Oxidative Stress and Heart Failure

Far from being a direct complication of primary damage to heart muscle, it is now recognised that the pathogenesis of heart failure may rely on a combination of neurohormonal, cellular and molecular factors. An overwhelming number of systems appear to be activated in heart failure and contribute in some way towards structural remodelling.

Comprising a comprehensive evaluation of the experimental and clinical data relating oxidative stress and heart failure, this text proposes that oxidative stress may be the common pathway for muscle dysfunction, cellular growth and remodelling, and mytocyte death. Acknowledged experts in the field here present a persuasive argument for raising the profile of oxidative stress as an important, perhaps critical contributor to the adverse consequences of heart failure. This volume should serve as a rich source of supportive data for clinicians and investigators interested in the pathophysiology and treatment of heart failure, and as a platform on which to base further research.

Thirteen papers by doctors and researchers from North America, the United Kingdom, and China cover current research in heart failure, pathophysiology, clinical and laboratory evidence of oxidative stress, and therapeutic pathways and modulation. Specific chapters address topics like chronic heart failure, free radicals, animal models, the regulation of oxidative stress, beta-blockers, enzyme inhibitors, acute coronary syndromes, endothelial dysfunction, and antioxidant vitamins and apoptosis. Diagrams, graphs, and other images (including a few in color) support the text. Annotation c. Book News, Inc., Portland, OR

Doody Review Services

Reviewer:Jose C Mendez, MD(Loyola University Stritch School of Medicine)
Description:This is a comprehensive review on the role of free radicals and oxidative stress in the pathogenesis of congestive heart failure. In 292 pages, divided into three sections, the book proposes that oxidative stress may be a common pathway for the development of heart failure.
Purpose:The purpose is to provide a much needed review of the subject for investigators and clinicians, and also to encourage further research and clinical applications in the field of oxidative stress and heart failure. The authors, experts in the field, describe the methods and results of their studies conducted in their own laboratory. Nevertheless, the authors manage to keep the text focused and quite comprehensible for the general clinician.
Audience:This is suggested reading for broad audience, including general practitioners as well as clinical general cardiologists and heart failure specialists.
Features:The first section is an excellent review of the most current definition of heart failure, epidemiology, natural history of the disease, and the pathophysiology. This section is accompanied by useful tables and illustrations to supplement the text. The second section discusses up-to-date clinical and laboratory evidence of the role of oxidative stress in the pathophysiology of heart failure. Chapter four of this section is a nice summary of the evidence of how oxidative stress may contribute to the development of heart failure through endothelial dysfunction. Another important and well written chapter in this section is the one on a model of iron overload leading to diastolic heart failure and another model of systolic heart failure following cardiac injury that involves cytokine excess and free radical excess, leading to remodeling and myocyte death. In the third and the last section of the book, specific antioxidant effects of different classes of heart failure drugs are explored. The last three chapters of this section discuss further endothelial dysfunction, oxidative stress and heart failure, and review the clinical and laboratory evidence on the effects of antioxidant vitamins and their experimental and clinical roles in inhibiting myocyte apoptosis and progression of heart failure.
Assessment:This book provides a comprehensive overview of the heart failure syndrome and the evidence of the role of oxidative stress in its development. The tables and illustrations in the book help to deepen the understanding of the text. An increased number of such illustrations might have made the book even more accessible and this is, perhaps, the main shortcoming of the book. This book can be useful for clinicians to further their understanding of the pathogenesis of heart failure and how the different therapeutic pathways may improve mortality and morbidity. Furthermore, for those who are currently pursuing research in this field, the book serves as an excellent reference guide in addition to being a source of ideas and encouragement.