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Research advances in the mechanisms of circadian regulation in heart failure

WANG Qiong¹, ZHANG Jia-Yang², QIU Le-Jia¹, CHEN Li-Hong^1,*

¹Health Science Center, East China Normal University, Shanghai 200241, China；²School of Basic Medicine, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China

Abstract

The circadian clock is an endogenous time-keeping system that maintains physiological homeostasis by integrating environmental and genetic interactions. Heart failure is a complex clinical syndrome characterized by structural abnormalities and/or functional impairment of the heart. Growing evidence suggests that core circadian components, such as BMAL1 and REV-ERBα, play important roles in modulating myocardial energy metabolism, inflammatory responses, and oxidative stress, contributing to myocardial structural and metabolic remodeling during heart failure progression. Notably, circadian disruption is closely associated with heart failure, with aberrant blood pressure rhythms and disturbances in the sleep-wake cycle in patients. The time-dependent efficacy of heart failure medications further supports the potential of chronotherapy-based strategies to improve clinical outcomes. Here, we summarize the multifaceted regulatory roles of the circadian clock, particularly core clock genes, in heart failure pathogenesis, providing a theoretical framework for developing personalized chronotherapeutic strategies for heart failure management.

Key words: circadian clock; heart failure; chronobiology

Received: 　　Accepted:

Corresponding author: 陈丽红　　E-mail:

DOI: 10.13294/j.aps.2025.0063

Citing This Article：

WANG Qiong, ZHANG Jia-Yang, QIU Le-Jia, CHEN Li-Hong. Research advances in the mechanisms of circadian regulation in heart failure. Acta Physiol Sin 2025; 77 (4): 653-668 (in Chinese with English abstract).