title: The development of new medical treatments for acute decompensated heart failure.
abstract: There were almost 1 million hospitalizations for heart failure in 1999, representing a 155% increase over the last 20 years, and the treatment of these patients is an important and growing problem. However, currently available therapies, which are based on three basic mechanisms of action (diuresis, exogenous vasodilators, and cyclic adenosine monophosphate-dependent positive inotropes), have significant limitations that have encouraged the development of newer agents. The leading medications for this indication are representatives of three different therapeutic approaches, which include endogenous vasodilatory neurohormones (nesiritide), calcium sensitizers (levosimendan), and neurohormonal antagonists (tezosentan). These three agents represent a new generation of therapeutics for this important medical problem and may provide the means not only to treat symptoms, but also to improve longer-term clinical outcomes.
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Teerlink
mesh_terms: D000208:Acute Disease; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage / Q000627:therapeutic use*; D015337:Multicenter Studies as Topic; D045283:Natriuretic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D020097:Natriuretic Peptide, Brain; D010919:Placebos; D011724:Pyridazines / Q000008:administration & dosage / Q000627:therapeutic use*; D011725:Pyridines / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D017466:Receptors, Endothelin / Q000187:drug effects; D000077464:Simendan; D013777:Tetrazoles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D013997:Time Factors; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D045283:Natriuretic Agents; D010919:Placebos; D011724:Pyridazines; D011725:Pyridines; D017466:Receptors, Endothelin; D013777:Tetrazoles; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain; D000077464:Simendan; C120582:tezosentan