Abstract
Heart failure is a multifactorial clinical syndrome characterized by the inability of the heart to pump sufficient blood to the body. Despite recent advances in medical management, poor outcomes in patients with heart failure remain very high. This highlights a need for novel paradigms for effective, preventive and curative strategies. Substantial evidence supports the importance of endogenous melatonin in cardiovascular health and the benefits of melatonin supplementation in various cardiac pathologies and cardiometabolic disorders. Melatonin plays a crucial role in major pathological processes associated with heart failure including ischemic injury, oxidative stress, apoptosis, and cardiac remodeling. In this review, available evidence for the role of melatonin in heart failure is discussed. Current challenges and possible limitations of using melatonin in heart failure are also addressed. While few clinical studies have investigated the role of melatonin in the context of heart failure, current findings from experimental studies support the potential use of melatonin as preventive and adjunctive curative therapy in heart failure.
Highlights
Heart failure (HF) is a complex clinical syndrome characterized by the inability of the heart to pump sufficient blood to the body due to structural and/or functional cardiac abnormalities [1]
Several diseases including myocardial infarction, hypertension, certain infectious diseases, endocrine disorders, and cardiotoxicity, alone or in combination, may initiate a primary physiopathological process that leads to reduced ventricular function and, subsequently, to HF [1,3,4]
These benefits are associated with increased activities of cardiac sodium/potassium-ATPase and sarcoendoplasmic reticulum calcium-ATPase (SERCA), glutathione (GSH) contents and caveolin-3 levels, and decreased activities of plasma lactate dehydrogenase, creatine kinase, lysosomal enzyme, and cardiac myeloperoxidase and malondialdehyde (MDA) [38]
Summary
Heart failure (HF) is a complex clinical syndrome characterized by the inability of the heart to pump sufficient blood to the body due to structural and/or functional cardiac abnormalities [1]. Though many factors may play a role, the increase in the global burden of HF is mostly attributed to the aging population, increased survival following acute myocardial infarction, and the high prevalence of metabolic disorders (obesity and diabetes) and related cardiac complications [1,3] In this regard, several diseases including myocardial infarction, hypertension, certain infectious diseases (e.g., rheumatic heart disease and Chagas disease), endocrine disorders (e.g., diabetes), and cardiotoxicity (e.g., during chemotherapy and drug abuse), alone or in combination, may initiate a primary physiopathological process (e.g., oxidative stress, apoptosis and fibrosis) that leads to reduced ventricular function and, subsequently, to HF [1,3,4]. Considering the significant role of metabolic disorders in HF, the role of melatonin in metabolic syndrome-related HF is summarized
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