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Efficacy and safety of sacubitril/valsartan in patients on peritoneal dialysis: a systematic review and meta-analysis.
J Bras Nefrol
Caio Lima da Silva, Pandora Eloa Oliveira Fonseca, Viviane Calice-Silva +3 more
Sacubitril/valsartan is a recommended medication for managing heart failure (HF). However, its role in peritoneal dialysis (PD) patients remains uncertain. We conducted this systematic review and singlearm meta-analysis to assess the efficacy and safety of sacubitril/valsartan in this population.
GLP-1 Receptor Agonists.
N Engl J Med
Clifford J Rosen, Julie R Ingelfinger
Glucagon-like peptide-1 (GLP-1) receptor agonists are incretin analogues that promote glucose-mediated insulin release and are used to treat type 2 diabetes mellitus and obesity. GLP-1 receptor agonists and GLP-1 and glucose-dependent insulinotropic peptide agonists have several mechanisms of action, including reduction of gastric emptying, inhibition of glucagon secretion, beneficial changes in the intestinal microbiome, and direct effects on hypothalamic nuclei to enhance satiety (which promotes weight loss). Beyond the impressive effects of GLP-1 receptor agonists on blood glucose levels and body weight, large-scale randomized, controlled trials have shown that GLP-1 receptor agonists reduce cardiovascular risk and slow progression to renal failure in persons at high risk and those with type 2 diabetes. Adverse side effects from GLP-1 receptor agonists are mostly gastrointestinal but may also include loss of muscle and bone mass. Questions remain about long-term adherence, weight regain after discontinuation of treatment, and the functional implications of the loss of muscle and bone mass. Recent and ongoing targeted studies suggest the possibility of additional uses for GLP-1 receptor agonists.
Emerging Role of Dual Glucagon-Like Peptide-1 (GLP-1)/Glucose-Dependent Insulinotropic Polypeptide (GIP) Receptor Agonists in Cardiovascular Prevention.
Cureus
Nicolle Contreras Figueroa, Maynor Jose Lopez Mendoza, Asdrubal Ulloa +3 more
Dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists have emerged as a novel therapeutic class with potential relevance for cardiovascular prevention, particularly in the context of obesity and type 2 diabetes mellitus. Incretin physiology provides the biological foundation for this approach, as GLP-1 and GIP exert complementary metabolic and vascular effects. While GLP-1 receptor agonists have demonstrated well-established reductions in major adverse cardiovascular events, GIP has regained interest due to evidence suggesting preserved vascular and anti-atherosclerotic actions despite reduced insulinotropic efficacy in diabetes.  Dual receptor agonism integrates these pathways, leading to substantial improvements in cardiometabolic risk factors. Agents such as tirzepatide induce marked and sustained weight loss, with significant reductions in visceral adiposity, a key driver of cardiovascular disease. These effects are accompanied by robust improvements in glycemic control and insulin sensitivity, resulting in attenuation of glucotoxicity and lipotoxicity, both of which contribute to endothelial dysfunction and myocardial injury. Additional benefits include reductions in blood pressure, favorable modulation of lipid profiles, and suppression of systemic inflammatory markers, alongside improvements in endothelial function and vascular stiffness. Pharmacologically, dual GLP-1/GIP receptor agonists are engineered to provide balanced receptor activation, allowing superior metabolic efficacy compared with single GLP-1 receptor agonists. Clinical trial data indicate cardiovascular safety and improvements in surrogate cardiovascular endpoints, with reductions in major cardiometabolic risk factors comparable to those achieved with established incretin therapies. However, definitive evidence of incremental cardiovascular outcome benefits remains limited.
Surgical resection of an adrenocorticotropic hormone-producing pulmonary typical carcinoid with mediastinal lymph node metastasis and high programmed death-ligand 1 expression.
