The Role of Oxidative Stress and Inflammatory Parameters in Heart Failure

p16INK4a Aggravated Sepsis-associated Cardiac Injury by Inhibiting the PI3K/AKT Pathway and Inducing Redox Imbalance

Severe sepsis can promote myocardial injury and cardiac dysfunction, but role of p16 in sepsis-induced myocardial injury remains undefined. PBMCs were collected from patients. Expression of inflammatory factors and NLRP3 pathway were detected by Western blotting and qPCR in WT and p16KO mice. Then detect cardiomyocyte apoptosis and ROS levels in vitro. Detailed pathways and mechanisms were revealed through quantitative proteomic analysis combined with GSEA and KEGG analysis. p16 was overexpressed in PBMCs of patient. p16 knockout alleviated cardiac dysfunction in LPS-induced mice and inhibited NLRP3 inflammasome pathway in vivo and in vitro. Quantitative proteomic analysis revealed that p16 knockout contributed to the activation of the PI3K/Akt pathway in LPS-induced cardiac injury. p16 knockout promoted activation of the PI3K/Akt pathway and ameliorated NLRP3 pathway inhibition and redox imbalance thus improving cardiac function in LPS-induced cardiomyopathy mice.

Impact of Lifestyle Modifications Along With Pharmacological Treatment of Heart Failure: A Narrative Review

Heart failure (HF) remains a leading cause of morbidity and mortality worldwide. While pharmacological therapy is foundational, lifestyle modifications are increasingly recognised for their complementary role. This narrative review explores the synergistic effects of lifestyle interventions, combined with pharmacological treatment, in HF management. A literature search (2000-2025) was conducted using PubMed, Scopus, Cochrane, and Google Scholar, to identify studies on integrative approaches to HF care. Lifestyle changes, such as dietary modification, exercise, weight management, smoking and alcohol cessation, and psychosocial support, enhance the efficacy of standard therapies, improve quality of life, and reduce hospitalisations. Integration with medications, like renin-angiotensin-aldosterone system (RAAS) inhibitors, beta-blockers, and sodium-glucose cotransporter-2 (SGLT2) inhibitors, shows improved neurohormonal balance, reduced inflammation, better endothelial function, and delayed cardiac remodelling. However, socioeconomic and cultural barriers challenge real-world implementation. Combining lifestyle interventions with pharmacotherapy provides a holistic, patient-centred strategy for HF management. Future efforts should focus on personalised care, multidisciplinary teams, and policy support, to improve adherence and outcomes.

Use of FGF-23 and sαKlotho for Risk Stratification in Patients with Acute Heart Failure

Background/Objectives: Soluble αKlotho (sαKlotho) and fibroblast growth factor 23 (FGF-23) are increased in acute heart failure (AHF). This study aimed to assess changes in serum sαKlotho and FGF-23 concentrations during an episode of AHF as well as the usefulness of both biomarkers for predicting long-term prognosis. Methods: The study included 104 consecutive patients hospitalized in t he intensive cardiac care unit due to AHF (mean age, 65.8 ± 14.6 years; mean ejection fraction, 31.4% ± 14). New-onset AHF was reported in 43.3% of the population. Blood samples were measured at entry and on discharge from hospital. The main clinical outcomes assessed in this study were all-cause mortality or rehospitalization due to HF during a 3-year follow-up. Results: At admission sαKlotho, FGF-23, and NT-pro BNP levels, compared with discharge, were significantly higher at p < 0.001, p < 0.001, and p < 0.001 respectively. The 3-year Kaplan-Meier analysis, based on tertiles, revealed, for sαKlotho levels from Tertile 1 on admission and at discharge, a 2-fold higher rate of all-cause mortality or rehospitalization for HF compared with Tertile 3 (p = 0.006 and p = 0.028, respectively). One-third of patients showed an increase in FGF-23 and sαKlotho levels during hospitalization. Patients with the highest percentage increase in the levels of both biomarkers had an elevated risk of all-cause morality or hospitalization for HF (hazard ratio, 2.75; confidence interval, 1.19-6.35; p = 0.02). Conclusions: sαKlotho and FGF-23 levels are elevated during an episode of AHF. Low sαKlotho levels are associated with an increased risk of all-cause mortality or rehospitalization for HF. Increases in sαKlotho and FGF-23 values during hospitalization identify patients with poor prognosis.

