# Redox Imbalance and Genetic Mutations in Heart Failure: Synergistic Mechanisms and Therapeutic Strategies

**Authors:** Vinod Kumar Balakrishnan, Abinayaa Rajkumar, Monisha K. G. Ganesh, Harilalith Reddy Kovvuri, Durgadevi Selvam, Preetam Krishnamurthy, Sandhya Sundaram, Kalaiselvi Periandavan, Sankaran Ramesh, Muralidharan Thoddi Ramamurthy, Namakkal S. Rajasekaran

PMC · DOI: 10.3390/genes17020225 · 2026-02-11

## TL;DR

This review explores how redox imbalance and genetic mutations work together to cause heart failure and discusses potential treatments.

## Contribution

The paper provides a comprehensive synthesis of the synergistic roles of redox signaling and genetic mutations in heart failure.

## Key findings

- Redox imbalance and genetic mutations interact to drive cardiac dysfunction.
- Current therapies targeting redox balance and genetic mutations show promise but have limitations.
- Understanding the redox–genetic axis is crucial for developing new heart failure treatments.

## Abstract

Heart failure (HF) is a significant global health challenge, with rising prevalence and a complex, multifactorial pathophysiology. Emerging evidence suggests that disruptions in redox signaling pathways and genetic mutations play critical, synergistic roles in the development and progression of HF. This comprehensive review synthesizes current knowledge on how redox imbalance and genetic alterations interact to drive cardiac dysfunction and critically evaluates the therapeutic strategies targeting these mechanisms. We begin by introducing the basic concepts of redox biology and its role in maintaining cardiac homeostasis. Next, we examine the specific redox signaling pathways and genetic mutations implicated in HF pathogenesis, highlighting the latest mechanistic insights and findings from human studies. The complex interplay between redox dysregulation and genetic factors is explored, including their synergistic effects, compensatory mechanisms, and illustrative case studies. We also review current therapeutic strategies aimed at restoring redox balance and correcting underlying genetic mutations, discussing their progress and limitations. Finally, we present the latest research advances, identify critical knowledge gaps, and propose future directions for both basic and translational research. Understanding the redox–genetic axis is key to developing novel, targeted therapies to address the growing HF epidemic.

## Linked entities

- **Diseases:** heart failure (MONDO:0005252)

