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Heart Failure: From Pathogenesis to Innovative Treatments

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: 20 May 2026 | Viewed by 3421

Special Issue Editors


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Guest Editor
Laboratory of Molecular and Experimental Cardiology, Department of Internal Medicine, University Clinic, Heart Center, Technische Universität Dresden, 01307 Dresden, Germany
Interests: heart failure; skeletal muscle biology; endothelial function

E-Mail Website
Guest Editor
Department of Internal Medicine, University Clinic, Heart Center, Technische Universität Dresden, 01307 Dresden, Germany
Interests: endothelial function; cardiovascular disease; heart failure

Special Issue Information

Dear Colleagues,

Heart failure is still an epidemic disease affecting about 1% to 2% of the population worldwide. About half of the patients present with reduced left ventricular ejection fraction (LVEF). In the other half LVEF is preserved. Underlying pathogenesis and subsequently the efficacy of treatment approaches differ in these patient populations. Despite molecular and structural alterations in the myocardium, also peripheral organs like the skeletal muscle and the diaphragm exhibit molecular changes associated with muscle dysfunction and atrophy. The ultimate goal of understanding the pathology is to improve prevention strategies and treatment options for heart failure patients. In recent years, several molecular studies helped to unravel pathophysiological aspects and new treatment options for heart failure and related comorbidities.

We encourage submission of original full research papers as well as review articles dealing with novel mechanistic insights and details of molecular alterations in heart failure. We also encourage submission of manuscripts that focus on translating basic molecular knowledge to new medical applications in heart failure. Articles reporting novel technologies aimed at identifying disease biomarkers are also welcomed.

Topics include, but are not limited to, the following:

  • New insights in the molecular mechanisms of heart failure, not only limited to the myocardium itself
  • New molecular biomarkers and profiling of heart failure: discriminating between HFrEF and HFpEF, treatment stratification, and efficacy.
  • Preclinical research that leads to novel therapies derived from molecular processes and cellular interactions, including gene therapy, nanomedicine-based therapies, and therapy based on small molecules.
  • Clinical studies investigating treatment strategies for heart failure patients.

Prof. Dr. Volker Adams
Dr. Ephraim Bernhard Winzer
Guest Editors

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Keywords

  • heart failure
  • HFrEF
  • HFpEF
  • comorbidities
  • pathophysiology
  • treatment

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Published Papers (2 papers)

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Research

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22 pages, 8802 KB  
Article
Mitochondrial Targeting by Elamipretide Improves Myocardial Bioenergetics Without Translating into Functional Benefits in HFpEF
by Antje Schauer, Daniela Jahn, Beatrice Vahle, Peggy Barthel, Anita Männel, Gunar Fabig, Axel Linke, Volker Adams and Antje Augstein
Int. J. Mol. Sci. 2026, 27(2), 1060; https://doi.org/10.3390/ijms27021060 - 21 Jan 2026
Viewed by 865
Abstract
Mitochondrial dysfunction contributes to impaired myocardial energetics and performance in heart failure with preserved ejection fraction (HFpEF). Elamipretide (Ela) enhances mitochondrial bioenergetics in preclinical models, yet its relevance in HFpEF remains unclear. This study examined the effects of Ela on cardiac mitochondrial function, [...] Read more.
Mitochondrial dysfunction contributes to impaired myocardial energetics and performance in heart failure with preserved ejection fraction (HFpEF). Elamipretide (Ela) enhances mitochondrial bioenergetics in preclinical models, yet its relevance in HFpEF remains unclear. This study examined the effects of Ela on cardiac mitochondrial function, structure, and cardiovascular performance in a rodent HFpEF model. Female obese ZSF1 rats received vehicle or Ela for 12 weeks, with age-matched lean rats as controls. Cardiac function and hemodynamics were assessed by echocardiography and pressure–volume analysis. Mitochondrial respiration was measured in permeabilized fibers and ultrastructure evaluated by transmission electron microscopy. Molecular and histological analyses included cardiolipin lipidomics and mRNA/protein profiling of hypertrophic, fibrotic, and inflammatory markers. Ela modestly improved complex I and II respiration, whereas mitochondrial ultrastructure, cardiolipin composition, and tafazzin expression were unchanged. Diastolic dysfunction persisted, reflected by unchanged E/é, ventricular stiffness factor β, and titin phosphorylation. Compared to untreated HFpEF, systolic performance showed a mild decline, with small reductions in LV ejection fraction and end-systolic elastance. Accordingly, cardiac remodeling, including hypertrophy, fibrosis, and inflammatory activation, remained unaltered. Vascular stiffness slightly increased, while carotid reactivity and morphology were preserved. In conclusion, despite enhanced mitochondrial respiration following Ela treatment, no functional or structural benefits were observed in experimental HFpEF, suggesting limited therapeutic efficacy once HFpEF is established. Full article
(This article belongs to the Special Issue Heart Failure: From Pathogenesis to Innovative Treatments)
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Review

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25 pages, 1188 KB  
Review
Mitochondria-Enriched Extracellular Vesicles (EVs) for Cardiac Bioenergetics Restoration: A Scoping Review of Preclinical Mechanisms and Source-Specific Strategies
by Dhienda C. Shahannaz, Tadahisa Sugiura and Taizo Yoshida
Int. J. Mol. Sci. 2025, 26(22), 11052; https://doi.org/10.3390/ijms262211052 - 15 Nov 2025
Cited by 8 | Viewed by 2190
Abstract
Mitochondrial dysfunction is a pivotal contributor to cardiac disease progression, making it a critical target in regenerative interventions. Extracellular vesicles (EVs) have recently emerged as powerful mediators of mitochondrial transfer and cardiomyocyte repair. This review highlights recent advancements in EV bioengineering and their [...] Read more.
Mitochondrial dysfunction is a pivotal contributor to cardiac disease progression, making it a critical target in regenerative interventions. Extracellular vesicles (EVs) have recently emerged as powerful mediators of mitochondrial transfer and cardiomyocyte repair. This review highlights recent advancements in EV bioengineering and their applications in cardiac mitochondrial rescue, with a particular focus on EVs derived from induced pluripotent stem cell–derived cardiomyocytes (iPSC-CMs). Drawing upon a growing body of preclinical evidence, we examine the mechanisms of mitochondrial content delivery, EV uptake dynamics, and comparative bioenergetic restoration outcomes across EV sources. Special emphasis is placed on therapeutic outcomes such as adenosine triphosphate (ATP) restoration, reactive oxygen species (ROS) modulation, and improvements in contractility and infarct size. The convergence of mitochondrial biology, stem cell-derived EV platforms, and engineering innovations positions mitochondria-enriched EVs as a promising non-cellular regenerative modality for cardiovascular disease. Full article
(This article belongs to the Special Issue Heart Failure: From Pathogenesis to Innovative Treatments)
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