Atrial myopathy and heart failure: Immunomolecular mechanisms and clinical implications

Heart failure (HF) remains a major global health challenge defined by the inability of the heart to adequately meet systemic metabolic requirements. While ventricular dysfunction has traditionally been the primary focus in both conceptual and clinical frameworks of HF, emerging evidence highlights a...

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Detalles Bibliográficos
Autores: Gil Fernández, Marta, Bueno Sen, Andrea, Cantolla Pablo, Paula, Val Blasco, Almudena, Ruiz Hurtado, Gema, Delgado, Carmen, Cubillos, Carolina, Boscá Gomar, Lisardo, Fernández Velasco, María
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad Autónoma de Madrid
Repositorio:Biblos-e Archivo. Repositorio Institucional de la UAM
Idioma:inglés
OAI Identifier:oai:dnet:biblosearchi::42933e594b368e0319bb1aeee0b8808b
Acceso en línea:https://hdl.handle.net/10486/778580
https://dx.doi.org/10.3390/ijms26178210
Access Level:acceso abierto
Palabra clave:atrial myopathy
heart failure
inflammation
innate immunity
Medicina
Química
Descripción
Sumario:Heart failure (HF) remains a major global health challenge defined by the inability of the heart to adequately meet systemic metabolic requirements. While ventricular dysfunction has traditionally been the primary focus in both conceptual and clinical frameworks of HF, emerging evidence highlights atrial myopathy—covering structural, functional, electrical, metabolic, and neurohormonal remodeling—as a central yet often overlooked contributor to disease progression across the HF spectrum. This review offers a comprehensive overview of the molecular and cellular mechanisms underlying atrial remodeling, with a focus on inflammation and innate immune activation as key pathogenic mediators. Among pattern recognition receptors, Toll-like receptors (TLRs) and NOD-like receptors (NLRs) play crucial roles in translating myocardial stress into pro-inflammatory, profibrotic, and pro-arrhythmic signals that exacerbate HF. By combining experimental and clinical evidence, we emphasize atrial myopathy as both a biomarker and an active driver of HF deterioration, advocating for the inclusion of atrial-targeted diagnostics and immunomodulatory therapies in future HF treatment approaches. Such a paradigm shift holds significant potential for improved risk stratification, arrhythmia prevention, attenuation of structural remodeling, and ultimately, better prognosis and clinical outcomes in this increasingly common syndrome