Faculty of Health Sciences, Department of Biochemistry and Molecular Biology, University of Bielsko-Biala, Willowa St. 2, 43-309, Bielsko-Biala, Poland.
Faculty of Health Sciences, Department of Emergency Medicine, University of Bielsko-Biala, Willowa St. 2, 43-309, Bielsko-Biala, Poland.
Heart Fail Rev. 2020 May;25(3):537-548. doi: 10.1007/s10741-019-09875-1.
Despite significant advances in the prevention and treatment of heart failure (HF), the prognosis in patients who have been hospitalised on at least one occasion due to exacerbation of HF is still poor. Therefore, a better understanding of the underlying pathophysiological mechanisms of HF is crucial in order to achieve better results in the treatment of this clinical syndrome. One of the areas that, for years, has aroused the interest of researchers is the activation of the immune system and the elevated levels of biomarkers of inflammation in patients with both ischaemic and non-ischaemic HF. Additionally, it is intriguing that the level of circulating pro-inflammatory biomarkers correlates with the severity of the disease and prognosis in this group of patients. Unfortunately, clinical trials aimed at assessing interventions to modulate the inflammatory response in HF have been disappointing, and the modulation of the inflammatory response has had either no effect or even a negative effect on the HF prognosis. The article presents a summary of current knowledge on the role of immune system activation and inflammation in the pathogenesis of HF. Understanding the immunological mechanisms pathogenetically associated with left ventricular remodelling and progression of HF may open up new therapeutic possibilities for HF.
尽管在心力衰竭(HF)的预防和治疗方面取得了重大进展,但至少因 HF 恶化而住院一次的患者的预后仍然较差。因此,更好地了解 HF 的潜在病理生理机制对于治疗这种临床综合征至关重要。多年来,一个引起研究人员兴趣的领域是免疫系统的激活和缺血性和非缺血性 HF 患者的炎症生物标志物水平升高。此外,有趣的是,循环促炎生物标志物的水平与该组患者疾病的严重程度和预后相关。不幸的是,旨在评估调节 HF 炎症反应的干预措施的临床试验令人失望,炎症反应的调节对 HF 的预后没有影响,甚至产生负面影响。本文总结了目前关于免疫系统激活和炎症在 HF 发病机制中的作用的知识。了解与左心室重构和 HF 进展相关的免疫发病机制可能为 HF 开辟新的治疗可能性。