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全面综述:揭示炎症在心力衰竭病因中的作用

A Comprehensive Review: Unraveling the Role of Inflammation in the Etiology of Heart Failure.

作者信息

Roman-Pepine Diana, Serban Adela Mihaela, Capras Roxana-Denisa, Cismaru Cristina Mihaela, Filip Adriana Gabriela

机构信息

Department of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, 400348, Cluj-Napoca-Napoca, Romania.

Cardiology Department, Heart Institute Niculae Stăncioiu, 19-21 Motilor Street, 400001, Cluj-Napoca- Napoca, Romania.

出版信息

Heart Fail Rev. 2025 May 14. doi: 10.1007/s10741-025-10519-w.

DOI:10.1007/s10741-025-10519-w
PMID:40360833
Abstract

Heart failure (HF) remains a leading cause of morbidity and mortality worldwide, with inflammation playing a pivotal role in its pathogenesis. This comprehensive review aims to elucidate the intricate mechanisms by which inflammation contributes to the development and progression of HF. The review synthesizes current research on the involvement of both innate and adaptive immune responses in HF, highlighting the roles of cytokines, chemokines, and other inflammatory mediators. Recent studies have demonstrated that chronic inflammation, driven by factors such as oxidative stress, neurohormonal activation, and metabolic disturbances, leads to adverse cardiac remodeling and impaired myocardial function. The review explores how systemic inflammation, characterized by elevated levels of inflammatory biomarkers like C-reactive protein (CRP) and interleukin-6 (IL-6), correlates with HF severity and outcomes. Additionally, it discusses the impact of comorbid conditions such as diabetes, obesity, and hypertension on inflammatory pathways and HF risk. The review also delves into the therapeutic implications of targeting inflammation in HF. Despite mixed results from early clinical trials, emerging evidence suggests that anti-inflammatory therapies offer benefits in specific HF phenotypes. The potential of novel therapeutic strategies, including the use of biologics and small molecule inhibitors, is examined in the context of their ability to modulate inflammatory responses and improve clinical outcomes.

摘要

心力衰竭(HF)仍然是全球发病和死亡的主要原因,炎症在其发病机制中起着关键作用。这篇综述旨在阐明炎症导致HF发生和发展的复杂机制。该综述综合了目前关于先天性和适应性免疫反应在HF中的作用的研究,强调了细胞因子、趋化因子和其他炎症介质的作用。最近的研究表明,由氧化应激、神经激素激活和代谢紊乱等因素驱动的慢性炎症会导致不良的心脏重塑和心肌功能受损。该综述探讨了以C反应蛋白(CRP)和白细胞介素-6(IL-6)等炎症生物标志物水平升高为特征的全身炎症如何与HF严重程度和预后相关。此外,它还讨论了糖尿病、肥胖和高血压等合并症对炎症途径和HF风险的影响。该综述还深入探讨了针对HF炎症进行治疗的意义。尽管早期临床试验结果不一,但新出现的证据表明,抗炎疗法在特定的HF表型中具有益处。包括使用生物制剂和小分子抑制剂在内的新型治疗策略的潜力,在其调节炎症反应和改善临床结果的能力背景下进行了研究。

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Curr Probl Cardiol. 2025 Mar;50(3):102968. doi: 10.1016/j.cpcardiol.2024.102968. Epub 2024 Dec 7.
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Heart Failure: A Deficiency of Energy-A Path Yet to Discover and Walk.心力衰竭:能量缺乏——一条尚待探索与践行的道路
Biomedicines. 2024 Nov 12;12(11):2589. doi: 10.3390/biomedicines12112589.
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Evidence for Aldosterone Antagonism in Heart Failure.
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Card Fail Rev. 2024 Nov 12;10:e15. doi: 10.15420/cfr.2024.10. eCollection 2024.
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Inflammation in Obesity-Related HFpEF: The STEP-HFpEF Program.肥胖相关性 HFpEF 中的炎症:STEPHFpEF 计划。
J Am Coll Cardiol. 2024 Oct 22;84(17):1646-1662. doi: 10.1016/j.jacc.2024.08.028. Epub 2024 Aug 30.
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Colchicine in acutely decompensated heart failure: the COLICA trial.秋水仙碱治疗急性失代偿性心力衰竭:COLICA试验
Eur Heart J. 2024 Aug 30;45(45):4826-36. doi: 10.1093/eurheartj/ehae538.
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Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial.司美格鲁肽在肥胖合并心力衰竭患者中的心血管结局:SELECT 试验的预先指定分析。
Lancet. 2024 Aug 24;404(10454):773-786. doi: 10.1016/S0140-6736(24)01498-3.
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