title: [Organ-protection therapy. A new therapeutic approach for acute heart failure?].
abstract: Unlike the prolonged benefit produced by the treatment of chronic heart failure, newer drugs tested for the treatment of acute heart failure in the last decade have failed to provide evidence of clinical benefit beyond some improvement in symptom relief. In particular, no drug has shown the ability to reduce the higher medium- and long-term risk of morbidity and mortality in these patients after an episode of decompensation. Current understanding of the pathophysiology of acute heart failure and its consequences has led to the hypothesis that, beyond symptom control, effective therapies for this syndrome should target not only the hemodynamic changes of the initial phase of the syndrome but should also "protect" the organism from the activation of neurohumoral and inflammatory pathways triggered by the decompensation episode, which persist in time and confer a risk of deleterious effects in several organs and tissues. Serelaxin, a new drug related to the peptidic endogenous hormones of the relaxin family, has recently been shown to provide multiple beneficial effects in terms of "organ protection" - not only in the cardiovascular and renal systems - from these acute heart failure-related deleterious changes. This drug has already been tested in acute heart failure patients with encouraging results in terms of medium-term clinical benefit, rendering serelaxin as a serious candidate for first-line, prognosis-modifying therapy in this syndrome.
authors.affiliation: Servicio de Medicina Interna, Unidad de Geriatría, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. Electronic address: dchivite@bellvitgehospital.cat.
authors.forename: David
authors.initials: D
authors.lastname: Chivite
authors.affiliation: Servicio de Medicina Interna, Unidad de Geriatría, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Francesc
authors.initials: F
authors.lastname: Formiga
authors.affiliation: Servicio de Medicina Interna, Unidad de Geriatría, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Corbella
mesh_terms: D000208:Acute Disease; D000577:Amides / Q000627:therapeutic use; D001552:Benzazepines / Q000627:therapeutic use; D059347:Cardio-Renal Syndrome / Q000209:etiology / Q000517:prevention & control; D004280:Dobutamine / Q000627:therapeutic use; D005650:Fumarates / Q000627:therapeutic use; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use; D007249:Inflammation; D053208:Kaplan-Meier Estimate; D015337:Multicenter Studies as Topic; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use; D011379:Prognosis; D011724:Pyridazines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D012065:Relaxin / Q000627:therapeutic use*; D000077464:Simendan; D035703:Therapies, Investigational; D000077602:Tolvaptan
chemical_list: D000577:Amides; D001552:Benzazepines; D005650:Fumarates; D006835:Hydrazones; D011724:Pyridazines; D011994:Recombinant Proteins; C577649:serelaxin protein, human; D020097:Natriuretic Peptide, Brain; D000077602:Tolvaptan; D000077464:Simendan; D004280:Dobutamine; C446481:aliskiren; D012065:Relaxin
keywords: Acute heart failure; Insuficiencia cardíaca aguda; Organ protection; Organoprotección; Relaxin; Relaxina