Int Cancer Conf J
Masakazu Matsuda, Fumihiko Kinoshita, Yukina Takeichi +9 more
The programmed death-ligand 1 positivity rate in typical carcinoid is generally low; however, cases with programmed death-ligand 1 expression are more frequently associated with lymph node metastasis and have a poorer prognosis. While immune checkpoint inhibitors were incorporated into adjuvant chemotherapy regimens for programmed death-ligand 1-positive non-small cell lung cancer, their efficacy in pulmonary carcinoids remains unclear. A 47-year-old woman presented to a local clinic with moon face. Laboratory testing revealed elevated levels of adrenocorticotropic hormone and cortisol and adrenocorticotropic hormone-dependent Cushing's syndrome was suspected. For further evaluation, the patient was referred to our hospital. Computed tomography revealed a nodule in the left lower lobe of the lung and enlargement of the left hilar lymph node, suggesting ectopic Cushing's syndrome. Left lung cancer (cT1bN1M0, cStage IIB) was suspected, and the patient underwent robot-assisted thoracoscopic left lower lobectomy with ND2a-2 lymph node dissection for diagnostic and therapeutic purposes. Pathological examination confirmed a diagnosis of typical carcinoid (pT1bN2M0, pStage IIIA) with high programmed death-ligand 1 expression. Considering the presence of mediastinal lymph node involvement and programmed death-ligand 1 expression, the patient received four courses of cisplatin and vinorelbine, followed by treatment with atezolizumab. Postoperatively, her adrenocorticotropic hormone levels normalized, and the patient has been alive 18 months postoperatively without recurrence. Programmed death-ligand 1-positive typical carcinoids are associated with a higher frequency of lymph node metastasis and poorer prognosis. Additional case investigations are required to assess the efficacy of immune checkpoint inhibitors in typical carcinoid.
Small-cell carcinoma of the cervix with acute-onset psychotic symptoms associated with clinically diagnosed ectopic ACTH production: a case report.
Front Oncol
Kanako Ozaki, Junya Fujino, Kaoru Niimi +11 more
Small-cell carcinoma of the cervix (SCCC) is a rare and highly aggressive histological subtype of cervical cancer, associated with poor prognosis. SCCC is histologically classified as a neuroendocrine tumor and has the potential to produce ectopic hormones, leading to various paraneoplastic syndromes. This report is a rare case of recurrent SCCC presenting with psychiatric symptoms due to endogenous Cushing's syndrome caused by ectopic adrenocorticotropic hormone (ACTH) production. The patient initially developed mood and behavioral disturbances as the disease progressed, leading to hospitalization under the suspicion of a primary psychiatric disorder. However, further evaluation, prompted by the discovery of severe hypokalemia, revealed Cushing's syndrome associated with clinically diagnosed ectopic ACTH production in the setting of recurrent disease. Her psychiatric symptoms rapidly remitted following the administration of a cortisol synthesis inhibitor. This case highlights the importance of considering endocrine disorders as potential causes of psychiatric manifestations in patients with cancer, particularly those with neuroendocrine tumors such as SCCC. Acute and marked elevation of endogenous cortisol can induce distinct psychiatric symptoms, such as manic features and grandiose delusions, that often respond better to endocrine treatment aimed at normalizing cortisol levels rather than to antipsychotic therapy alone. Clinicians should be aware of this rare but important clinical presentation as timely diagnosis and management can improve patient outcomes.
Central amygdala neuropeptide Y neurons drive hedonic ingestive behaviour independent of energy homeostasis.
Int J Obes (Lond)
Neda Rafiei, Caitlin S Mitchell, Philip Jean-Richard-Dit-Bressel +5 more
Neuropeptide Y (NPY), a key orexigenic neurotransmitter, is widely expressed in the central nervous system, including in a distinct subpopulation of neurons within the central nucleus of the amygdala (CeA). While CeA NPY neurons contribute to energy regulation during chronic stress or high-fat diet exposure, the role of these neurons in modulating ingestive behaviour under standard conditions, particularly in response to caloric and non-caloric cues remains poorly understood.
A chimeric natriuretic peptide (Ev-NP) inhibits isoproterenol (ISO)-induced hypertrophic growth in in vivo and in vitro models by enhancing cGMP and its downstream signaling targets: In silico docking and binding efficacy analysis with NPR-A and NPR-B receptors.
