Current limitations in treatment of heart failure: new avenues and treatment options.
Chronic heart failure is one of the main causes of death in western countries. Despite state-of-the-art treatment including angiotensin-converting enzyme inhibitors, beta-blockers, and spironolactone, survival and relief from symptoms still are unacceptably poor in patients with chronic heart failure. The present article gives an overview of current limitations in the treatment of heart failure and points out possible treatment options in the future. It seems possible to reduce or at least delay progression of heart failure by adding drugs that interfere with novel pathophysiologic aspects in heart failure activation of the neuroendocrine system, including catecholamines, angiotensin II, cytokines, and endothelins, as well as alteration of calcium homeostasis and energy depletion.
Drexler
Helmut
H
Medizinische Hochschule Hannover, Germany. Drexler.Helmut@MH-Hannover.de
Fuchs
Martin
M
D000251:Adenosine Triphosphatases / Q000378:metabolism; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002135:Calcium-Binding Proteins / Q000627:therapeutic use; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004734:Energy Metabolism / Q000502:physiology; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D012519:Sarcoplasmic Reticulum / Q000187:drug effects / Q000201:enzymology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D000099211:Phospholamban
D000251:Adenosine Triphosphatases; D000806:Angiotensin-Converting Enzyme Inhibitors; D002135:Calcium-Binding Proteins; D014409:Tumor Necrosis Factor-alpha; D000099211:Phospholamban