Treating heart failure with preserved ejection fraction: learning from pulmonary fibrosis

Research output: Contribution to journalReview article

Abstract

Heart failure with preserved ejection fraction (HFpEF) has a poor prognosis, and an effective treatment is currently lacking. Increasing evidence suggests a prevailing pathogenic role of cardiac fibrosis in HFpEF, which generates the possibility of a mechanistic overlap with pulmonary fibrosis. Indeed, cardiac and pulmonary fibrosis share some characteristics and molecular pathways, such as that of transforming growth factor-β. If pulmonary and cardiac fibrosis share common pathways, we can hypothesize a beneficial effect of anti-fibrotic drugs used in idiopathic pulmonary fibrosis on cardiac outcomes. Of note, pirfenidone has been tested in animal models of cardiac fibrosis and was found to be effective in reducing ventricular remodelling. Yet, no results are hitherto available for humans. In this review article, we discuss the potential benefit of anti-fibrotic treatment in HFpEF. In particular, we propose to reappraise safety data collected in placebo-controlled trials of anti-fibrotic drugs in idiopathic pulmonary fibrosis, to explore the hypothesis that these might reduce cardiac fibrosis.

Original languageEnglish
Pages (from-to)1385-1391
Number of pages7
JournalEuropean Journal of Heart Failure
Volume20
Issue number10
DOIs
Publication statusPublished - Oct 1 2018

Fingerprint

Pulmonary Fibrosis
Idiopathic Pulmonary Fibrosis
Fibrosis
Heart Failure
Learning
Ventricular Remodeling
Transforming Growth Factors
Pharmaceutical Preparations
Animal Models
Placebos
Safety
Therapeutics

Keywords

  • Fibrosis
  • Heart failure with preserved ejection fraction
  • Idiopathic pulmonary fibrosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Treating heart failure with preserved ejection fraction : learning from pulmonary fibrosis. / Graziani, Francesca; Varone, Francesco; Crea, Filippo; Richeldi, Luca.

In: European Journal of Heart Failure, Vol. 20, No. 10, 01.10.2018, p. 1385-1391.

Research output: Contribution to journalReview article

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N2 - Heart failure with preserved ejection fraction (HFpEF) has a poor prognosis, and an effective treatment is currently lacking. Increasing evidence suggests a prevailing pathogenic role of cardiac fibrosis in HFpEF, which generates the possibility of a mechanistic overlap with pulmonary fibrosis. Indeed, cardiac and pulmonary fibrosis share some characteristics and molecular pathways, such as that of transforming growth factor-β. If pulmonary and cardiac fibrosis share common pathways, we can hypothesize a beneficial effect of anti-fibrotic drugs used in idiopathic pulmonary fibrosis on cardiac outcomes. Of note, pirfenidone has been tested in animal models of cardiac fibrosis and was found to be effective in reducing ventricular remodelling. Yet, no results are hitherto available for humans. In this review article, we discuss the potential benefit of anti-fibrotic treatment in HFpEF. In particular, we propose to reappraise safety data collected in placebo-controlled trials of anti-fibrotic drugs in idiopathic pulmonary fibrosis, to explore the hypothesis that these might reduce cardiac fibrosis.

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