Peptides
Jayashree Bheeman, Ananthan Krishnan Dhanabalan, Gopinath Nagaraj +4 more
A chimeric natriuretic peptide (Ev-NP) was engineered and created with an intention of having a dual NPR-A/NPR-B activation, resistance to degradation, and with a strong renal, and anti-hypertrophic actions in the heart. In the present study, we aim to investigate the anti-hypertrophic properties of a novel chimeric natriuretic peptide, Ev-NP (37 amino acids), against isoproterenol (ISO)-induced hypertrophy in H9c2 cells in vitro and in a rat model in vivo. The effects on anti-hypertrophy and cGMP stimulation were evaluated in H9c2 cells exposed to ISO, both with and without Ev-NP, at concentrations ranging from 10 to 50 nM over 24 h. A significant dose-dependent increase in cGMP was observed in Ev-NP-treated H9c2 cells compared to controls. Furthermore, Ev-NP treatment significantly (P < 0.001) decreased ISO-induced hypertrophic growth in H9c2 cells by elevating cGMP levels. In H9c2 cells overexpressing Npr1 and co-treated with Ev-NP, a stronger anti-hypertrophic effect was observed, as demonstrated by a significant reduction (P < 0.001) in hypertrophic marker gene expression (α-sk, BNP, and β-MHC) compared to cells treated only with ISO. Furthermore, cytokine array analysis showed that Ev-NP treatment normalized ISO-induced up-regulation of pro-inflammatory and growth factor proteins in H9C2 cells. The in vivo anti-hypertrophic study also showed that Ev-NP significantly reduced (90%) the hypertrophic growth caused by ISO in Wistar rats. Importantly, treatment with Ev-NP restored the ISO-induced reductions in cGMP and NPR-A levels in the rat hearts. In silico analysis revealed that Ev-NP exhibited a stronger affinity for the NPR-A receptor, with a binding energy of -490.17 kcal/mol, compared to NPR-B binding energy of -390.77 kcal/mol. The native ANP exhibited a binding energy of -314.68 kcal/mol with NPR-A. These findings suggest that Ev-NP has promising anti-hypertrophic properties, and its therapeutic potential can be harnessed to treat and manage cardiac hypertrophy and heart failure in humans.
Impairment of Macrophage Functions by the Senescence-Associated Secretory Phenotype of Vascular Smooth Muscle Cells-Brief Report.
Arterioscler Thromb Vasc Biol
Dimitrios Tsitsipatis, Tatiana Rodriguez Rivera, Mary Kaileh +6 more
This study aimed to determine the effect of senescent vascular smooth muscle cells (VSMCs) on foam cell formation and macrophage phagocytic activity in atherosclerotic conditions.
Reprogramming aging astrocytes in Alzheimer's disease.
Trends Neurosci
Maria Alfonso-Triguero, Amaia M Arranz
Alzheimer's disease typically unfolds within an aging brain, where astrocytic transcriptional programs are extensively remodeled. A recent study by Choi and colleagues shows that reinstating an aging-dependent Sox9 (SRY-box transcription factor 9)-MEGF10 (multiple EGF-like domains 10) axis restores amyloid clearance and preserves cognition in mouse models. These findings suggest that astrocyte dysfunction reflects destabilized, yet recoverable, homeostatic programs rather than irreversible degeneration.
Acyl-CoA-binding protein (ACBP): a poor-prognosis biomarker in sepsis and a target for disease mitigation.
Signal Transduct Target Ther
Flavia Lambertucci, Omar Motiño, Uxía Nogueira-Recalde +25 more
Sepsis remains a major clinical challenge, with high mortality and long-term disability despite current interventions. Here, we identify the tissue hormone acyl-CoA-binding protein (ACBP), also known as diazepam-binding inhibitor (DBI), as a biomarker and driver of poor outcome in sepsis. ACBP/DBI was elevated in the plasma of septic patients and associated with organ dysfunction and increased mortality. In murine models of endotoxemia, Escherichia coli infection, and polymicrobial sepsis, genetic deletion or antibody-mediated neutralization of ACBP/DBI conferred robust protection by dampening cytokine storm and preserving organ function. Across these three models, neutralization of ACBP/DBI with monoclonal antibodies restored thermoregulation and reduced mortality. Mechanistically, ACBP/DBI inhibition enhanced resilience to lipopolysaccharide-induced sterile inflammation and improved bacterial clearance by macrophages and granulocytes in vivo and in vitro. These effects were observed in monomicrobial infection models and confirmed by high-dimensional immunophenotyping in a polymicrobial sepsis model. Notably, ACBP/DBI inhibition could be favorably combined with glucocorticoids, enhancing survival and reversing histopathological, transcriptional or metabolic signatures of septic shock across heart, kidney, liver, lung, spleen and plasma. These findings position ACBP/DBI as a mechanistic amplifier of sepsis pathophysiology and propose its neutralization, alone or in combination with corticosteroids, as a promising therapeutic strategy to interrupt the fatal trajectory of septic shock.
Mitochondrial Calcium Dysregulation and Targeted Therapies in Heart Failure.
