Initial damage to the heart leads to disease-specific activation of the immune system, whereas overlapping immune mechanisms occur in the chronic phase of heart failure across different aetiologies.
This ESC scientific statement details the complex, aetiology-dependent role of the innate immune system in the development and progression of chronic cardiomyopathy.
Activation of the immune system in heart failure (HF) has been recognized for over 20 years. Initially, experimental studies demonstrated a maladaptive role of the immune system. However, several phase III trials failed to show beneficial effects in HF with therapies directed against an immune activation. Preclinical studies today describe positive and negative effects of immune activation in HF. These different effects depend on timing and aetiology of HF. Therefore, herein we give a detailed review on immune mechanisms and their importance for the development of HF with a special focus on commonalities and differences between different forms of cardiomyopathies. The role of the immune system in ischaemic, hypertensive, diabetic, toxic, viral, genetic, peripartum, and autoimmune cardiomyopathy is discussed in depth. Overall, initial damage to the heart leads to disease specific activation of the immune system whereas in the chronic phase of HF overlapping mechanisms occur in different aetiologies.
Frantz et al. (Mon,) conducted a review in Chronic Cardiomyopathy and Heart Failure. Initial damage to the heart leads to disease-specific activation of the immune system, whereas overlapping immune mechanisms occur in the chronic phase of heart failure across different aetiologies.