Novel pathophysiological insight and treatment strategies for heart failure - Lessons from mice and patients

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

The ultimate goal of heart failure (HF) treatment is to improve the prognosis of patients. Previous basic, clinical, and population studies have advanced the modem treatment of HF, but efficacy is still limited especially in 'real world' patients. There are 2 approaches to solve this crucial issue. First is the further development of novel therapeutic strategies based on new insight into the pathophysiology of myocardial remodeling and failure. Second is the improvement of the quality of care in routine clinical practice. The basic approach is to develop the treatment of myocardial remodeling by regulating mitochondrial oxidative stress. In the failing heart, oxygen radicals are the result of defects of mitochondrial electron transport, causing mitochondrial DNA damage and functional decline, and further production of oxygen radicals. Oxidative stress causes myocyte hypertrophy, apoptosis, and interstitial fibrosis by activating matrix metalloproteinases, all of which result in myocardial remodeling and failure. Therefore, mitochondrial oxidative stress and DNA damage are good therapeutic targets. The clinical approach is to develop effective strategies of HF management for the 'real world' patients. Readmission because of exacerbation is common in HF patients and further impairs their quality of life. Noncompliance with treatment is the most common precipitating factor for readmission. Regular medical follow-up and social support are important components that should be included in the disease management program of HF patients. These basic and clinical approaches are needed to establish new and effective treatment strategies for Japanese patients with HF.

Original languageEnglish
Pages (from-to)1095-1103
Number of pages9
JournalCirculation Journal
Volume68
Issue number12
DOIs
Publication statusPublished - Dec 1 2004

Fingerprint

Heart Failure
Oxidative Stress
Therapeutics
DNA Damage
Reactive Oxygen Species
Modems
Precipitating Factors
Quality of Health Care
Disease Management
Electron Transport
Treatment Failure
Matrix Metalloproteinases
Mitochondrial DNA
Social Support
Muscle Cells
Hypertrophy
Fibrosis
Quality of Life
Apoptosis
Population

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Novel pathophysiological insight and treatment strategies for heart failure - Lessons from mice and patients. / Tsutsui, Hiroyuki.

In: Circulation Journal, Vol. 68, No. 12, 01.12.2004, p. 1095-1103.

Research output: Contribution to journalReview article

@article{f49776620bca45c0accdac921bc6a991,
title = "Novel pathophysiological insight and treatment strategies for heart failure - Lessons from mice and patients",
abstract = "The ultimate goal of heart failure (HF) treatment is to improve the prognosis of patients. Previous basic, clinical, and population studies have advanced the modem treatment of HF, but efficacy is still limited especially in 'real world' patients. There are 2 approaches to solve this crucial issue. First is the further development of novel therapeutic strategies based on new insight into the pathophysiology of myocardial remodeling and failure. Second is the improvement of the quality of care in routine clinical practice. The basic approach is to develop the treatment of myocardial remodeling by regulating mitochondrial oxidative stress. In the failing heart, oxygen radicals are the result of defects of mitochondrial electron transport, causing mitochondrial DNA damage and functional decline, and further production of oxygen radicals. Oxidative stress causes myocyte hypertrophy, apoptosis, and interstitial fibrosis by activating matrix metalloproteinases, all of which result in myocardial remodeling and failure. Therefore, mitochondrial oxidative stress and DNA damage are good therapeutic targets. The clinical approach is to develop effective strategies of HF management for the 'real world' patients. Readmission because of exacerbation is common in HF patients and further impairs their quality of life. Noncompliance with treatment is the most common precipitating factor for readmission. Regular medical follow-up and social support are important components that should be included in the disease management program of HF patients. These basic and clinical approaches are needed to establish new and effective treatment strategies for Japanese patients with HF.",
author = "Hiroyuki Tsutsui",
year = "2004",
month = "12",
day = "1",
doi = "10.1253/circj.68.1095",
language = "English",
volume = "68",
pages = "1095--1103",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "12",

}

TY - JOUR

T1 - Novel pathophysiological insight and treatment strategies for heart failure - Lessons from mice and patients

AU - Tsutsui, Hiroyuki

PY - 2004/12/1

Y1 - 2004/12/1

N2 - The ultimate goal of heart failure (HF) treatment is to improve the prognosis of patients. Previous basic, clinical, and population studies have advanced the modem treatment of HF, but efficacy is still limited especially in 'real world' patients. There are 2 approaches to solve this crucial issue. First is the further development of novel therapeutic strategies based on new insight into the pathophysiology of myocardial remodeling and failure. Second is the improvement of the quality of care in routine clinical practice. The basic approach is to develop the treatment of myocardial remodeling by regulating mitochondrial oxidative stress. In the failing heart, oxygen radicals are the result of defects of mitochondrial electron transport, causing mitochondrial DNA damage and functional decline, and further production of oxygen radicals. Oxidative stress causes myocyte hypertrophy, apoptosis, and interstitial fibrosis by activating matrix metalloproteinases, all of which result in myocardial remodeling and failure. Therefore, mitochondrial oxidative stress and DNA damage are good therapeutic targets. The clinical approach is to develop effective strategies of HF management for the 'real world' patients. Readmission because of exacerbation is common in HF patients and further impairs their quality of life. Noncompliance with treatment is the most common precipitating factor for readmission. Regular medical follow-up and social support are important components that should be included in the disease management program of HF patients. These basic and clinical approaches are needed to establish new and effective treatment strategies for Japanese patients with HF.

AB - The ultimate goal of heart failure (HF) treatment is to improve the prognosis of patients. Previous basic, clinical, and population studies have advanced the modem treatment of HF, but efficacy is still limited especially in 'real world' patients. There are 2 approaches to solve this crucial issue. First is the further development of novel therapeutic strategies based on new insight into the pathophysiology of myocardial remodeling and failure. Second is the improvement of the quality of care in routine clinical practice. The basic approach is to develop the treatment of myocardial remodeling by regulating mitochondrial oxidative stress. In the failing heart, oxygen radicals are the result of defects of mitochondrial electron transport, causing mitochondrial DNA damage and functional decline, and further production of oxygen radicals. Oxidative stress causes myocyte hypertrophy, apoptosis, and interstitial fibrosis by activating matrix metalloproteinases, all of which result in myocardial remodeling and failure. Therefore, mitochondrial oxidative stress and DNA damage are good therapeutic targets. The clinical approach is to develop effective strategies of HF management for the 'real world' patients. Readmission because of exacerbation is common in HF patients and further impairs their quality of life. Noncompliance with treatment is the most common precipitating factor for readmission. Regular medical follow-up and social support are important components that should be included in the disease management program of HF patients. These basic and clinical approaches are needed to establish new and effective treatment strategies for Japanese patients with HF.

UR - http://www.scopus.com/inward/record.url?scp=10944230435&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10944230435&partnerID=8YFLogxK

U2 - 10.1253/circj.68.1095

DO - 10.1253/circj.68.1095

M3 - Review article

C2 - 15564690

AN - SCOPUS:10944230435

VL - 68

SP - 1095

EP - 1103

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 12

ER -