Deleterious cardiovascular effect of exosome in digitalis-treated decompensated congestive heart failure

J Biochem Mol Toxicol. 2020 May;34(5):e22462. doi: 10.1002/jbt.22462. Epub 2020 Feb 11.

Abstract

Heart failure (HF) is a medical condition inability of the heart to pump sufficient blood to meet the metabolic demand of the body to take place. The number of hospitalized patients with cardiovascular diseases is estimated to be more than 1 million each year, of which 80% to 90% of patients ultimately progress to decompensated HF. Digitalis glycosides exert modest inotropic actions when administered to patients with decompensated HF. Although its efficacy in patients with HF and atrial fibrillation is clear, its value in patients with HF and sinus rhythm has often been questioned. A series of recent studies have cast serious doubt on the benefit of digoxin when added to contemporary HF treatment. We are hypothesizing the role and mechanism of exosome and its biological constituents responsible for worsening the disease state and mortality in decompensated HF patients on digitalis.

Keywords: Wnt; calcium-calmodulin kinase II; exosome; heart failure; protein kinase C.

Publication types

  • Review

MeSH terms

  • Anti-Arrhythmia Agents / pharmacology
  • Anti-Arrhythmia Agents / therapeutic use*
  • Atrial Fibrillation / drug therapy*
  • Cardiotonic Agents / pharmacology
  • Cardiotonic Agents / therapeutic use*
  • Digitalis / chemistry*
  • Digoxin / pharmacology
  • Digoxin / therapeutic use*
  • Exosomes / drug effects*
  • Heart Failure / drug therapy*
  • Humans
  • Plant Extracts / pharmacology
  • Plant Extracts / therapeutic use*
  • Wnt Signaling Pathway / drug effects

Substances

  • Anti-Arrhythmia Agents
  • Cardiotonic Agents
  • Plant Extracts
  • Digoxin