Direct Stimulation of Cardiogenesis
A New Paradigm for Treating Heart Disease
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Heart failure (HF) is highly prevalent and is associated with substantial mortality and morbidity, despite the many treatment options currently available. We propose a potential new approach to treating heart disease: promoting cardiogenesis from existing cardiac myocytes by inhibiting the Hippo pathway, a stop growth pathway in the heart.
HF is the third leading cause of cardiovascular death in the United States. It is a syndrome associated with high mortality, considerable morbidity, and an economic burden that is often relentlessly progressive. The American Heart Association and American College of Cardiology classify HF into 4 stages: stage A, presence of risk factors, but with normal cardiac function and structure; stage B, subclinical changes in left ventricular (LV) structure and function; stage C, clinical HF; and stage D, advanced HF.
Coronary artery disease is present in approximately half of patients with new-onset clinical HF and is especially prevalent in patients with a reduced LV ejection fraction. Data from Framingham show a rise in post–myocardial infarction (MI) clinical HF rates between 1971 and 2000, which is primarily due to an increase in HF incidence in the early post-MI period. It has been speculated that because intervention and thrombolytic therapy have improved survival in patients with MI, the population of patients at risk of post-MI HF has grown.
Major clinical risk factors for HF include age, male sex, hypertension, electrocardiographic evidence of LV hypertrophy, MI, diabetes mellitus, valvular heart disease, and obesity. …