Histamine H2 Receptor Antagonists in the Treatment and Prevention of Heart Failure

Despite advancements in the treatment of heart failure (HF) and modest improvements in survival rates over the past few decades, mortality rate remains significantly high. HF not only imposes a significant economic burden on patients' families but also presents a substantial challenge to society at large. Therefore, effective treatment and prevention strategies are crucial. Numerous studies have demonstrated that histamine H2 receptor antagonists (H2RAs) can benefit patients with HF through various mechanisms. These mechanisms encompass promoting sodium and water excretion, vasodilation, enhancing cardiac output, reducing levels of inflammatory cytokines, improving ventricular remodeling, and reducing mortality rate. Additionally, H2RAs exert beneficial effects on typical risk factors and may prevent the onset of HF. This review aims to elucidate the mechanisms underlying the treatment and prevention of HF using H2RAs. For patients requiring either prevention or management of HF, and who concurrently have acid-related diseases, H2RAs may represent a suitable therapeutic option.

Clustering Based on Laboratory Data in Patients With Heart Failure Admitted to the Intensive Care Unit

BACKGROUND

Heart failure (HF) is a common condition that imposes a significant burden on healthcare systems. We aimed to identify subgroups of patients with heart failure admitted to the ICU using routinely measured laboratory biomarkers.

METHODS

A large dataset (N = 1176) of patients with heart failure admitted to the ICU at the Beth Israel Deaconess Medical Center in Boston, USA, between June 1, 2001, and October 31, 2012, was analyzed. We clustered patients to identify laboratory phenotypes. Cluster profiling was then performed to characterize each cluster, using a binary logistic model.

RESULTS

Two distinct clusters of patients were identified (N = 679 and 497). There was a significant difference in the mortality rate between Clusters 1 and 2 (50 [7.4%] vs. 109 [21.9%], respectively, p < 0.001). Patients in the Cluster 2 were significantly older (mean [SD] age = 72.35 [14.40] and 76.37 [11.61] years, p < 0.001) with a higher percentage of chronic kidney disease (167 [24.6%] vs. 262 [52.7%], respectively, p < 0.001). The logistic model was significant (Log-likelihood ratio p < 0.001, pseudo R2 = 0.746) with an area under the curve of 0.905. The odds ratio for leucocyte count, mean corpuscular volume (MCV), red blood cell (RBC) distribution width, hematocrit (HcT), lactic acid, blood urea nitrogen (BUN), serum potassium, magnesium, and sodium were significant (all p < 0.05).

CONCLUSION

Laboratory data revealed two phenotypes of ICU-admitted patients with heart failure. The two phenotypes are of prognostic importance in terms of mortality rate. They can be differentiated using blood cell count, kidney function status, and serum electrolyte concentrations.

Astaxanthin Supplementation Effects in Right Ventricle of Rats Exposed to Chronic Intermittent Hypobaric Hypoxia

In Chile, individuals are commonly exposed to high altitude due to the work shift system, involving days of exposure to high altitude followed by days at sea level over the long term, which can result in chronic intermittent hypobaric hypoxia (CIHH). CIHH can cause high-altitude pulmonary hypertension (HAPH), the principal manifestation of which is right ventricular hypertrophy (RVH), in some cases leading to heart failure and eventually death. Studies have shown the contribution of oxidative stress and inflammation to RVH development. Recently, it was determined that the pigment astaxanthin has high antioxidant capacity and strong anti-inflammatory and cardioprotective effects. Therefore, the aim of this study was to determine the effects of astaxanthin on RVH development in rats subjected to CIHH.

METHODS

Thirty two male Wistar rats were randomly assigned to the following groups (n = 8 per group): the normoxia with vehicle (NX), normoxia with astaxanthin (NX + AS), chronic intermittent hypobaric hypoxia with vehicle (CIHH), and chronic intermittent hypobaric hypoxia with astaxanthin (CIHH + AS) groups. CIHH was simulated by 2 days in a hypobaric chamber followed by 2 days at sea level for 29 days.

RESULTS

Exposure to CIHH induced RVH and increased lipid peroxidation (MDA), Nox2 expression, and SOD activity, however, it decreased pro-IL-1β expression. Astaxanthin restored oxidative stress markers (Nox2 and MDA), increased GPx activity, and decreased RVH compared to CIHH.

CONCLUSION

Astaxanthin alleviates RVH and reduces Nox2 and MDA levels while increasing GPx activity in rats subjected to CIHH. These findings provide new insights of astaxanthin as a new nutraceutical against high-altitude effects.

Editorial Commentary on the Special Issue "Antioxidant Therapy for Cardiovascular Diseases"-Cutting-Edge Insights into Oxidative Stress and Antioxidant Therapy in Cardiovascular Health

Recent advances in cardiovascular research have increasingly emphasized oxidative stress as a central mechanism in the pathogenesis and progression of cardiovascular diseases [...].