Inflammatory cytokines and immune signalling in heart failure: mechanisms, models and emerging therapies

Inflammation plays a central role in the pathophysiology of heart failure (HF), and contributes to disease progression, morbidity and mortality. However, the relationships between inflammatory cytokines and different HF subtypes are complex, heterogeneous and bidirectional. In this review, we examine inflammatory pathways, biomarker profiles and comorbidities in HF with reduced, mildly reduced and preserved ejection fraction, and summarize evidence on the use of high-sensitivity C-reactive protein as a biomarker for systemic inflammation in HF. We provide insights into emerging methodologies for biomarker discovery in HF, and discuss the use of animal models to elucidate underlying mechanisms and test potential treatment strategies. Finally, we provide an overview of the therapeutic landscape, touching on past challenges and future opportunities for the development of targeted anti-inflammatory therapies in HF.