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Review Series

Heart failure

Series edited by Michael D. Schneider and Ivor J. Benjamin

A post-production grant for this series was provided by the Novartis Institutes for BioMedical Research, Inc.
Substantial progress has been made in the treatment of heart failure, as scientists have determined the underlying etiology, pathogenesis and mechanisms behind the disease. This review series delves into the interrelated triggers that culminate in heart failure and the therapeutic avenues available to patients.

Articles in series

Learning from failure: congestive heart failure in the postgenomic age
Ivor J. Benjamin, Michael D. Schneider
Ivor J. Benjamin, Michael D. Schneider
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):495-499. https://doi.org/10.1172/JCI24477.
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Learning from failure: congestive heart failure in the postgenomic age

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Abstract

The prognosis of heart failure is worse than that of most cancers, but new therapeutic interventions using stem and other cell-based therapies are succeeding in the fight against it, and old drugs, with new twists, are making a comeback. Genetically engineered animal models are driving insights into the molecular mechanisms that cause hearts to fail, accelerating drug discoveries, and inspiring cell-based therapeutic interventions for both acquired and inheritable cardiac diseases.

Authors

Ivor J. Benjamin, Michael D. Schneider

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Oxygen, oxidative stress, hypoxia, and heart failure
Frank J. Giordano
Frank J. Giordano
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):500-508. https://doi.org/10.1172/JCI24408.
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Oxygen, oxidative stress, hypoxia, and heart failure

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Abstract

A constant supply of oxygen is indispensable for cardiac viability and function. However, the role of oxygen and oxygen-associated processes in the heart is complex, and they and can be either beneficial or contribute to cardiac dysfunction and death. As oxygen is a major determinant of cardiac gene expression, and a critical participant in the formation of ROS and numerous other cellular processes, consideration of its role in the heart is essential in understanding the pathogenesis of cardiac dysfunction.

Authors

Frank J. Giordano

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NO/redox disequilibrium in the failing heart and cardiovascular system
Joshua M. Hare, Jonathan S. Stamler
Joshua M. Hare, Jonathan S. Stamler
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):509-517. https://doi.org/10.1172/JCI24459.
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NO/redox disequilibrium in the failing heart and cardiovascular system

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Abstract

There is growing evidence that the altered production and/or spatiotemporal distribution of reactive oxygen and nitrogen species creates oxidative and/or nitrosative stresses in the failing heart and vascular tree, which contribute to the abnormal cardiac and vascular phenotypes that characterize the failing cardiovascular system. These derangements at the integrated system level can be interpreted at the cellular and molecular levels in terms of adverse effects on signaling elements in the heart, vasculature, and blood that subserve cardiac and vascular homeostasis.

Authors

Joshua M. Hare, Jonathan S. Stamler

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Genetic causes of human heart failure
Hiroyuki Morita, … , Jonathan Seidman, Christine E. Seidman
Hiroyuki Morita, … , Jonathan Seidman, Christine E. Seidman
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):518-526. https://doi.org/10.1172/JCI24351.
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Genetic causes of human heart failure

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Abstract

Factors that render patients with cardiovascular disease at high risk for heart failure remain incompletely defined. Recent insights into molecular genetic causes of myocardial diseases have highlighted the importance of single-gene defects in the pathogenesis of heart failure. Through analyses of the mechanisms by which a mutation selectively perturbs one component of cardiac physiology and triggers cell and molecular responses, studies of human gene mutations provide a window into the complex processes of cardiac remodeling and heart failure. Knowledge gleaned from these studies shows promise for defining novel therapeutic targets for genetic and acquired causes of heart failure.

Authors

Hiroyuki Morita, Jonathan Seidman, Christine E. Seidman

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Protein kinase cascades in the regulation of cardiac hypertrophy
Gerald W. Dorn II, Thomas Force
Gerald W. Dorn II, Thomas Force
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):527-537. https://doi.org/10.1172/JCI24178.
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Protein kinase cascades in the regulation of cardiac hypertrophy

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Abstract

In broad terms, there are 3 types of cardiac hypertrophy: normal growth, growth induced by physical conditioning (i.e., physiologic hypertrophy), and growth induced by pathologic stimuli. Recent evidence suggests that normal and exercise-induced cardiac growth are regulated in large part by the growth hormone/IGF axis via signaling through the PI3K/Akt pathway. In contrast, pathological or reactive cardiac growth is triggered by autocrine and paracrine neurohormonal factors released during biomechanical stress that signal through the Gq/phospholipase C pathway, leading to an increase in cytosolic calcium and activation of PKC. Here we review recent developments in the area of these cardiotrophic kinases, highlighting the utility of animal models that are helping to identify molecular targets in the human condition.

