title: Overview of emerging pharmacologic agents for acute heart failure syndromes.
abstract: BACKGROUND
  Several therapies commonly used for the treatment of acute heart failure syndromes (AHFS) present some well-known limitations and have been associated with an early increase in the risk of death. There is, therefore, an unmet need for new pharmacologic agents for the early management of AHFS that may improve both short- and long-term outcomes.
  
  
  OBJECTIVE
  To review the recent evidence on emerging pharmacologic therapies in AHFS.
  
  
  METHODS
  A systematic search of peer-reviewed publications was performed on MEDLINE, EMBASE and Clinical Trials.gov from January 1990 to August 2007. The results of unpublished or ongoing trials were obtained from presentations at national and international meetings and pharmaceutical industry releases. Bibliographies from these references were also reviewed, as were additional articles identified by content experts.
  
  
  RESULTS
  Cumulative data from large studies and randomised trials suggest that therapies with innovative mechanisms of action may safely and effectively reduce pulmonary congestion or improve cardiac performance in AHFS patients.
  
  
  CONCLUSIONS
  Some investigational agents for the management of AHFS are able to improve haemodynamics and/or clinical status. In spite of these promising findings, no new agent has demonstrated a clear benefit in terms of long-term clinical outcomes compared to placebo or conventional therapies.
authors.affiliation: Department of Cardiovascular Sciences, European Hospital, Rome, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: De Luca
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mebazaa
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Filippatos
authors.forename: John T
authors.initials: JT
authors.lastname: Parissis
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Voors
authors.forename: Markku
authors.initials: M
authors.lastname: Nieminen
authors.forename: Faiez
authors.initials: F
authors.lastname: Zannad
authors.forename: Andrew
authors.initials: A
authors.lastname: Rhodes
authors.forename: Ali
authors.initials: A
authors.lastname: El-Banayosy
authors.forename: Kenneth
authors.initials: K
authors.lastname: Dickstein
authors.forename: Mihai
authors.initials: M
authors.lastname: Gheorghiade
mesh_terms: D000241:Adenosine / Q000037:antagonists & inhibitors; D002317:Cardiovascular Agents / Q000494:pharmacology / Q000627:therapeutic use; D019332:Endothelin-1 / Q000037:antagonists & inhibitors; D005043:Etiocholanolone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006835:Hydrazones / Q000494:pharmacology / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use; D010480:Perhexiline / Q000494:pharmacology / Q000627:therapeutic use; D011724:Pyridazines / Q000494:pharmacology / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000077464:Simendan; D000254:Sodium-Potassium-Exchanging ATPase / Q000037:antagonists & inhibitors; D013577:Syndrome; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D002317:Cardiovascular Agents; D019332:Endothelin-1; D006835:Hydrazones; D011724:Pyridazines; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain; D000077464:Simendan; D005043:Etiocholanolone; D000254:Sodium-Potassium-Exchanging ATPase; D000241:Adenosine; D010480:Perhexiline; C468128:Istaroxime