Oxidative stress and inflammation in the evolution of heart failure: From pathophysiology to therapeutic strategies

• Published in: European journal of preventive cardiology Vol. 27; no. 5; p. 494
• Main Authors: Aimo, Alberto, Castiglione, Vincenzo, Borrelli, Chiara, Saccaro, Luigi F, Franzini, Maria, Masi, Stefano, Emdin, Michele, Giannoni, Alberto
• Format: Journal Article
• Language: English
• Published: England 01.03.2020
• Subjects: Animals; Anti-Inflammatory Agents - adverse effects; Anti-Inflammatory Agents - therapeutic use; Antioxidants - adverse effects; Antioxidants - therapeutic use; Comorbidity; Heart - drug effects; Heart - physiopathology; Heart Disease Risk Factors; Heart Failure - drug therapy; Heart Failure - epidemiology; Heart Failure - metabolism; Heart Failure - physiopathology; Humans; Inflammation Mediators - antagonists & inhibitors; Inflammation Mediators - metabolism; Myocardium - metabolism; Myocardium - pathology; Oxidative Stress - drug effects; Reactive Oxygen Species - antagonists & inhibitors; Reactive Oxygen Species - metabolism; Signal Transduction; Oxidative stress; heart failure; inflammation
• ISSN: 2047-4881
• DOI: 10.1177/2047487319870344

Both oxidative stress and inflammation are enhanced in chronic heart failure. Dysfunction of cardiac mitochondria is a hallmark of heart failure and a leading cause of oxidative stress, which in turn exerts detrimental effects on cellular components, including mitochondria themselves, thus generating a vicious circle. Oxidative stress also causes myocardial tissue damage and inflammation, contributing to heart failure progression. Furthermore, a subclinical inflammatory state may be caused by heart failure comorbidities such as obesity, diabetes mellitus or sleep apnoeas. Some markers of both oxidative stress and inflammation are enhanced in chronic heart failure and hold prognostic significance. For all these reasons, antioxidants or anti-inflammatory drugs may represent interesting additional therapies for subjects either at high risk or with established heart failure. Nonetheless, only a few clinical trials on antioxidants have been carried out so far, with several disappointing results except for vitamin C, elamipretide and coenzyme Q10. With regard to anti-inflammatory drugs, only preliminary data on the interleukin-1 antagonist anakinra are currently available. Therefore, a comprehensive, deep understanding of our current knowledge on oxidative stress and inflammation in chronic heart failure is key to providing some suggestions for future research on this topic.