[Gene therapy for heart failure]

Pharmacological, device, and surgical therapies can be used in the management of heart failure. Because those conventional therapies are not effective in patients with the most severe heart failure, gene therapy is expected to become a viable alternative. The molecular pathways that contribute to the development of heart failure have been clarified in recent years. Specific molecular interventions have been evaluated in heart failure models, and the results indicate the potential for gene transfer strategies that are customized to target the individual molecular defects responsible for heart failure. Gene transfer studies have shown that modulating calcium homeostasis, manipulating beta-adrenergic receptor signaling, and augmenting cardiomyocyte resistance to apoptosis can be expected to be useful therapeutic modalities.