Heart Failure in Chronic Infectious and Inflammatory Conditions: Mechanistic Insights from Clinical Heterogeneity

Curr Heart Fail Rep. 2022 Oct;19(5):267-278. doi: 10.1007/s11897-022-00560-3. Epub 2022 Jul 15.

Abstract

Purpose of review: The balance between inflammation and its resolution plays an important and increasingly appreciated role in heart failure (HF) pathogenesis. In humans, different chronic inflammatory conditions and immune-inflammatory responses to infection can lead to diverse HF manifestations. Reviewing the phenotypic and mechanistic diversity of these HF presentations offers useful clinical and scientific insights.

Recent findings: HF risk is increased in patients with chronic inflammatory and autoimmune disorders and relates to disease severity. Inflammatory condition-specific HF manifestations exist and underlying pathophysiologic causes may differ across conditions. Although inflammatory disease-specific presentations of HF differ, chronic excess in inflammation and auto-inflammation relative to resolution of this inflammation is a common underlying contributor to HF. Further studies are needed to phenotypically refine inflammatory condition-specific HF pathophysiologies and prognoses, as well as potential targets for intervention.

Keywords: Chronic inflammatory and autoimmune disorders; Heart failure pathogenesis; Inflammation resolution; Persistent inflammation; Trained immunity.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Chronic Disease
  • Heart Failure*
  • Humans
  • Inflammation / complications
  • Prognosis