title: Novel Therapies for Heart Failure　- Where Do They Stand?
abstract: Despite advances in therapy, patients with heart failure (HF) continue to experience unacceptably high rates of hospitalization and death, as well as poor quality of life. As a consequence, there is an urgent need for new treatments that can improve the clinical course of the growing worldwide population of HF patients. Serelaxin and ularatide, both based on naturally occurring peptides, have potent vasodilatory as well as other effects on the heart and kidneys. For both agents, phase 3 studies that are designed to determine whether they improve outcomes in patients with acute HF have completed enrollment. TRV027, a biased ligand for the type 1 angiotensin receptor with effects that extend beyond traditional angiotensin-receptor blockers is also being studied in the acute HF population. Omecamtiv mecarbil, an inotropic agent that improves myocardial contractility by a novel mechanism, and vericiguat, a drug that stimulates soluble guanylate cyclase, are both being developed to treat patients with chronic HF. Finally, despite the negative results of the CUPID study, gene transfer therapy continues to be explored as a means of improving the function of the failing heart. The basis for the use of these drugs and their current status in clinical trials are discussed. (Circ J 2016; 80: 1882-1891).
authors.affiliation: University of California, San Diego.
authors.forename: Barry
authors.initials: B
authors.lastname: Greenberg
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D009320:Atrial Natriuretic Factor / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006321:Heart / Q000503:physiopathology; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007668:Kidney; D009842:Oligopeptides / Q000009:adverse effects / Q000627:therapeutic use*; D010446:Peptide Fragments / Q000009:adverse effects / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012065:Relaxin / Q000009:adverse effects / Q000627:therapeutic use*; D014664:Vasodilation / Q000187:drug effects
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D009842:Oligopeptides; D010446:Peptide Fragments; D011994:Recombinant Proteins; C577649:serelaxin protein, human; C056452:Ularitide; D009320:Atrial Natriuretic Factor; D012065:Relaxin; C555534:Sar-Arg-Val-Tyr-Ile-His-Pro-Ala-OH