Clinical Application of Melatonin in the Treatment of Cardiovascular Diseases: Current Evidence and New Insights into th
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REVIEW ARTICLE
Clinical Application of Melatonin in the Treatment of Cardiovascular Diseases: Current Evidence and New Insights into the Cardioprotective and Cardiotherapeutic Properties Mohammad Hossein Pourhanifeh 1 & Ehsan Dehdashtian 2 & Azam Hosseinzadeh 3 & Seyed Hashem Sezavar 4 & Saeed Mehrzadi 3 Accepted: 4 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Cardiovascular diseases (CVDs) are the leading global cause of mortality and disability, tending to happen in younger individuals in developed countries. Despite improvements in medical treatments, the therapy and long-term prognosis of CVDs such as myocardial ischemia–reperfusion, atherosclerosis, heart failure, cardiac hypertrophy and remodeling, cardiomyopathy, coronary artery disease, myocardial infarction, and other CVDs threatening human life are not satisfactory enough. Therefore, many researchers are attempting to identify novel potential therapeutic methods for the treatment of CVDs. Melatonin is an antiinflammatory and antioxidant agent with a wide range of therapeutic properties. Recently, several investigations have been carried out to evaluate its effectiveness and efficiency in CVDs therapy, focusing on mechanistic pathways. Herein, this review aims to summarize current findings of melatonin treatment for CVDs. Keywords Cardiovascular diseases . Melatonin . Myocardial ischemia–reperfusion . Atherosclerosis . Hypertension . Heart failure . Cardiac hypertrophy . Cardiac remodeling . Cardiomyopathy . Coronary artery disease . Myocardial infarction
Introduction Cardiovascular diseases (CVDs) remain the leading causes of morbidity and mortality worldwide, despite research to understand the mechanisms and pathophysiology involved in the pathogenesis. Among these, coronary artery disease has a greater burden on global economy and health [1, 2]. Currently, it is well-recognized that physical inactivity, obesity, smoking, and poor diet are diverse modifiable risk factors Mohammad Hossein Pourhanifeh and Ehsan Dehdashtian contributed equally to this work. * Saeed Mehrzadi [email protected]; [email protected] 1
Hala Research Center of IRI, FDA, Tehran, Iran
2
School of Medicine, Iran University of Medical Sciences, Tehran, Iran
3
Razi Drug Research Center, Iran University of Medical Sciences, Tehran, Iran
4
Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
for cardiovascular diseases, all of which result in a proinflammatory state [3]. All improvements in medical treatments as well as therapeutic procedures for CVDs have only been capable of decreasing its mortality rates in Central and Western Europe; however, an absolute promotion has been seen in cardiovascular mortality worldwide [4]. Melatonin, a molecule mainly produced by the pineal gland, has various features that may contribute to its cardioprotective effects [5, 6]. The protective actions of melatonin could be receptor mediated or rec
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