Drera Andrea, Rodella Luca, Brangi Elisa, Riccardi Mauro, Vizzardi Enrico
Institute of Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25123 Brescia, Italy.
Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Spedali Civili di Brescia, 23123 Brescia, Italy.
J Clin Med. 2024 Apr 25;13(9):2534. doi: 10.3390/jcm13092534.
The endothelium is a continuous layer of cells that coats the interior walls of arteries, capillaries, and veins. It has an essential regulatory role in hemostatic function, vascular tone, inflammation, and platelet activity. Endothelial dysfunction is characterized by a shift to a proinflammatory and prothrombic state, and it could have a bidirectional relationship with heart failure (HF). Due to neurohormonal activation and shear stress, HFrEF may promote endothelial dysfunction, increase ROS synthesis, and reduce nitric oxide production. Different studies have also shown that endothelium function is damaged in HFpEF because of a systemic inflammatory state. Some clinical trials suggest that drugs that have an effect on endothelial dysfunction in patients with HF or cardiovascular disease may be a therapeutic option. The aim of this review is to highlight the pathogenetic correlation between endothelial dysfunction and heart failure and the related potential therapeutic options.
内皮是一层连续的细胞，覆盖在动脉、毛细血管和静脉的内壁。它在止血功能、血管张力、炎症和血小板活性方面具有重要的调节作用。内皮功能障碍的特征是转变为促炎和促血栓形成状态，并且它可能与心力衰竭（HF）存在双向关系。由于神经激素激活和剪切应力，射血分数降低的心力衰竭（HFrEF）可能会促进内皮功能障碍，增加活性氧（ROS）合成，并减少一氧化氮生成。不同的研究还表明，由于全身性炎症状态，射血分数保留的心力衰竭（HFpEF）患者的内皮功能会受损。一些临床试验表明，对心力衰竭或心血管疾病患者的内皮功能障碍有影响的药物可能是一种治疗选择。本综述的目的是强调内皮功能障碍与心力衰竭之间的发病机制相关性以及相关的潜在治疗选择。
