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The pathophysiology of heart failure is complex, but mitochondrial dysfunction is an emerging therapeutic target to improve cardiac function. In this Consensus Statement, insights into the mechanisms of mitochondrial dysfunction in heart failure are presented, along with an overview of emerging treatments with the potential to improve the function of the failing heart by targeting mitochondria.
The dual-acting angiotensin-receptor–neprilysin inhibitor (ARNI) LCZ696, approved for treatment of heart failure with reduced ejection fraction, is the first approval for chronic neprilysin inhibition. Neprilysin metabolizes many peptides, suggesting many potential consequences of chronic neprilysin inhibition, both beneficial and adverse. This Review summarizes current knowledge on neprilysin inhibitor therapy, and the possible consequences of chronic inhibition.
Atherosclerosis is a disease of ageing, and the most common cause of death in the industrialized world. Cell senescence and the therapeutic removal of senescent cells using 'senolytics' are topical areas of science and translational medicine. A new study reports surprising findings on cell senescence and atherosclerosis with important therapeutic implications.
Ischaemic cardiomyopathy leads to destruction of cardiomyocytes beyond the regenerative potential of the adult human heart. The murine heart can regenerate in utero and shortly after birth, but oxidative stress eventually arrests cardiomyocyte division. Chronic hypoxia in mice has now been shown to induce the cell cycle in cardiomyocytes, resulting in cardiac regeneration.
Microorganisms that populate the human body have been shown to be involved in metabolic and cardiovascular disorders, but the precise mechanisms are not completely understood. In this Review, Lindskog Jonsson and Bäckhed describe the different pathways by which the gut microbiota might affect the development of atherosclerosis.
Inflammatory processes are central to the development and complications of atherosclerosis and acute myocardial infarction. In this Review, Ruparelia et al. summarize the inflammatory pathways involved in these cardiovascular diseases, highlight contemporary techniques to characterize and quantify inflammation, and consider how they might be used to guide specific treatments.