title: New medical therapies for heart failure.
abstract: Heart failure (HF) can rightfully be called the epidemic of the 21(st) century. Historically, the only available medical treatment options for HF have been diuretics and digoxin, but the capacity of these agents to alter outcomes has been brought into question by the scrutiny of modern clinical trials. In the past 4 decades, neurohormonal blockers have been introduced into clinical practice, leading to marked reductions in morbidity and mortality in chronic HF with reduced left ventricular ejection fraction (LVEF). Despite these major advances in pharmacotherapy, our understanding of the underlying disease mechanisms of HF from epidemiological, clinical, pathophysiological, molecular, and genetic standpoints remains incomplete. This knowledge gap is particularly evident with respect to acute decompensated HF and HF with normal (preserved) LVEF. For these clinical phenotypes, no drug has been shown to reduce long-term clinical event rates substantially. Ongoing developments in the pharmacotherapy of HF are likely to challenge our current best-practice algorithms. Novel agents for HF therapy include dual-acting neurohormonal modulators, contractility-enhancing agents, vasoactive and anti-inflammatory peptides, and myocardial protectants. These novel compounds have the potential to enhance our armamentarium of HF therapeutics.
authors.affiliation: Department of Cardiology, Oslo University Hospital Ullevål, 0407 Oslo, Norway.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: von Lueder
authors.affiliation: Monash Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Krum
mesh_terms: D000577:Amides / Q000008:administration & dosage; D000613:Aminobutyrates / Q000008:administration & dosage; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage; D001713:Biphenyl Compounds; D004077:Digoxin / Q000008:administration & dosage; D004338:Drug Combinations; D005650:Fumarates / Q000008:administration & dosage; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D045265:Natriuretic Peptides / Q000008:administration & dosage; D010446:Peptide Fragments / Q000008:administration & dosage; D012910:Snake Venoms / Q000008:administration & dosage; D013777:Tetrazoles / Q000008:administration & dosage; D000068756:Valsartan
chemical_list: D000577:Amides; D000613:Aminobutyrates; D001713:Biphenyl Compounds; D004338:Drug Combinations; D005650:Fumarates; D045265:Natriuretic Peptides; D010446:Peptide Fragments; D012910:Snake Venoms; D013777:Tetrazoles; C446481:aliskiren; D004077:Digoxin; C056452:Ularitide; D000068756:Valsartan; D009320:Atrial Natriuretic Factor; C575835:cenderitide; C549068:sacubitril and valsartan sodium hydrate drug combination