Vol 8 ◽  
Author(s):  
Boyang Xiang ◽  
Zongliang Yu ◽  
Xiang Zhou
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Cardiovascular Mortality ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Current Evidence ◽  
Angiotensin Receptor ◽  
Medical Treatments

Background: The medical treatments of chronic heart failure have made remarkable progress in recent years. It is crucial to determine the optimal drug combination based on current evidence.Methods: A search of PubMed, EMBASE, and Cochrane CENTRAL databases was conducted for studies on angiotensin receptor-neprilysin inhibitors (ARNIs), sodium-glucose cotransporter 2 inhibitors (SGLT2is), angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), beta-blockers (BBs), mineralocorticoid receptor antagonists (MRAs), and ivabradine (IVA) between 1987 and 2021. The network meta-analysis was performed to compare the efficacy of drug therapies in heart failure with reduced ejection fraction (HFrEF).Results: Forty-eight randomized controlled trials (RCTs), which overall included 68,074 patients with HF and left ventricular ejection fraction (LVEF) ≤ 40%, were identified and included in the network meta-analysis. The efficacies of 13 intervention classes, including monotherapies or combinations of ACEI, ARB, ARNI, BB, MRA, SGLT2i, IVA, and placebo, on hospitalization for HF, cardiovascular mortality, and all-cause mortality were compared. Among the 13 included interventions, ARNI+BB+MRA, SGLT2i+ACEI+BB+MRA, and IVA+ACEI+BB+MRA were found to be best in terms of all three outcomes. Compared with placebo, these three drug combinations were associated with significant reductions in the risk of all-cause death, cardiovascular mortality and hospitalization for HF.Conclusions: ARNI+BB+MRA, SGLT2i+ACEI+BB+MRA, and IVA+ACEI+BB+MRA were the top three therapies for patients with HFrEF. The increasing use of combinations of conventional and novel drugs contributed to progressive reductions in hospitalization and mortality in patients with HFrEF.

scholarly journals Therapeutic Approaches in Mitochondrial Dysfunction, Proteolysis, and Structural Alterations of Diaphragm and Gastrocnemius in Rats With Chronic Heart Failure

2015 ◽  
Vol 231 (7) ◽  
pp. 1495-1513 ◽  
Author(s):  
Esther Barreiro ◽  
Ester Puig-Vilanova ◽  
Judith Marin-Corral ◽  
Alba Chacón-Cabrera ◽  
Anna Salazar-Degracia ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Mitochondrial Dysfunction ◽  
Therapeutic Approaches ◽  
Structural Alterations

scholarly journals Outcome measures in a combined exercise rehabilitation programme for adults with COPD and chronic heart failure: A preliminary stakeholder consensus event

2019 ◽  
Vol 16 ◽  
pp. 147997311986795 ◽  
Author(s):  
Amy V Jones ◽  
Rachael A Evans ◽  
William D-C Man ◽  
Charlotte E Bolton ◽  
Samantha Breen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Outcome Measures ◽  
Rehabilitation Programme ◽  
Current Evidence ◽  
Chronic Obstructive ◽  
Exercise Rehabilitation ◽  
Combined Exercise ◽  
Median Rank ◽  
Stakeholder Consensus

Combined exercise rehabilitation for chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) is potentially attractive. Uncertainty remains as to the baseline profiling assessments and outcome measures that should be collected within a programme. Current evidence surrounding outcome measures in cardiac and pulmonary rehabilitation were presented by experts at a stakeholder consensus event and all stakeholders ( n = 18) were asked to (1) rank in order of importance a list of categories, (2) prioritise outcome measures and (3) prioritise baseline patient evaluation measures that should be assessed in a combined COPD and CHF rehabilitation programme. The tasks were completed anonymously and related to clinical rehabilitation programmes and associated research. Health-related quality of life, exercise capacity and symptom evaluation were voted as the most important categories to assess for clinical purposes (median rank: 1, 2 and 3 accordingly) and research purposes (median rank; 1, 3 and 4.5 accordingly) within combined exercise rehabilitation. All stakeholders agreed that profiling symptoms at baseline were ‘moderately’, ‘very’ or ‘extremely’ important to assess for clinical and research purposes in combined rehabilitation. Profiling of frailty was ranked of the same importance for clinical purposes in combined rehabilitation. Stakeholders identified a suite of multidisciplinary measures that may be important to assess in a combined COPD and CHF exercise rehabilitation programme.

scholarly journals Influence of the dense extract from herb of Primula veris L. On the oxidative stress development and the functional state of the cardiomyocytes mitochondria of rats with experimental chronic heart failure

2018 ◽  
Vol 64 (4) ◽  
pp. 334-343
Author(s):  
T.A. Popova ◽  
E.A. Muzyko ◽  
M.V. Kustova ◽  
M.A. Bychenkova ◽  
V.N. Perfilova ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Mitochondrial Dysfunction ◽  
Respiratory Chain ◽  
Malonic Dialdehyde ◽  
Respiratory Control ◽  
Respiratory Chain Complexes ◽  
Chain Complexes ◽  
Primula Veris

