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Circ Res. 2015 Mar 27;116(7):1254-68. doi: 10.1161/CIRCRESAHA.116.302317.

Innate immunity and the failing heart: the cytokine hypothesis revisited.

Author information

1
From the Division of Cardiology, Department of Medicine, Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO. dmann@dom.wustl.edu.

Abstract

Elevated levels of inflammatory mediators have been identified in patients with heart failure, including heart failure with reduced and preserved ejection fraction, as well as acute decompensated heart failure. Moreover, experimental studies have shown repeatedly that activation of inflammation in the heart provokes left ventricular remodeling and left ventricular dysfunction. Nonetheless, phase III clinical trials that have attempted to antagonize inflammatory mediators have been negative with respect to the primary end points of the trials, and in some patients, resulted in worsening heart failure or death. The following review will discuss how recent developments in the field of innate immunity have advanced our understanding of the role of inflammation in the pathogenesis of heart failure and will discuss the negative outcomes of the existing clinical trials in light of this new information.

KEYWORDS:

clinical trials; heart failure; inflammation; innate immunity

PMID:
25814686
PMCID:
PMC4380242
DOI:
10.1161/CIRCRESAHA.116.302317
[Indexed for MEDLINE]
Free PMC Article

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