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Related Concept Videos

Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
35
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

305
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
305
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

282
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
282
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

30
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
30
Hormonal Regulation01:33

Hormonal Regulation

32.7K
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
32.7K
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

440
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
440

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Related Experiment Video

Updated: May 11, 2025

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

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Focus on finerenone: the FINEARTS-HF study.

Stefano Tolone1, Maria Denitza Tinti2, Giovanni Pulignano1

  • 1UOC Cardiology, Cardio-Thoracic-Vascular Department, San Camillo Forlanini Hospital, Rome, Italy.

European Heart Journal Supplements : Journal of the European Society of Cardiology
|April 18, 2025
PubMed
Summary
This summary is machine-generated.

Mineralocorticoid receptor antagonists (MRAs) like finerenone significantly reduce heart failure events in patients with mildly reduced or preserved ejection fraction. This study highlights finerenone

Keywords:
FinerenoneHFmrEFHFpEF

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Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Mineralocorticoid receptor (MR) blockade is standard for heart failure with reduced ejection fraction (HFrEF).
  • Benefits of MR blockade are less clear for heart failure with mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF).
  • Previous studies like TOPCAT showed limited efficacy in these HF subtypes.

Purpose of the Study:

  • To evaluate the efficacy and safety of the non-steroidal MR antagonist finerenone in patients with HFmrEF or HFpEF.
  • To assess finerenone's impact on cardiovascular death and worsening heart failure (WHF) events.

Main Methods:

  • The FINEARTS-HF study enrolled patients with HFmrEF or HFpEF.
  • Participants received the non-steroidal MR antagonist finerenone.
  • The primary endpoint was a composite of cardiovascular death and WHF events.

Main Results:

  • Finerenone significantly reduced the primary composite endpoint, mainly due to a decrease in total WHF events.
  • Efficacy was consistent across the full left ventricular ejection fraction (LVEF) spectrum.
  • Benefits were observed regardless of concomitant therapies (e.g., SGLT2 inhibitors), sex, or age, with early onset.

Conclusions:

  • The non-steroidal MR antagonist finerenone demonstrates significant efficacy in reducing heart failure events in patients with HFmrEF and HFpEF.
  • Finerenone shows a favorable safety and tolerability profile.
  • These findings support finerenone as a potential new therapeutic option for a broader range of heart failure patients.