Rev Cardiovasc Med
Mengting Liu, Yunpeng Jin
Heart failure (HF) is steadily increasing in prevalence and poses a major global health challenge, with substantial medical and economic burdens. HF represents the terminal stage of diverse cardiac disorders and is characterized by poor prognosis despite the availability of conventional pharmacological treatments, underscoring the urgent need for novel therapeutic approaches. Accumulating evidence highlights a strong association between HF and mitochondrial dysfunction, of which dysregulated mitochondrial calcium (mCa2+) homeostasis plays a pivotal role in disease pathogenesis. Ca2+ serves as an essential signaling messenger that regulates energy metabolism and also governs cell survival and myocardial contractility. Thus, this review introduces the mechanisms of mCa2+ uptake and efflux and the association of these processes with HF and emerging therapeutic strategies. We also discuss mCa2+ uniporter (MCU) inhibitors and Elamipretide, a mitochondria-targeted peptide. Collectively, this work provides novel insights and preclinical evidence supporting mitochondria-based interventions for HF.
SELFormer-guided discovery of xanthohumol and cirsilineol as multi-target natural therapeutics for type 2 diabetes: computational prediction and experimental validation.
Food Funct
Junyu Zhou, Chen Li, Meiling Liu +1 more
Type 2 diabetes mellitus (T2DM) requires multi-target therapeutic approaches addressing both insulin resistance and insulin secretion deficits. Although natural compounds are promising multi-target candidates, systematic identification of their polypharmacological profiles remains challenging. The objective of this study was to establish a computational framework for identifying natural compounds with multi-target therapeutic potential against T2DM through integrated structure-activity analysis and experimental validation. We developed an SELFormer deep learning model to predict natural compound activities against six T2DM-related proteins including glucagon-like peptide-1 receptor (GLP1R), kinesin family member-11 (KIF11) for insulin secretion and insulin receptor (INSR), peroxisome proliferator-activated receptor-gamma (PPARG), fibroblast growth factor receptor-1 (FGFR1) and insulin-like growth factor-1 receptor (IGF1R) for insulin resistance. Uniform Manifold Approximation and Projection (UMAP) for dimension reduction clustering characterized chemical space distributions and molecular docking validated multi-target binding. Selected compounds were experimentally validated using 3T3-L1 adipocytes and mouse insulinoma (MIN6) pancreatic β-cells. The SELFormer model achieved R2 = 0.937 and RMSE = 0.331 on the training dataset and R2 = 0.918 and RMSE = 0.353 on the testing dataset, with minimal overfitting (ΔR2 = 0.019). Among approximately two million screened compounds, 35 natural compounds demonstrated high predicted activity (pIC50 > 7), clustering into eight distinct chemical families. Multi-target network analysis and molecular docking identified curcumin, xanthohumol, hesperetin, (-)-epicatechin, and cirsilineol as lead candidates with favorable binding energies ranging from -7 to -10 kcal mol-1 across the six targets. Food source analysis identified strawberries, grapes, and tea as rich dietary sources of these bioactive compounds. In 3T3-L1 adipocytes, all five compounds significantly enhanced insulin-stimulated glucose uptake at 10 μM, achieving efficacy comparable to that of metformin. In MIN6 cells, xanthohumol and cirsilineol increased glucose-stimulated insulin secretion to levels comparable to exendin-4, while curcumin, hesperetin, and (-)-epicatechin produced modest but significant increases. In conclusion, this integrated computational and experimental framework identified food-derived natural compounds with validated dual-pathway therapeutic activity against T2DM, providing a systematic and reproducible methodology for multi-target drug discovery in complex metabolic disorders.
Self-assembled mesoporous bioglass polyphenol nanozymes for repairing musculoskeletal trauma.
