Inflammatory Mediators in Heart Failure

Heart failure represents a systemic disease with profound effects on multiple peripheral tissues. There is growing evidence that inflammation not only contributes to the pathogenesis and progression of a variety of cardiomyopathies, but also, the systemic syndrome of heart failure. Mechanistically, systemic and local inflammatory responses drive critical aspects of this pathology. In this chapter, we will discuss pathological mechanisms that drive inflammation and highlight clinical findings from trials that have investigated the role of inflammation in heart failure progression and outcomes. We will also describe emerging roles for distinct innate immune subsets that reside within the pediatric and adult heart focusing on the recently described embryonic and bone marrow monocyte-derived macrophage lineages. Within this context, we will discuss the how the immune mechanisms might be differentially targeted to modulate inflammation and tissue repair in children with heart failure.