Article ; Online: Recent advances in the pharmacological therapy of chronic heart failure: Evidence and guidelines.
2022 Volume 238, Page(s) 108185
Abstract: Heart failure (HF) is a clinical syndrome with symptoms and or signs caused by a structural and/or functional cardiac abnormality and associated with elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion. It is ...
| Abstract | Heart failure (HF) is a clinical syndrome with symptoms and or signs caused by a structural and/or functional cardiac abnormality and associated with elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion. It is classified according to left ventricular ejection fraction (LVEF): HF with reduced EF (HFrEF) with an LVEF of ≤40%, HF with mildly reduced EF (HFmrEF) with an LVEF of 41 to 49%, HF with preserved EF (HFpEF) with an LVEF of ≥50%, and HF with improved EF (HFimpEF) with a baseline LVEF of ≤40%, a ≥ 10% increase from baseline LVEF, and a second measurement of LVEF of >40%. Despite the remarkable progress in the management of HF over the past decades, its prognosis is still poor with higher rates of mortality and hospitalization due to worsening HF. Therefore, the development of novel strategies including pharmacologic therapy is needed to further improve its prognosis. Recent large-scale clinical trials have demonstrated the efficacy of newer pharmacological agents including angiotensin II receptor/neprilysin inhibitor (ARNI), sacubitril/valsartan, type 2 sodium-glucose cotransporter (SGLT2) inhibitors, dapagliflozin, empagliflozin and sotagliflozin, and soluble guanylyl cyclase (sGC) stimulator, vericiguat, and cardiac myosin activator, omecamtiv mecarbil. This review focuses the recent advances in the pharmacological agents for treatment of chronic heart failure, including their mechanisms of action, the evidence based on the clinical trials, and the guideline recommendations for their use. |
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| MeSH term(s) | Aminobutyrates ; Biphenyl Compounds ; Cardiac Myosins/therapeutic use ; Chronic Disease ; Glucose ; Heart Failure ; Humans ; Neprilysin ; Receptors, Angiotensin/therapeutic use ; Sodium/therapeutic use ; Sodium-Glucose Transporter 2 ; Soluble Guanylyl Cyclase/therapeutic use ; Stroke Volume ; Valsartan/therapeutic use ; Ventricular Function, Left |
| Chemical Substances | Aminobutyrates ; Biphenyl Compounds ; Receptors, Angiotensin ; Sodium-Glucose Transporter 2 ; sacubitril (17ERJ0MKGI) ; Valsartan (80M03YXJ7I) ; Sodium (9NEZ333N27) ; Neprilysin (EC 3.4.24.11) ; Cardiac Myosins (EC 3.6.1.-) ; Soluble Guanylyl Cyclase (EC 4.6.1.2) ; Glucose (IY9XDZ35W2) |
| Language | English |
| Publishing date | 2022-04-09 |
| Publishing country | England |
| Document type | Journal Article ; Review |
| ZDB-ID | 194735-7 |
| ISSN | 1879-016X ; 0163-7258 |
| ISSN (online) | 1879-016X |
| ISSN | 0163-7258 |
| DOI | 10.1016/j.pharmthera.2022.108185 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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