[New medical therapies for the treatment of systolic heart failure].
Heart failure is characterized by sodium and fluid retention, sympathetic overactivation, parasympathetic withdrawal, vasoconstrictor activation and cytokine elevation. New therapies for heart failure attempt to control neurohormonal activation and limit progressive left ventricular dysfunction. Nesiritide (human B-type natriuretic peptide) is a recently approved new vasodilator that has been given to almost 1000 patients in numerous clinical investigations, it belongs to a new class of heart failure drugs known as natriuretic peptides. Nesiritide decreases pulmonary capillary wedge pressure, systemic vascular resistance, mean right atrial pressure and pulmonary artery pressure, while improving cardiac index, stroke volume and heart failure symptoms. Many endothelin receptor antagonists are in various stages of development. Early clinical studies have demonstrated beneficial cardiovascular hemodynamic effects. Other new drugs for heart failure also include calcium sensitizers, neutral endopeptidase and vasopeptidase inhibitors, aldosteron receptor antagonists, vasopressin antagonists and cytokine inhibitors. All are being actively investigated and many show significant promise as beneficial therapies in the treatment of heart failure.
Andréka
Péter
P
Semmelweis Egyetem, Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Budapest.
Nádházi
Zoltán
Z
Vándor
László
L
Takács
Eszter
E
Szánthó
Gergely
G
Kónya
László
L
Tulassay
Zsolt
Z
D015220:Calcium Channels / Q000187:drug effects; D016207:Cytokines / Q000037:antagonists & inhibitors; D065128:Endothelin Receptor Antagonists; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000494:pharmacology / Q000627:therapeutic use; D015260:Neprilysin / Q000037:antagonists & inhibitors; D010727:Phosphoric Diester Hydrolases / Q000187:drug effects; D013599:Systole; D014667:Vasopressins / Q000037:antagonists & inhibitors
D015220:Calcium Channels; D016207:Cytokines; D065128:Endothelin Receptor Antagonists; D004791:Enzyme Inhibitors; D014667:Vasopressins; D020097:Natriuretic Peptide, Brain; D010727:Phosphoric Diester Hydrolases; D015260:Neprilysin