Did giraffe cardiovascular evolution solve the problem of heart failure with preserved ejection fraction?

Barbara Natterson-Horowitz; Basil M Baccouche; Jennifer Mary; Tejas Shivkumar; Mads Frost Bertelsen; Christian Aalkjær; Morten H Smerup; Olujimi A Ajijola; Joseph Hadaya; Tobias Wang

doi:10.1093/emph/eoab016

Did giraffe cardiovascular evolution solve the problem of heart failure with preserved ejection fraction?

Evol Med Public Health. 2021 Jun 11;9(1):248-255. doi: 10.1093/emph/eoab016. eCollection 2021.

Authors

Barbara Natterson-Horowitz^{1

2

3}, Basil M Baccouche^{2

4}, Jennifer Mary⁵, Tejas Shivkumar⁶, Mads Frost Bertelsen⁷, Christian Aalkjær⁸, Morten H Smerup⁹, Olujimi A Ajijola¹⁰, Joseph Hadaya^{10

11}, Tobias Wang¹²

Affiliations

¹ Department of Medicine, Harvard Medical School, Boston, MA, USA.
² Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, USA.
³ Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
⁴ Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
⁵ Zoobiquity Research Initiative at UCLA, Los Angeles, CA 90024, USA.
⁶ Brentwood School, Los Angeles, CA, USA.
⁷ Copenhagen Zoo, Frederiksberg, Denmark.
⁸ Department Biomedicine, Aarhus University, Aarhus, Denmark.
⁹ Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
¹⁰ UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
¹¹ Molecular, Cellular and Integrative Physiology Program, UCLA, Los Angeles, CA, USA.
¹² Zoophysiology, Department of Biology, Aarhus University, Aarhus, Denmark.

Abstract

The evolved adaptations of other species can be a source of insight for novel biomedical innovation. Limitations of traditional animal models for the study of some pathologies are fueling efforts to find new approaches to biomedical investigation. One emerging approach recognizes the evolved adaptations in other species as possible solutions to human pathology. The giraffe heart, for example, appears resistant to pathology related to heart failure with preserved ejection fraction (HFpEF)-a leading form of hypertension-associated cardiovascular disease in humans. Here, we postulate that the physiological pressure-induced left ventricular thickening in giraffes does not result in the pathological cardiovascular changes observed in humans with hypertension. The mechanisms underlying this cardiovascular adaptation to high blood pressure in the giraffe may be a bioinspired roadmap for preventive and therapeutic strategies for human HFpEF.

Keywords: cardiovascular; comparative; heart failure with preserved ejection fraction; left ventricular hypertrophy; resistance.