The role of oxidative stress in the onset and progression of heart failure has been extensively studied. Pre-clinical studies showed promising results with various anti-oxidative strategies, but these beneficial effects did not translate into positive results in clinical studies in patients with heart failure. This might be caused by inadequate patient inclusion criteria or offtarget effects of currently employed therapies.
Therefore, we believe there is still room for novel antioxidant approaches in heart failure. In particular, targeting the endogenous antioxidant capacity might be interesting new targets in the treatment of heart failure. Of interest would be the development of medications capable of interacting with the components of the 𝛾-glutamyl cycle or NAD+ production, which may lead to novel treatment options for heart failure in the future.