title: Review of vasodilators in acute decompensated heart failure: the old and the new.
abstract: Despite substantial improvements in treatment for chronic heart failure, morbidity and mortality for acute decompensated heart failure (ADHF) remain high. Treatment of ADHF is focused on controlling symptoms rather than improving long-term outcomes. The vasodilators nitroglycerin (NTG) and sodium nitroprusside (SNP) have been used in ADHF for decades, but, since the development of nesiritide 10 years ago, interest in new vasodilators has grown. Therapies that improve not only hemodynamics and symptoms but also long-term outcomes are in high demand, and numerous new vasodilatory agents have been investigated, including various natriuretic peptides, soluble guanylyl cyclase agents, renin-angiotensin-aldosterone system-modifying agents, and others. A review of the literature shows that few of them rise to the challenge set by NTG and SNP.
authors.affiliation: Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA. carl2452@umn.edu
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Carlson
authors.forename: Peter M
authors.initials: PM
authors.lastname: Eckman
mesh_terms: D000208:Acute Disease; D000818:Animals; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents
keywords: Nitroglycerin; natriuretic peptide; sodium nitroprusside