American Heart Association

Follistatin-like protein 1 (FSTL1): A cardiokine that alters metabolism and reverses remodelling in tachy-pacing canine HF

Contributor: Mat Bull

FSTL1 is a molecule with tremendous potential. While already considered an important clinical biomarker and cardioprotective cardiokine (a molecule secreted by cardiac muscle), Recchia et al demonstrate that FSTL1 also serves as a regulator of energy substrate metabolism. Using a canine tachy-pacing HF model, infusion of recombinant human FSTL1 exhibited efficacy in reversing pathological cardiac metabolism and remodelling.

Progenitor cells are decreased in heart failure and specific to HF type

Contributor: Mat Bull

Do progenitor cells matter for patients with HF? First, what is a progenitor cell? A progenitor cell is a stem cell that has potential to differentiate into multiple different cell types. Progenitor cells are classified by cluster of differentiation surface markers, which act as receptors and ligands to their target tissue. CD34+ progenitor cells have been shown to play a role in vascular and myocardial regeneration and in this article are shown to be an important biomarker in heart failure.

Ivabradine: Valuable in HFrEF for a select few

Contributor: Mat Bull

Less is more when it comes to heart rate in HF. Ivabradine, a sinus node inhibitor, lowers heart rate, thereby decreasing myocardial demand. Some beta blockers have mortality benefit in HFrEF as shown by the MERIT-HF and COPERNICUS trials, and a side effect of these drugs is heart rate lowering. Thus, beta-blockers are standard of care in HFrEF; however, at maximally indicated doses, undesired side effects often occur. Since ivabradine targets very specific ion channels within the SA node, further heart rate reduction is possible. But which patients are eligible for this therapy? Read on.