Advanced glycation end-products, a pathophysiological pathway in the cardiorenal syndrome

• Published in: Heart failure reviews Vol. 17; no. 2; pp. 221 - 228
• Main Authors: Willemsen, Suzan, Hartog, Jasper W. L., Heiner-Fokkema, M. Rebecca, van Veldhuisen, Dirk J., Voors, Adriaan A.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.03.2012; Springer Nature B.V
• Subjects: Cardio-Renal Syndrome - metabolism; Cardio-Renal Syndrome - physiopathology; Cardiology; Chronic Disease; Glycation End Products, Advanced - metabolism; Heart - physiopathology; Heart Failure, Diastolic - metabolism; Humans; Kidney - physiopathology; Medicine; Medicine & Public Health; Renal Insufficiency - metabolism; Heart failure; Diastolic dysfunction; Advanced glycation end-products; Cardiorenal syndrome; Renal failure
• ISSN: 1382-4147; 1573-7322
• DOI: 10.1007/s10741-010-9225-z

The prevalence of heart failure (HF) is increasing. A distinction is made between diastolic HF (preserved left ventricular ejection fraction (LVEF)) and systolic HF (reduced LVEF). Advanced glycation end-products (AGEs) are crystallized proteins that accumulate during ageing, but are particularly increased in patients with diabetes mellitus and in patients with renal failure. Through the formation of collagen crosslinks, and by interaction with the AGE-receptor, which impairs calcium handling and increases fibrosis, AGE-accumulation has pathophysiologically been associated with the development of diastolic and renal dysfunction. Interestingly, diastolic dysfunction is a frequent finding in elderly patients, diabetic patients and in patients with renal failure. Taken together, this suggests that AGEs are related to the development and progression of diastolic HF and renal failure. In this review, the role of AGEs as a possible pathophysiological factor that link the development and progression of heart and renal failure, is discussed. Finally, the role of AGE intervention as a possible treatment in HF patients will be discussed.