February 1, 2002Annual Review of Medicine
New Therapeutics for Chronic Heart Failure
Population
Patients with chronic heart failure
Design
Review
Authors
Discussion
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Implication
Supports neurohormonal targeting in HF management; leaves open optimal sequencing of emerging agents pending prospective trials.
Key Points
- Review historical cardiorenal and hemodynamic models of chronic heart failure while detailing the biological rationale behind established and emerging neurohormonal therapies.
- Reviewed classic mechanistic frameworks focusing on renal blood flow abnormalities, fluid retention, reduced cardiac output, and peripheral vasoconstriction.
- Evaluated the modern neurohormonal model of disease progression and its role in guiding therapeutic development.
- Heart failure paradigm has shifted from managing fluid retention and mechanical hemodynamics to counteracting the toxic effects of overactivated endogenous biological systems.
- Emerging therapies focus on targeting specific neurohormonal pathways to halt or reverse progressive cardiac dysfunction.
Structured PICO
P
Population
Patients with chronic heart failure
I
Intervention
Existing and emerging heart failure therapies
This review highlights the paradigm shift in heart failure management towards a neurohormonal model and discusses the rationale for current and emerging therapies.
Cite This Study
Mann et al. (2002) studied this question.