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慢性感染和炎症性疾病中的心力衰竭:临床异质性的机制见解。

Heart Failure in Chronic Infectious and Inflammatory Conditions: Mechanistic Insights from Clinical Heterogeneity.

机构信息

Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA.

Division of Cardiology, Department of Medicine, Northwestern University, Chicago, IL, USA.

出版信息

Curr Heart Fail Rep. 2022 Oct;19(5):267-278. doi: 10.1007/s11897-022-00560-3. Epub 2022 Jul 15.

Abstract

PURPOSE OF REVIEW

The balance between inflammation and its resolution plays an important and increasingly appreciated role in heart failure (HF) pathogenesis. In humans, different chronic inflammatory conditions and immune-inflammatory responses to infection can lead to diverse HF manifestations. Reviewing the phenotypic and mechanistic diversity of these HF presentations offers useful clinical and scientific insights.

RECENT FINDINGS

HF risk is increased in patients with chronic inflammatory and autoimmune disorders and relates to disease severity. Inflammatory condition-specific HF manifestations exist and underlying pathophysiologic causes may differ across conditions. Although inflammatory disease-specific presentations of HF differ, chronic excess in inflammation and auto-inflammation relative to resolution of this inflammation is a common underlying contributor to HF. Further studies are needed to phenotypically refine inflammatory condition-specific HF pathophysiologies and prognoses, as well as potential targets for intervention.

摘要

目的综述

在心力衰竭(HF)发病机制中,炎症及其消退之间的平衡起着重要且日益受到重视的作用。在人类中,不同的慢性炎症状态和对感染的免疫炎症反应可导致不同的 HF 表现。回顾这些 HF 表现的表型和机制多样性提供了有用的临床和科学见解。

最近的发现

患有慢性炎症性和自身免疫性疾病的患者 HF 风险增加,且与疾病严重程度相关。存在炎症状态特异性 HF 表现,且潜在的病理生理原因可能因疾病状态而异。尽管 HF 的炎症状态特异性表现不同,但与炎症消退相比,慢性炎症和自身炎症的过度是 HF 的一个常见潜在致病因素。需要进一步的研究来对炎症状态特异性 HF 病理生理学和预后进行表型细化,以及确定潜在的干预靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f49c/9283814/dae91c1f05fd/11897_2022_560_Fig1_HTML.jpg

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