Biomaterials
Shuao Zhao, Yesheng Jin, Zhihao Jia +7 more
Volumetric Musculoskeletal Trauma (VMST), which is characterized by volumetric muscle loss accompanied by bone injury, poses a significant challenge to regenerative medicine. While current therapies primarily focus on the individual regeneration of muscle or bone, there is no systematic and integrated treatment strategy. In this study, we developed a CuMBG-PA, a copper-doped nanozyme based on mesoporous bioactive glass (MBG) and procyanidin (PA), for integrated muscle and bone repair of VMST. CuMBG-PA self-assembles into a stable polyphenol network via Cu-PA coordination bonds, enhancing PA stability and reactive oxygen species-scavenging capacity. In vitro and in vivo experiments demonstrated that CuMBG-PA promoted osteogenesis and myogenesis while exhibiting high biocompatibility and antibacterial activity. Single-cell RNA-sequencing results revealed that CuMBG-PA synergistically induces stem cell differentiation and promotes tissue repair through multiple myoskeletal shared metabolic pathways. Mechanistically, CuMBG-PA exerts its beneficial effects by increasing the number of Proteoglycan 4 (Prg4) + fibro/adipogenic progenitor cells (FAPs), which highly express fibronectin and insulin-like growth factor. In addition, PRG4 regulates immune cells, removes overactivated muscle satellite cells, reduces muscle fibrosis, and promotes functional recovery during regeneration. In summary, this work demonstrates that the novel self-assembled CuMBG-PA nanozyme represents a potential biomaterial-based strategy for integrated muscle and bone repair in VMST.
TRPV2 is essential for calcium signalling in the early stages of myogenesis.
Biochem Biophys Res Commun
Yanzhu Chen, Kimiaki Katanosaka, Yuki Katanosaka
Skeletal muscle responds to stressors such as exercise and muscle injury by adaptive remodelling. The resilience of skeletal muscle involves not only mature muscle fibres but also the adjacent muscle satellite cells (MuSCs). We previously found that transient receptor potential vanilloid type 2 (TRPV2) is expressed in MuSCs and is essential for MuSC proliferation and activation in MuSC-specific conditional knockout mice. These mice show no mechanical-load-induced muscle hypertrophy and delayed injury-induced muscle regeneration. The effect of TRPV2 on Ca2+ signalling during early myogenesis is unknown; however, here, we demonstrate that tranilast, an inhibitor of TRPV2, suppressed IP3R-derived Ca2+ oscillations in early myogenesis. The addition of adenovirus (Ad)-TRPV2 or Ad-Cre recombinase to floxed-TRPV2 cells modulated TRPV2 expression, and demonstrated the TRPV2 dependence of IP3R and MEF2c expression, nuclear translocation of MEF2c, and Ca2+ oscillations. These findings indicate that TRPV2 regulates intracellular Ca2+ signalling during early myogenesis and highlight its potential as a target for the prevention and treatment of muscle disorders.
Effect of Semaglutide on Body Weight, Blood Lipid Profile, and Adipokine Status in Obese Patients.
Kardiologiia
A V Tyurina, N S Kurochkina, M V Yezhov
Aim        To evaluate the dynamic impact of an 8-month glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy with semaglutide on anthropometric metrics, blood lipid profiles, and adipokine status in obese patients, with and without type 2 diabetes mellitus (T2DM).Material and methods    The study included 65 patients with obesity, 26 of whom had T2DM. All participants were prescribed semaglutide, with dose titration up to 1 mg once weekly over 8 months. Before and after the treatment period, the following variables were assessed: anthropometric data (body weight, body weight index, waist circumference), biochemical parameters (lipid profile, glucose, aspartate aminotransferase, alanine aminotransferase, creatinine), and adipokine concentrations (leptin, adiponectin, resistin) via immunofluorescence assay.Results  Semaglutide therapy was associated with a statistically significant reduction in body weight (p&lt;0.001), body mass index (p&lt;0.001), and waist circumference (p&lt;0.001). Improvements in the lipid profile were observed over time, including decreased concentrations of low-density lipoprotein cholesterol (p=0.001), triglycerides (p&lt;0.001), and total cholesterol (p=0.001), alongside an increase in high-density lipoprotein cholesterol (p&lt;0.01). Therapy significantly impacted adipokine status: a statistically significant increase in anti-atherogenic adiponectin (p&lt;0.001) and a decrease in leptin levels (p&lt;0.001) were recorded, indicating improved adipose tissue metabolic function. However, no significant changes in resistin concentrations were found. Additionally, positive effects on liver and kidney function markers were noted, manifested by reductions in aspartate aminotransferase and alanine aminotransferase activity, as well as creatinine levels. In the subgroup of patients with T2DM, a statistically significant improvement in glycemic control was observed.Conclusion         Semaglutide therapy for 8 months in obese patients yielded a robust cardiometabolic impact, characterized by significant weight reduction, optimized lipid profiles, and improved liver and kidney function markers, alongside a favorable restructuring of adipokine status. These results support the use of GLP-1 RAs not only for glycemic and weight control but also as a multifaceted cardioprotective therapy for obese patients.
