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2016 ; 594
(14
): 3963-80
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Arrhythmogenic and metabolic remodelling of failing human heart
#MMPMID27019074
Gloschat CR
; Koppel AC
; Aras KK
; Brennan JA
; Holzem KM
; Efimov IR
J Physiol
2016[Jul]; 594
(14
): 3963-80
PMID27019074
show ga
Heart failure (HF) is a major cause of morbidity and mortality worldwide. The
global burden of HF continues to rise, with prevalence rates estimated at 1-2%
and incidence approaching 5-10 per 1000 persons annually. The complex
pathophysiology of HF impacts virtually all aspects of normal cardiac function -
from structure and mechanics to metabolism and electrophysiology - leading to
impaired mechanical contraction and sudden cardiac death. Pharmacotherapy and
device therapy are the primary methods of treating HF, but neither is able to
stop or reverse disease progression. Thus, there is an acute need to translate
basic research into improved HF therapy. Animal model investigations are a
critical component of HF research. However, the translation from cellular and
animal models to the bedside is hampered by significant differences between
species and among physiological scales. Our studies over the last 8 years show
that hypotheses generated in animal models need to be validated in human in vitro
models. Importantly, however, human heart investigations can establish
translational platforms for safety and efficacy studies before embarking on
costly and risky clinical trials. This review summarizes recent developments in
human HF investigations of electrophysiology remodelling, metabolic remodelling,
and ?-adrenergic remodelling and discusses promising new technologies for HF
research.