Эпигенетические сигналы при сердечной недостаточности: новые возможности для ранней диагностики и эффективной терапии

Сердечная недостаточность (СН) представляет собой тяжелый клинический синдром, связанный со значительной заболеваемостью и смертностью. Согласно механизмам развития СН подразделяется на две основные клинические формы: сердечную недостаточность с низкой фракцией выброса (СНнФВ) и сердечную недостаточность с сохраненной фракцией выброса (СНсФВ). Если для СНнФВ были разработаны эффективные и специфические методы лечения, благодаря которым распространенность этой формы СН снизилась за последние годы, то в отношении пациентов с СНсФВ прогноз остается неблагоприятным, а эффективных методов лечения пока не существует. В связи с этим идентификация новых молекулярных мишеней и терапевтических подходов представляется важной задачей современной медицины. Данные, полученные в этом направлении, выявили ключевое участие эпигенетических сигналов в регуляции программ транскрипции, лежащих в основе развития СНсФВ, что способствовало разработке селективных эпигенетических препаратов, способных удалять транскрипционные изменения и тем самым задерживать или предотвращать прогрессирование СНсФВ. Дальнейшее тщательное исследование индивидуального эпигенетического ландшафта может предоставить в будущем возможности для разработки персонализированных эпигенетических биомаркеров и методов лечения СНсФВ. Цель настоящего обзора — рассмотреть роль эпигенетического процессинга, а также его диагностические и терапевтические возможности при СНсФВ.

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