Targeting myocardial remodelling to develop novel therapies for heart failure: a position paper from the Working Group on Myocardial Function of the European Society of Cardiology

The failing heart is characterized by complex tissue remodelling involving increased cardiomyocyte death, and impairment of sarcomere function, metabolic activity, endothelial and vascular function, together with increased inflammation and interstitial fibrosis. For years, therapeutic approaches for heart failure (HF) relied on vasodilators and diuretics which relieve cardiac workload and HF symptoms. The introduction in the clinic of drugs interfering with beta-adrenergic and angiotensin signalling have ameliorated survival by interfering with the intimate mechanism of cardiac compensation. Current therapy, though, still has a limited capacity to restore muscle function fully, and the development of novel therapeutic targets is still an important medical need. Recent progress in understanding the molecular basis of myocardial dysfunction in HF is paving the way for development of new treatments capable of restoring muscle function and targeting specific pathological subsets of LV dysfunction. These include potentiating cardiomyocyte contractility, increasing cardiomyocyte survival and adaptive hypertrophy, increasing oxygen and nutrition supply by sustaining vessel formation, and reducing ventricular stiffness by favourable extracellular matrix remodelling. Here, we consider drugs such as omecamtiv mecarbil, nitroxyl donors, cyclosporin A, SERCA2a (sarcoplasmic/endoplasmic Ca(2 +) ATPase 2a), neuregulin, and bromocriptine, all of which are currently in clinical trials as potential HF therapies, and discuss novel molecular targets with potential therapeutic impact that are in the pre-clinical phases of investigation. Finally, we consider conceptual changes in basic science approaches to improve their translation into successful clinical applications.

Optimising mirid control on cocoa farms through complementary monitoring systems

Mirids (Sahlbergella singularis and Distantiella theobroma) are the most important insect pests affecting cocoa production across West Africa. Understanding the population dynamics of mirids is key to their management, however, the current recommended hand-height assessment method is labour intensive. The objective of the study was to compare recently developed mirid sex pheromone trapping and visual hand-height assessment methods as monitoring tools on cocoa farms and to consider implications for a decision support system. Ten farms from the Eastern and Ashanti regions of Ghana were used for the study. Mirid numbers and damage were assessed fortnightly on twenty trees per farm, using both methods, from January 2012 to April 2013. The mirid population increased rapidly in June, reached a peak in September and began to decline in October. There was a significant linear relationship between numbers of mirids sampled to hand-height and mirid damage. High numbers of male mirids were recorded in pheromone traps between January and April 2012 after which there was a gradual decline. There was a significant inverse relationship between numbers of trapped adult mirids and mirids sampled to hand-height (predominantly nymphs). Higher temperatures and lower relative humidities in the first half of the year were associated with fewer mirids at hand-height but larger numbers of adult males were caught in pheromone traps. The study showed that relying solely on one method is not sufficient to provide accurate information on mirid population dynamics and a combination of the two methods is necessary.