Authors

Gerald W. Dorn II, Thomas Force

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Toward transcriptional therapies for the failing heart: chemical screens to modulate genes
Timothy A. McKinsey, Eric N. Olson
Timothy A. McKinsey, Eric N. Olson
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):538-546. https://doi.org/10.1172/JCI24144.
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Toward transcriptional therapies for the failing heart: chemical screens to modulate genes

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Abstract

In response to acute and chronic stresses, the heart frequently undergoes a remodeling process that is accompanied by myocyte hypertrophy, impaired contractility, and pump failure, often culminating in sudden death. The existence of redundant signaling pathways that trigger heart failure poses challenges for therapeutic intervention. Cardiac remodeling is associated with the activation of a pathological gene program that weakens cardiac performance. Thus, targeting the disease process at the level of gene expression represents a potentially powerful therapeutic approach. In this review, we describe strategies for normalizing gene expression in the failing heart with small molecules that control signal transduction pathways directed at transcription factors and associated chromatin-modifying enzymes.

Authors

Timothy A. McKinsey, Eric N. Olson

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Mitochondrial energy metabolism in heart failure: a question of balance
Janice M. Huss, Daniel P. Kelly
Janice M. Huss, Daniel P. Kelly
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):547-555. https://doi.org/10.1172/JCI24405.
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Mitochondrial energy metabolism in heart failure: a question of balance

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Abstract

The mitochondrion serves a critical role as a platform for energy transduction, signaling, and cell death pathways relevant to common diseases of the myocardium such as heart failure. This review focuses on the molecular regulatory events and downstream effector pathways involved in mitochondrial energy metabolic derangements known to occur during the development of heart failure.

Authors

Janice M. Huss, Daniel P. Kelly

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Altered intracellular Ca2+ handling in heart failure
Masafumi Yano, … , Yasuhiro Ikeda, Masunori Matsuzaki
Masafumi Yano, … , Yasuhiro Ikeda, Masunori Matsuzaki
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):556-564. https://doi.org/10.1172/JCI24159.
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Altered intracellular Ca2+ handling in heart failure

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Abstract

Structural and functional alterations in the Ca2+ regulatory proteins present in the sarcoplasmic reticulum have recently been shown to be strongly involved in the pathogenesis of heart failure. Chronic activation of the sympathetic nervous system or of the renin-angiotensin system induces abnormalities in both the function and structure of these proteins. We review here the considerable body of evidence that has accumulated to support the notion that such abnormalities contribute to a defectiveness of contractile performance and hence to the progression of heart failure.

Authors

Masafumi Yano, Yasuhiro Ikeda, Masunori Matsuzaki

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Death begets failure in the heart
Roger S.-Y. Foo, … , Kartik Mani, Richard N. Kitsis
Roger S.-Y. Foo, … , Kartik Mani, Richard N. Kitsis
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):565-571. https://doi.org/10.1172/JCI24569.
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Death begets failure in the heart

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Abstract

Recently, low — but abnormal — rates of cardiomyocyte apoptosis have been observed in failing human hearts. Genetic and pharmacological studies suggest that this cell death is causally linked to heart failure in rodent models. Herein, we review these data and discuss potential therapeutic implications.

Authors

Roger S.-Y. Foo, Kartik Mani, Richard N. Kitsis

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Unchain my heart: the scientific foundations of cardiac repair
Stefanie Dimmeler, … , Andreas M. Zeiher, Michael D. Schneider
Stefanie Dimmeler, … , Andreas M. Zeiher, Michael D. Schneider
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):572-583. https://doi.org/10.1172/JCI24283.
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Unchain my heart: the scientific foundations of cardiac repair

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Abstract

In humans, the biological limitations to cardiac regenerative growth create both a clinical imperative — to offset cell death in acute ischemic injury and chronic heart failure — and a clinical opportunity; that is, for using cells, genes, and proteins to rescue cardiac muscle cell number or in other ways promote more efficacious cardiac repair. Recent experimental studies and early-phase clinical trials lend credence to the visionary goal of enhancing cardiac repair as an achievable therapeutic target.

Authors

Stefanie Dimmeler, Andreas M. Zeiher, Michael D. Schneider

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