Tirzepatide in Metabolic Diseases: Clinical Efficacy and Safety Beyond Diabetes and Obesity.
Med Res Rev
Shixuan Dong, Ying Xu, Ran Gan +3 more
Tirzepatide, a novel dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, has attracted substantial attention for its exceptional efficacy in managing type 2 diabetes and obesity. Emerging evidence suggests that tirzepatide may also exert broad therapeutic benefits in cardiovascular diseases, metabolic dysfunction-associated steatotic liver disease, and chronic kidney disease. However, its potential clinical risks are increasingly being recognized. This review begins by outlining the structural and pharmacological advantages of tirzepatide. We then comprehensively evaluate recent clinical evidence, including randomized controlled trials and real-world studies, based on a comprehensive literature search, to analyze its efficacy and safety for metabolic disorders. Tirzepatide exhibits considerable promise in treating multiple metabolic diseases; however, its therapeutic benefits must be carefully weighed against potential risks. Conclusions on cardiorenal benefits are supported by high-level outcome trials, while the evidence for hepatic, renal and musculoskeletal effects is exploratory or preliminary. Further large-scale, long-term studies remain essential to fully elucidate its mechanisms of action and overall clinical impact, given the current safety signals and other evidence are largely based on case reports, post hoc analyses, and non-prespecified endpoints. Continued pharmacovigilance is also crucial to identify and mitigate potential adverse drug reactions in diverse patient populations, especially for rare but serious events identified through spontaneous reporting systems.
Dose-response analysis of tirzepatide and acute pancreatitis: An international systematic review and quantitative meta-analysis of randomised trials.
Pancreatology
Olivia Benny, Anurag Agarwal, Harvey Alecock +47 more
Tirzepatide, a dual GIP/GLP-1 receptor agonist for type 2 diabetes and obesity, carries a theoretical risk of pancreatitis. Whether risk varies by dose is uncertain.
Glucagon-like peptide-1 receptor agonists reduce experimental atherosclerosis progression, inflammatory biomarkers and cardiovascular events, irrespective of hyperglycaemia and obesity.
Eur Heart J
Mohamad B Kassab, Haitham Khraishah, Andrew Thrapp +16 more
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduce cardiovascular events. However, their impact on atherosclerosis and inflammation, regardless of diabetes or obesity, is unknown. Here, GLP-1 RA effects were investigated on (i) atherosclerosis burden and inflammation in vivo in rabbits and (ii) inflammatory biomarkers and major adverse cardiovascular events (MACE) in clinical subjects, adjusted for glycaemic and obesity status.
Cardiometabolic and Antioxidant Properties of Modified C-Terminal Fragments of Apelin in Experimental Cardiac Pathology.
Kardiologiia
O I Pisarenko, I M Studneva
The development of new drugs for cardiovascular diseases based on endogenous peptide hormones is a field of significant interest, driving intensive experimental research. One promising direction is the synthesis of short bioactive peptides that mimic the effects of larger peptide molecules while offering superior physicochemical properties. Recent studies have shown that C-terminal fragments of the peptide apelin mitigate metabolic and functional impairments following cardiac injury. This review summarizes current literature alongside our own experimental findings regarding the effects of apelin-13, [Pyr1]apelin-13, apelin-12, and its chemically modified analogs on the heart during in vitro and in vivo pathophysiological modeling. The therapeutic spectrum of apelin-12 analogs in the damaged myocardium includes reduced cardiomyocyte death, decreased membrane damage, improved myocardial metabolic status, and the suppression of reactive oxygen species and lipid peroxidation products. These findings highlight the potential of molecular construction of apelin receptor (APJ) agonists with enhanced proteolytic resistance and shelf-life stability as a foundation for a new class of cardiovascular drugs.
Biomarker-Guided Versus Clinically Guided Management Strategies for Heart Failure: A Systematic Review and Meta-Analysis.
Rev Cardiovasc Med
Hao Zhou, Ting Liu, Fuxia Lan +3 more
The clinical value of B-type natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided therapy for improving outcomes in patients with heart failure (HF) remains controversial. Thus, this meta-analysis synthesizes the available evidence from randomized controlled trials (RCTs) to determine whether a biomarker-guided strategy reduces all-cause mortality and HF-related hospitalizations compared with clinically guided management.