[New therapy concepts for heart failure with preserved ejection fraction]

Area of Science:

• Cardiology
• Pharmacology
• Biomedical Research

Background:

• Heart failure with preserved ejection fraction (HFpEF) management is challenging, with no established survival-prolonging therapies.
• Current HFpEF management focuses on symptom control, fluid retention, heart rate, and comorbidity management.
• Emerging research highlights the nitric oxide-cyclic guanosine monophosphate-protein kinase (NO-cGMP-PK) pathway's dysregulation in HFpEF.

Purpose of the Study:

• To review current challenges and emerging therapeutic strategies for HFpEF.
• To discuss novel drug targets and mechanisms implicated in HFpEF.
• To present preclinical and early-phase studies investigating new HFpEF interventions.

Main Methods:

• Review of recent advancements in HFpEF research and clinical investigations.
• Discussion of drugs targeting the NO-cGMP-PK pathway, including LCZ 696 and vericiguat.
• Exploration of preclinical studies on matrix, intracellular calcium, energy regulation, microRNAs, and devices.

Main Results:

• No definitive survival-prolonging therapy for HFpEF is currently established.
• LCZ 696 (neprilysin inhibitor) and vericiguat (soluble guanylate cyclase stimulator) are under investigation for their potential to modulate the NO-cGMP-PK pathway.
• Ongoing research explores novel mechanisms and devices for HFpEF treatment.

Conclusions:

• Effective management of HFpEF requires addressing fluid balance, heart rate, and comorbidities to enhance quality of life.
• Targeting the NO-cGMP-PK pathway represents a promising avenue for future HFpEF therapies.
• Further research into novel mechanisms and interventions is crucial for developing effective HFpEF treatments.