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Distinctive patterns of inflammation across the heart failure syndrome

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Abstract

Inflammation has long been known to play a role in heart failure (HF). Earlier studies demonstrated that inflammation contributes to the pathogenesis of HF with reduced ejection fraction (HFrEF), and the knowledge about molecules and cell types specifically involved in inflammatory events has been constantly increased ever since. However, conflicting results of several trials with anti-inflammatory treatments led to the conclusions that inflammation does participate in the progression of HFrEF, but more likely it is not the primary event. Conversely, it has been suggested that inflammation drives the development of HF with preserved ejection fraction (HFpEF). Recently the pharmacological blockade of interleukin-1 has been shown to prevent HF hospitalization and mortality in patients with prior myocardial infarction, lending renewed support to the hypothesis that inflammation is a promising therapeutic target in HF. Inflammation has also been proposed to underlie both HF and commonly associated conditions, such as chronic kidney disease or cancer. Within this last paradigm, an emergent role has been ascribed to clonal hematopoiesis of indeterminate potential. Here, we summarize the recent evidence about the role of inflammation in HF, highlighting the similarities and differences in HFrEF vs. HFpEF, and discuss the diagnostic and therapeutic opportunities raised by antinflammatory-based approaches.

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Authors and Affiliations

  1. Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, 6000 Harry Hines Blvd, NB11.208, Dallas, TX, 75390-8573, USA

    Gabriele G. Schiattarella

  2. Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy

    Gabriele G. Schiattarella

  3. Comprehensive Heart Failure Center (CHFC), University Clinic Würzburg, Würzburg, Germany

    Vasco Sequeira

  4. Department of Internal Medicine, University of Genova, Genoa, Italy

    Pietro Ameri

  5. IRCCS Ospedale Policlinico San Martino – IRCCS Italian Cardiovascular Network, Genoa, Italy

    Pietro Ameri

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  1. Gabriele G. Schiattarella
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  2. Vasco Sequeira
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  3. Pietro Ameri
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Correspondence to Gabriele G. Schiattarella or Pietro Ameri.

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Schiattarella, G.G., Sequeira, V. & Ameri, P. Distinctive patterns of inflammation across the heart failure syndrome. Heart Fail Rev 26, 1333–1344 (2021). https://doi.org/10.1007/s10741-020-09949-5

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