Current and Future Therapeutic Agents in the Man—agement of Heart Failure

Congestive heart failure is a disease in which initially compensatory changes in car-diac, vascular, and renal functions become detrimental over time. The changes are mediated bg a largenumber of neurohormones and cytokines. Counter-regulatory hormones also play a role, but are general-ly insufficient to offset the adverse effects of the neurohormones or progression of the disease. Symp-toms of heart failure occurs in the presence of systolic dysfunction, usually documented by a decrease inejection fraction, or can present with impaired diastolic function occasionally labeled as heart failurewith preserved systolic function of the left ventricle. Heart failure and its treatment represent a medicalproblem of significant importance because of the high mortality associated with it despite the current ther-apy, which has substantial evidence of reduction in mortality and morbidity. Prevention or slowing of theprogressive deterioration in function of the heart and other organs involved through utilizing new

Current and Future Therapeutic Agents in the Management of Heart Failure

Congestive heart failure is a disease in which initially compensatory changes in cardiac , vascular, and renal functions become detrimental over time. The changes are mediated by a large number of neurohormones and cytokines. Counter-regulatory hormones also play a role, but are generally insufficient to offset the adverse effects of the neurohormones or progression of the disease. Symptoms of heart failure occurs in the 'presence of systolic dysfunction, usually documented by a decrease in ejection fraction, or can present with impaired diastolic function occasionally labeled as heart failure with preserved systolic function of the left ventricle. Heart failure and its treatment represent a medical problem of significant importance because of the high mortality associated with it despite the current therapy , which has substantial evidence of reduction in mortality and morbidity. Prevention or slowing of the progressive deterioration in function of the heart and other organs involved through utilizing new agents that affect more or different neurohormonal pathways may be beneficial and forms the focus of heart failure research and drug development. However , the multiplicity of hormonal effects mandate the use of complex therapy in the management of congestive heart failure(CHF). The new agents in addition to the conventional therapy used in the management of heart failure are; Human B-type nalriuretic peptide (in the treatment of decompensated CHF) , endothelin receptor antagonists, calcium sensitizers, neutral endopeptidase (NEP) and vasopeptidase inhibitors, vasopressin antagonists and cytokine inhibitors.