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Pathophysiology-based novel pharmacotherapy for heart failure with preserved ejection fraction
Dimitrios M Konstantinou1, Yiannis S Chatzizisis, George D Giannoglou
1First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece; Heart Failure Care Group, The Royal Brompton Hospital, London Imperial College, London, UK.
Pharmacology & Therapeutics
|June 25, 2013
Summary
Heart failure with preserved ejection fraction (HFpEF) affects many, lacking effective treatments. This review explores novel therapies targeting HFpEF pathophysiology for better patient outcomes.
Area of Science:
- Cardiology
- Pharmacology
- Internal Medicine
Background:
- Heart failure is a growing global health concern, with heart failure with preserved ejection fraction (HFpEF) accounting for approximately half of cases.
- Patients with HFpEF face high morbidity and mortality due to limited therapeutic options and prevalent comorbidities.
- Current standard treatments for heart failure with reduced ejection fraction (HFrEF), such as beta-blockers and renin-angiotensin-aldosterone system inhibitors, show no significant benefit in HFpEF.
Purpose of the Study:
- To provide an updated, pathophysiology-based review of novel pharmacotherapies for heart failure with preserved ejection fraction (HFpEF).
- To highlight the importance of understanding HFpEF mechanisms for developing new treatments.
Main Methods:
- Literature review focusing on the pathophysiology of HFpEF.
- Analysis of emerging pharmacological interventions based on updated pathophysiologic insights.
Main Results:
- Standard neurohormonal blockade therapies are ineffective for HFpEF.
- Novel therapeutic strategies are being developed based on a deeper understanding of HFpEF pathophysiology.
Conclusions:
- Understanding the intricate pathophysiology of HFpEF is crucial for identifying and developing effective pharmacological interventions.
- Further research into novel therapies targeting specific HFpEF mechanisms holds promise for improving patient outcomes.
Keywords:
ACEiANPARBsBH4BNPDPPDiastolic dysfunctionGCGLP-1HFpEFHFrEFHeart failureLate I(Na)NCXNONOSNa(+)–Ca(2+) exchangerPDEPKAPKGPathophysiologyPharmacotherapyRAASRyR2SERCA2TGF-β1angiotensin II receptor blockersangiotensin converting enzyme inhibitorsatrial natriuretic peptidebrain natriuretic peptidecAMPcGMPcyclic adenosine monophosphatecyclic guanosine monophosphatedipeptidyl-peptidaseglucagon like peptide-1guanylate cyclaseheart failure with preserved ejection fractionheart failure with reduced ejection fractionlate Na(+) currentnitric oxidenitric oxide synthasephosphodiesterasesprotein kinase Aprotein kinase Grenin–angiotensin–aldosterone systemryanodine receptor-2sarcoplasmic reticulum Ca(++) ATPase-isoform 2tetrahydrobiopterintransforming growth factor-β1
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