Management of Patients with Heart Failure: Focus on New Pharmaceutical and Device Options
- 5 August 2020
- journal article
- review article
- Published by Bentham Science Publishers Ltd. in Current Medicinal Chemistry
- Vol. 27 (27) , 4522-4535
Abstract
Hospitalization rates and survival of patients with Heart Failure (HF) have improved. However, 5-year mortality rates remain high and the prevalence of the disease is rising likely due to aging of the population and advances in diagnosis and treatment of other acute and chronic cardiovascular diseases. Over the past three decades the therapeutic armamentarium of heart failure has improved substantially with development of medications targeting neuro-hormonal activation and devices preventing sudden cardiac death and improving cardiac synchrony. Recently, inhibition of angiotensin receptors and neprilysin as well as sinoatrial pacemaker modulating f-current, have been found safe and effective strategies that improve HF hospitalization rates and/or mortality. Antidiabetic agents inhibiting sodium-glucose co-transporters 2, result in natriuresis and osmotic diuresis and may further improve HF related outcomes. Furthermore, emerging therapies such as cardiac myosin activators, soluble guanylate cyclase stimulators and non-steroidal mineralocorticoid receptor antagonists are undergoing investigation in phase II and III studies of HF patients. Finally, rapid evolution of in the management of advanced HF has occurred with the application of second and third generation continuous flow left ventricular assist devices in clinical practice. Ongoing clinical studies will validate the safety and efficacy of emerging therapeutic strategies in HF population underrepresented in previous clinical trials.Keywords
This publication has 76 references indexed in Scilit:
- The cGMP Signaling Pathway as a Therapeutic Target in Heart Failure With Preserved Ejection FractionJournal of the American Heart Association, 2013
- Dual Angiotensin Receptor and Neprilysin Inhibition as an Alternative to Angiotensin-Converting Enzyme Inhibition in Patients with Chronic Systolic Heart Failure: Rationale for and Design of the Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure Trial (PARADIGM-HF)European Journal of Heart Failure, 2013
- Safety and tolerability of the novel non-steroidal mineralocorticoid receptor antagonist BAY 94-8862 in patients with chronic heart failure and mild or moderate chronic kidney disease: a randomized, double-blind trialEuropean Heart Journal, 2013
- Forecasting the Impact of Heart Failure in the United StatesCirculation: Heart Failure, 2013
- A Prospective, Randomized Clinical Trial of Hemodynamic Support With Impella 2.5 Versus Intra-Aortic Balloon Pump in Patients Undergoing High-Risk Percutaneous Coronary InterventionCirculation, 2012
- Ivabradine in heart failure—no paradigm SHIFT…yetThe Lancet, 2010
- Heart rate as a risk factor in chronic heart failure (SHIFT): the association between heart rate and outcomes in a randomised placebo-controlled trialThe Lancet, 2010
- Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled studyThe Lancet, 2010
- Mechanical Circulatory SupportCirculation: Heart Failure, 2008
- Plasma Norepinephrine as a Guide to Prognosis in Patients with Chronic Congestive Heart FailureNew England Journal of Medicine, 1984