Language

English

Publication Date

10-12-2025

Journal

International Journal of Molecular Sciences

DOI

10.3390/ijms26209931

PMID

41155225

PMCID

PMC12563235

PubMedCentral® Posted Date

10-12-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Cardiac inflammation and hypertrophy develop as a pathologic response to an array of insults, such as myocardial infarctions, chronic systemic hypertension, and valvular defects. Due to the high prevalence of such conditions, there is an increasing need to prevent and halt cardiac hypertrophy. Because cardiac damage and subsequent remodeling can lead to arrhythmias, heart failure, and even sudden cardiac death, inhibition of cardiac hypertrophy is key to reducing cardiovascular-related mortality. The immune system is the driving force behind inflammatory reactions. All three pathways of complement system activation-classical, lectin, and alternative-are implicated in developing cardiac damage, inflammation, and hypertrophy due to infectious and non-infectious causes, autoimmune diseases, genetic polymorphisms, and forms of complement dysregulation. Of interest in this review is the role of the complement system, a collection of soluble and membrane-bound proteins that mediate inflammatory processes through interactions with signaling molecules and immune cells. This review comprehensively discusses the roles of these complement pathways in contagious, chronic inflammatory, genetic, and metabolic diseases. An overview of the completed and terminated clinical trials aimed at preventing cardiovascular mortality by targeting various aspects of the complement system and inflammatory reaction is included. Most current treatments for cardiac inflammation and remodeling primarily target the renin-angiotensin-aldosterone system (RAAS), which prevents further remodeling by reducing myocardial workload. However, moving forward, there may be a place for emerging anti-complement therapeutics, which impair the inflammatory response that generates hypertrophy itself.

Keywords

Humans, Cardiomegaly, Complement System Proteins, Animals, Inflammation, Complement Activation, Renin-Angiotensin System, complement immune system, complement anaphylatoxins, cardiac inflammation, cardiac hypertrophy, cardiac remodeling, autoimmune diseases, cardiovascular events, infectious diseases, genetic defects in complement genes, complement in metabolic diseases, cardiovascular adversities, cardiovascular diseases, cardiac arrhythmias

Published Open-Access

yes

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