Experimental chronic heart failure (CHF), caused by administration of L-isoproterenol (2.5 mg/kg twice a day intraperitoneally for 21 days), promotes uncoupling of respiration and oxidative phosphorylation. The rate of mitochondrial oxygen consumption in the metabolic state V3 by Chance in animals with CHF decreased by 53.3% (p<0.05) with malate using (as an oxidation substrate feeding сomplex I of the electron transport chain (ETC)), by 70.6% (p<0.05) with succinate using (сomplex II substrate) and by 63.6% (p<0.05) when malate and succinate were added simultaneously. The respiratory control ratio significantly decreased 2.3 times for сomplex I, 2.5 for сomplex II, and 2.6 times for the simultaneous operation of two respiratory chain complexes in mitochondria of CHF rats compared to intact animals. Mitochondrial dysfunction in experimental CHF is evidently due to the development of oxidative stress. It was revealed that the content of malonic dialdehyde (MDA) in the group of rats with experimental CHF was higher by 54.7% (p<0.05), as compared with intact animals. The activity of superoxide dismutase (SOD) and catalase was lower by 17.5% (p<0.05), and by 18.4%, respectively than in the intact group. The dense extract from herba of Primula veris L. (DEHPV) 30 mg/kg limits the development of mitochondrial dysfunction in rats with experimental CHF, as evidenced by an increase in the role of V3 respiration for the first and second respiratory chain complexes in 1.7 (p<0.05) and 2.0 times (p<0.05), respectively, the ratio of respiratory control (RCR) – 1.7 times (p<0.05) for сomplex I and 2 times (p<0.05) for сomplex II compared with the negative control. The concentration of MDA was by 15.7% (p<0.05), lower and the activity of SOD was by 56.3% (p<0.05) higher.

scholarly journals Current evidence-based therapy does not restore plasma apelin level in phenotypically diverse chronic heart failure patients

2017 ◽  
Vol 6 (2) ◽  
pp. 316 ◽  
Author(s):  
Vinu Wilson ◽  
Pankaj Prabhakar ◽  
Sandeep Seth ◽  
Subir K. Maulik
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Nonparametric Tests ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Current Evidence ◽  
Evidence Based ◽  
Mrna Levels ◽  
Ventricular Ejection Fraction ◽  
Plasma Apelin

Background: Apelin, endogenous peptide acting through its receptor (APJ), is the most potent inotropic agent known to man. Plasma apelin and cardiac APJ mRNA levels rise in early stages of chronic heart failure (CHF) but fall later in decompensated CHF. The effect of current evidence-based management of CHF on plasma apelin level is not known. We estimated change in plasma apelin level in CHF patients of diverse phenotypes treated with standard pharmacotherapy and compared it with the corresponding change in left ventricular ejection fraction (LVEF), plasma brain natriuretic peptide (BNP) level and quality of life (QoL).Methods: With ethical approval and written informed consent, venous blood samples were collected from 39 CHF [dilated cardiomyopathy (DCM) (n=21), restrictive cardiomyopathy (RCM) (n=9) and chronic constrictive pericarditis (CCP) (n=9)] patients and 10 age-matched healthy controls, at baseline and after 12 weeks. Plasma apelin and BNP were estimated by competitive ELISA (RayBiotech Inc.) and an auto-analyzer (Triage, Allere Inc.), respectively. QoL was assessed using Kansas City Cardiomyopathy Questionnaire (KCCQ). Nonparametric tests were applied and p-value <0.05 was considered significant.Results: Low LVEF, KCCQ score and high BNP levels were observed in all CHF patients compared to controls. Plasma apelin level was depressed in RCM and CCP patients compared to controls but not in DCM patients. These parameters did not change in any group after 3 months of standard pharmacotherapy.Conclusions: Current evidence-based management of CHF does not restore the depressed apelin-APJ axis. New drugs are required for specifically modulating this promising therapeutic target in CHF.

Chronic Heart Failure (Lecture). Part I (Definition, Classification, Diagnosis)

2016 ◽  
pp. 8-14
Author(s):  
Liudmyla Khimion ◽  
Oksana Yashchenko ◽  
Svitlana Danylyuk ◽  
Valeriia Vataga
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Current Evidence ◽  
Outpatient Basis ◽  
Main Current

The article shows the main current evidence on the diagnosis, course and treatment of chronic heart failure on an outpatient basis.

scholarly journals Mitochondrial Dysfunction and Heart Disease: Critical Appraisal of an Overlooked Association

2021 ◽  
Vol 22 (2) ◽  
pp. 614
Author(s):  
Giandomenico Bisaccia ◽  
Fabrizio Ricci ◽  
Sabina Gallina ◽  
Angela Di Baldassarre ◽  
Barbara Ghinassi
Keyword(s):  
Heart Failure ◽  
Mitochondrial Dysfunction ◽  
Ischemia Reperfusion Injury ◽  
Heart Diseases ◽  
Ischemia Reperfusion ◽  
Genetic Disorders ◽  
The Body ◽  
Current Evidence ◽  
Sodium Glucose Cotransporter ◽  
Energy Consuming

The myocardium is among the most energy-consuming tissues in the body, burning from 6 to 30 kg of ATP per day within the mitochondria, the so-called powerhouse of the cardiomyocyte. Although mitochondrial genetic disorders account for a small portion of cardiomyopathies, mitochondrial dysfunction is commonly involved in a broad spectrum of heart diseases, and it has been implicated in the development of heart failure via maladaptive circuits producing and perpetuating mitochondrial stress and energy starvation. In this bench-to-bedside review, we aimed to (i) describe the key functions of the mitochondria within the myocardium, including their role in ischemia/reperfusion injury and intracellular calcium homeostasis; (ii) examine the contribution of mitochondrial dysfunction to multiple cardiac disease phenotypes and their transition to heart failure; and (iii) discuss the rationale and current evidence for targeting mitochondrial function for the treatment of heart failure, including via sodium-glucose cotransporter 2 inhibitors.

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