Nicotinamide Adenine Dinucleotide in the Development and Treatment of Cardiac Remodeling and Aging

Background: Recently, the beneficial effects of nicotinamide adenine dinucleotide (NAD⁺) as an antiaging and antioxidant molecule have become a focus of research. However, the mechanisms by which NAD⁺ supplementation affects the associated metabolites under physiological conditions remain unclear. Specifically, although NAD⁺ is involved in several processes that are dysregulated in cardiovascular diseases, some effects of NAD⁺ precursors and NAD⁺ on cardiac diseases have started to gain recognition only recently. Objective: To discuss the influence of NAD⁺ supplementation on adverse cardiac remodeling and aging. Results: Supplementation with NAD⁺ precursors or nicotinamide riboside, which enhances or supplements the NAD⁺metabolome, might have a protective effect on the heart. NAD⁺ can alleviate chronic heart failure via mitochondrial oxidation-reduction (redox) state mechanism. Furthermore, NAD⁺ replenishment can improve the life span of mice. Conclusion: NAD⁺ exerts considerable antiaging and antioxidant effects with promising therapeutic effects. However, its effect on humans and its use as a dietary supplement need to be studied further.