Laboratuvardan Kliniğe: Kalp Yetmezliğinin Moleküler Tedavisi

Abstract

Koroner ve kalp-damar hastalıkları günümüzün önde gelen ölüm nedenidir; kalp yetmezliği ise primer etiyoloji arasında yer almaktadır. Kalp yetmezliği birçok hastalığın getirisi olarak ortaya çıkabildiğinden bu alanda yapılacak araştırmalar klinik sonuçlar ve tedavi açısından önemlidir. Kalp yetmezliğinin histopatolojisi, kalp hipertrofisi, inflamasyon, anjiyogenez ve apoptoz yolaklarını içerir. Kalp yetmezliği patolojisinin aydınlatılması konusu halen aktif bir araştırma alanıdır. İlerlemiş kalp yetmezliğinde tipik tedavi stratejisi tıbbi tedavi, mekanik ventriküler destek cihazları ve kalp naklidir. Değiştirilebilen ve değiştirilemeyen risk faktörleriyle ortaya çıkan kalp yetmezliği hem farmakolojik hem de non-farmakolojik tedavi uygulamalarıyla kontrol altına alınabilmektedir. Özellikle yeni tedavi yöntemlerine odaklanılması ve bunların kliniğe tanıtılması önemlidir. Henüz klinikte kullanılmamasına rağmen, birçok çalışma kalp yetmezliğinin önlenmesine yönelik moleküler tedavi seçenekleriyle umut verici sonuçlar vermiştir. In vivo yapılan çalışmalar, anjiyogenez uyarıldığında kalp yetmezliğinin ilerlemesinin durduğunu göstermiştir. Kök hücre tedavisinde de umut verici sonuçlar alınmakta iken aktif uygulama yapılamamaktadır. Kalp yetmezliği tedavisinde olumlu sonuç alınan çalışmalardan faz 1 ve 2. aşamayı takip eden çalışmaların yapılması ve günlük tedavi pratiğinde uygulanması beklenmektedir.

Keywords

• Kalp yetmezliği
• moleküler tedavi
• kök hücre terapi

From the Laboratory to the Clinic: Molecular Treatment of Heart Failure

Abstract

Coronary and cardiovascular diseases are the leading cause of death today, with heart failure being among the primary culprits. Heart failure can occur as a result of many diseases, so research in this area is important in terms of clinical outcomes and treatment. Histopathology of heart failure includes cardiac hypertrophy, inflammation, angiogenesis, and apoptosis pathways. The issue of elucidating the pathology of heart failure is still an area of active research. In advanced heart failure, the typical management strategy is medical treatment, mechanical ventricular support devices, and heart transplantation. Heart failure, which occurs with modifiable and non-modifiable risk factors, can be controlled with both non-pharmacological and pharmacological treatment applications. It is especially important to focus on new treatment methods and introduce them to the clinic. Although they are all not yet used in clinics, many studies have yielded promising results with molecular treatment options for heart failure prevention. Studies in animals have shown that heart failure stops proceeding when angiogenesis is induced. Promising results have also been achieved with stem cell therapy, but these may not be implementable for years. It is expected that studies following phases 1 and 2, of the studies which had positive results in the treatment of heart failure, will be conducted and applied in the daily treatment practice.

Keywords

• Heart failure
• molecular treatment
• stem cell therapy

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