Epigenetic signals in heart failure: new opportunities for early diagnosis and eff ective therapy

Heart failure (HF) is a severe clinical syndrome associated with signifi cant morbidity and mortality. According to the mechanisms of HF development, it is divided into two main clinical forms: heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). While eff ective and specifi c treatment methods have been developed for HFrEF, leading to a decrease in the prevalence of this form of HF in recent years, the prognosis for patients with HFpEF remains unfavourable, and eff ective treatment methods do not yet exist. Therefore, the identifi cation of new molecular targets and therapeutic approaches is considered an important task of modern medicine. Data obtained in this fi eld have revealed the key involvement of epigenetic signals in the regulation of transcriptional programs underlying the development of HFpEF, which has contributed to the development of selective epigenetic drugs capable of reversing transcriptional changes and thus delaying or preventing the progression of HFpEF. Further thorough investigation of individual epigenetic landscapes may provide opportunities in the future for the development of personalized epigenetic biomarkers and treatment methods for HFpEF. The aim of this review is to consider the role of epigenetic processing, as well as its diagnostic and therapeutic possibilities in HFpEF.