Oxidative Stress and Heart Failure

Abstract

Heart failure (HF) remains a major cause of disability, suffering, and death worldwide. The prevalence of HF increases with age and at an alarming pace in the elderly population aged 65 years or more. Importantly, the increase in HF prevalence, first seen in developed countries and currently in developing countries as well, has taken place despite tremendous advances in HF therapy and efforts to encourage implementation of management guidelines. The magnitude of this HF pandemic is staggering, affecting nearly 26 million people across the world. There are several reasons for this continued increase in HF prevalence despite optimal therapy; of these, two that stand out include (i) the aging-induced cardiovascular (CV) remodeling that modifies disease expression and response to therapy and aging-related increase in reactive oxygen species (ROS) and oxidative stress (OXS) that augment adverse left ventricular remodeling after myocardial injury; ii) the lifelong exposure to CV disease (CVD) risk factors that increase ROS and OXS, as well as inflammation. Other pathways and mechanisms leading to HF that are yet to be addressed may also involve OXS and inflammation. This chapter focuses on the evidence for ROS-induced myocardial damage during HF progression and some potential pharmacological interventions and strategies for reducing the damage. In addition, some key issues facing translation of experimental successes with antioxidant therapy into successes in clinical practice on the real-world stage are addressed.

The authors have nothing to disclose.