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KFO 155:  The Relevance of Biomechanics and Ca2+-Metabolism in Heart Failure and Regeneration

Subject Area Medicine
Term from 2006 to 2014
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 18652202
 
The socio-economical and medical impact of congestive heart failure is profound. Despite important therapeutical advances, heart failure patients have a substantially impaired quality of life and their 5-year-mortality exceeds 50 percent. Heart failure is a systemic disease in which pump failure and arrhythmogenesis are aggravated by neuro-endocrine mechanisms. Research efforts in the area of these neuro-endocrine mechanisms have, in recent years, significantly contributed to an improvement of therapy by using pharmacological inhibitors of the renin-angiotensin-aldosterone system (RAAS) and of beta-adrenergic receptors. Current research findings suggest that further therapeutic benefit can be expected from a better understanding of the myocardial remodelling processes and regeneration mechanisms. This is within the focus of our Clinical Research Unit.
The impairment of cardiac mechanics and the generation of cardiac arrhythmias are determined by molecular remodelling processes which are predominantly mediated by altered hemodynamic loading conditions of the heart. In this context, preload refers to augmented ventricular filling and distension of the myocardial wall during diastole. Afterload, in contrast, is determined by the vascular resistance and the myocardial wall tension during systole. Irrespective of the primary cause, alterations in pre- and/or afterload cause cardiac remodelling, hypertrophy, arrhythmogenesis and failure. Following myocardial infarction, such processes occur in the non-infarcted, hemodynamically challenged remote myocardium, while during arterial hypertension, in cardiac malformation, and genetically caused heart disease they occur ubiquitously in the myocardium.
Research within the Clinical Research Unit is targeted at identifying the signal transduction mechanisms specifically triggered by pre- and afterload. Within the focus are sarcomeric Z-disc proteins and their interactions with intracellular Ca2+-dependent signalling processes.
Furthermore, we want to evaluate which myocardial regenerative processes involving stem cells are possible and how they are determined by local, especially biomechanical load-dependent factors. This work will advance our understanding of the pathophysiology of molecular myocardial remodelling and will help develop novel therapeutic approaches in heart disease.
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