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Current and future therapeutic perspective in chronic heart failure
Annamaria Mascolo1, Gabriella di Mauro1, Donato Cappetta2
1Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Via Costantinopoli 16, 80138 Naples, Italy; Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy.
Pharmacological Research
|December 16, 2021
Summary
Heart failure with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF) lack effective treatments. Emerging therapies targeting the Renin-Angiotensin-Aldosterone System (RAAS) and SGLT2 inhibitors show promise for these heart failure types.
Area of Science:
- Cardiology
- Pharmacology
- Translational Medicine
Background:
- Heart failure incidence is declining, except for HFpEF, due to lack of effective treatments.
- HFmrEF lacks specific treatments and dedicated clinical trials.
- Current guidelines recommend RAAS blockers, beta-blockers, and MRAs for HFrEF, but not HFpEF/HFmrEF.
Purpose of the Study:
- To review heart failure pathophysiology.
- To summarize current pharmacological treatments for different heart failure phenotypes.
- To discuss emerging therapeutic strategies for HFpEF and HFmrEF.
Main Methods:
- Literature review and synthesis of current research on heart failure pathophysiology and treatment.
- Analysis of existing clinical trial data and treatment guidelines.
- Exploration of novel drug classes and therapeutic targets.
Main Results:
- RAAS blockers and ARNI are effective in HFrEF but not HFpEF.
- HFpEF and HFmrEF represent a significant unmet medical need.
- Stimulators of the non-classic RAAS and SGLT2 inhibitors are potential therapeutic avenues.
Conclusions:
- There is a critical need for novel treatments for HFpEF and HFmrEF.
- Targeting the ACE2/Angiotensin-(1-7) pathway and SGLT2 inhibition offers promising therapeutic alternatives.
- Further research and clinical trials are essential to validate new heart failure therapies.
Keywords:
Chronic heart failureHeart failure with preserved ejection fractionRenin-angiotensin-aldosterone systemTherapeutic perspectiveTreatmentMore Related Videos
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