## Full-text entities

- **Genes:** TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, ATP2A2 (ATPase sarcoplasmic/endoplasmic reticulum Ca2+ transporting 2) [NCBI Gene 488] {aka ATP2B, DAR, DD, RHABDO2, SERCA2}, MYBPC3 (myosin binding protein C3) [NCBI Gene 4607] {aka CMD1MM, CMH4, FHC, LVNC10, MYBP-C, cMyBP-C}, TNNT2 (troponin T2, cardiac type) [NCBI Gene 7139] {aka CMD1D, CMH2, CMPD2, LVNC6, RCM3, TnTC}, CYBB (cytochrome b-245 beta chain) [NCBI Gene 1536] {aka AMCBX2, CGD, CGDX, GP91-1, GP91-PHOX, GP91PHOX}, NPPB (natriuretic peptide B) [NCBI Gene 4879] {aka BNP, Iso-ANP}, TPM1 (tropomyosin 1) [NCBI Gene 7168] {aka C15orf13, CMD1Y, CMH3, HEL-S-265, HTM-alpha, LVNC9}, CAMK2G (calcium/calmodulin dependent protein kinase II gamma) [NCBI Gene 818] {aka CAMK, CAMK-II, CAMKG, MRD59}, DMD (dystrophin) [NCBI Gene 1756] {aka BMD, CMD3B, DXS142, DXS164, DXS206, DXS230}, TAFAZZIN (tafazzin, phospholipid-lysophospholipid transacylase) [NCBI Gene 6901] {aka BTHS, CMD3A, EFE, EFE2, G4.5, LVNCX}, FLNC (filamin C) [NCBI Gene 2318] {aka ABP-280, ABP280A, ABPA, ABPL, ARVC15, CMD1PP}, GLRX (glutaredoxin) [NCBI Gene 2745] {aka GRX, GRX1}, LMNA (lamin A/C) [NCBI Gene 4000] {aka CDCD1, CDDC, CMD1A, CMT2B1, EMD2, FPL}, PLK3 (polo like kinase 3) [NCBI Gene 1263] {aka CNK, FNK, PLK-3, PRK}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, REN (renin) [NCBI Gene 5972] {aka ADTKD4, HNFJ2, RTD}, IL6R (interleukin 6 receptor) [NCBI Gene 3570] {aka CD126, HIES5, IL-1Ra, IL-6R, IL-6R-1, IL-6RA}, TRPC3 (transient receptor potential cation channel subfamily C member 3) [NCBI Gene 7222] {aka SCA41, TRP3}, PLN (phospholamban) [NCBI Gene 5350] {aka CMD1P, CMH18, PLB}, C11orf96 (chromosome 11 open reading frame 96) [NCBI Gene 387763] {aka AG2}, TNNI3 (troponin I3, cardiac type) [NCBI Gene 7137] {aka CMD1FF, CMD2A, CMH7, RCM1, TNNC1, cTnI}, KCNQ1 (potassium voltage-gated channel subfamily Q member 1) [NCBI Gene 3784] {aka ATFB1, ATFB3, JLNS1, KCNA8, KCNA9, KVLQT1}, TTN (titin) [NCBI Gene 7273] {aka CMD1G, CMH9, CMPD4, CMYO5, CMYP5, EOMFC}, TXN (thioredoxin) [NCBI Gene 7295] {aka TRDX, TRX, TRX1, TXN1, Trx80}, PRRT2 (proline rich transmembrane protein 2) [NCBI Gene 112476] {aka BFIC2, BFIS2, DSPB3, DYT10, EKD1, FICCA}, SOD1 (superoxide dismutase 1) [NCBI Gene 6647] {aka ALS, ALS1, HEL-S-44, IPOA, SOD, STAHP}, NFE2L2 (NFE2 like bZIP transcription factor 2) [NCBI Gene 4780] {aka IMDDHH, NRF2, Nrf-2}, DNAH8 (dynein axonemal heavy chain 8) [NCBI Gene 1769] {aka ATPase, SPGF46, hdhc9}, CAT (catalase) [NCBI Gene 847], TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, HDAC9 (histone deacetylase 9) [NCBI Gene 9734] {aka HD7, HD7b, HD9, HDAC, HDAC7B, HDAC9B}, RBM24 (RNA binding motif protein 24) [NCBI Gene 221662] {aka RNPC6, dJ259A10.1}, MYH14 (myosin heavy chain 14) [NCBI Gene 79784] {aka DFNA4, DFNA4A, FP17425, MHC16, MYH17, NMHC II-C}, DES (desmin) [NCBI Gene 1674] {aka CDCD3, CSM1, CSM2, LGMD1D, LGMD1E, LGMD2R}, MYH7 (myosin heavy chain 7) [NCBI Gene 4625] {aka CMD1S, CMH1, CMYO7A, CMYO7B, CMYP7A, CMYP7B}, ACTC1 (actin alpha cardiac muscle 1) [NCBI Gene 70] {aka ACTC, ASD5, CMD1R, CMH11, LVNC4}, HMOX1 (heme oxygenase 1) [NCBI Gene 3162] {aka HMOX1D, HO-1, HSP32, bK286B10}, JUNB (JunB proto-oncogene, AP-1 transcription factor subunit) [NCBI Gene 3726] {aka AP-1}, CRYAB (crystallin alpha B) [NCBI Gene 1410] {aka CMD1II, CRYA2, CTPP2, CTRCT16, HEL-S-101, HSPB5}, SCN5A (sodium voltage-gated channel alpha subunit 5) [NCBI Gene 6331] {aka CDCD2, CMD1E, CMPD2, HB1, HB2, HBBD}, DNMT1 (DNA methyltransferase 1) [NCBI Gene 1786] {aka ADCADN, AIM, CXXC9, DNMT, HSN1E, MCMT}, TNNC1 (troponin C1, slow skeletal and cardiac type) [NCBI Gene 7134] {aka CMD1Z, CMH13, TN-C, TNC, TNNC}, RBM20 (RNA binding motif protein 20) [NCBI Gene 282996]
- **Diseases:** myocardial contraction (MESH:C536214), Mitochondrial dysfunction (MESH:D028361), myocardial remodeling (MESH:D064752), fibrosis (MESH:D005355), calcium overload (MESH:D019190), sarcomeric defects (MESH:D000013), injury to (MESH:D014947), inflammation (MESH:D007249), ventricular dysfunction (MESH:D018754), pump failure (MESH:D051437), energy deficiency (MESH:D011502), Cardiomyopathy (MESH:D009202), arrhythmia (MESH:D001145), diastolic dysfunction (MESH:D018487), arrhythmic (OMIM:212500), Duchenne muscular dystrophy (MESH:D020388), ischemia (MESH:D007511), ischemia-reperfusion injury (MESH:D015427), Mitochondrial genetic defects (MESH:C565376), cardiomyopathic (MESH:D044542), toxicity (MESH:D064420), end-stage DCM (MESH:D007676), cardiomyocyte hypertrophy (MESH:D006984), DCM (MESH:D002311), Cardiac Dysfunction (MESH:D006331), myopathy (MESH:D009135), HCM (MESH:D002312), cardiac remodeling (MESH:D020257), HF (MESH:D006333), calcium (MESH:D002128), arrhythmogenic right ventricular cardiomyopathy (MESH:D019571), left ventricular non-compaction cardiomyopathy (MESH:D056830), Familial cardiomyopathies (MESH:C536231), sodium channel (MESH:D020513), restrictive cardiomyopathy (MESH:D002313)
- **Chemicals:** lipid peroxides (MESH:D008054), ADP (MESH:D000244), aldosterone (MESH:D000450), vitamin E (MESH:D014810), nitrotyrosine (MESH:C002744), hydroxyl radicals (MESH:D017665), nitric oxide (MESH:D009569), vitamin C (MESH:D001205), 4-HNE (MESH:C027576), disulfide (MESH:D004220), perhexiline (MESH:D010480), trimetazidine (MESH:D014292), H2O2 (MESH:D006861), Ca2+ (-), O2 - (MESH:D013481), MDA (MESH:D008315), GSSG (MESH:D019803), NADP+ (MESH:D009249), thiol (MESH:D013438), OHs (MESH:C031356), lipid (MESH:D008055), cysteine (MESH:D003545), GSH (MESH:D005978), peroxynitrite (MESH:D030421), ATP (MESH:D000255), ROS (MESH:D017382), Calcium (MESH:D002118), glucose (MESH:D005947), RNS (MESH:D011886), NAD+ (MESH:D009243)
- **Species:** Homo sapiens (human, species) [taxon 9606]
- **Mutations:** R403Q, F764L, S532P, 1795insD, m.3243A>G, R141W, R719W, R120G

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12940293/full.md

---
Source: https://tomesphere.com/paper/PMC12940293