[New pharmacological approaches in heart failure: should we treat the endothelium?].
Heart failure is associated with endothelial dysfunction, characterized especially by a decreased nitric oxide (NO) production. The main consequences of this dysfunction appear to be: 1) at the coronary level, an altered myocardial perfusion associated with increased cardiac metabolic demand and, 2) at the peripheral level, an increased arterial resistance leading to increased afterload and cardiac work. Such an endothelial dysfunction may thus contribute to aggravate heart failure and represents an important pharmacological target in this disease. Indeed, these endothelial alterations may be reduced by "classic" treatments of heart failure (e.g. inhibitors of the renin angiotensin aldosterone system), as well as more recent approaches (e.g. ivabradine). Moreover, new approaches have been recently developed to specifically target the endothelial NO production, for example via inhibition of protein tyrosine phosphatase 1B, that may ultimately lead to new treatment of heart failure based on endothelial protection.
Richard
Vincent
V
Inserm U644 & CHU de Rouen, Institut de Recherche Biomédicale et IRFMP23, Université de Rouen, France. Vincent.Richard@univ-rouen.fr
Vercauteren
Magali
M
Gomez
Elodie
E
Thuillez
Christian
C
D000818:Animals; D003331:Coronary Vessels / Q000187:drug effects / Q000502:physiology; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology*; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans