Project description:With the total cases and economic burden of heart failure continuing to rise, there is an overwhelming need for novel therapies. Several drugs for heart failure have succeeded in preclinical and early-phase clinical trials, but most of them failed to show the real benefit in pivotal clinical trials. Meanwhile, the US Food and Drug Administration recently approved two promising new drugs to treat heart failure: ivabradine and sacubitril/valsartan. Furthermore, some of the newer agents in testing offer the potential for significant progress in addition to these drugs. Patiromer and zirconium cyclosilicate are attractive agents that are expected to prevent hyperkalemia during renin-angiotensin-aldosterone system inhibition, and serelaxin and urodilatin are promising drugs in the treatment of acute heart failure. Future clinical trials with more appropriate study designs, optimal clinical endpoints, and proper patient selection are mandatory to assess the true efficacy of these attractive compounds in clinical practice.

| S-EPMC4754001 | biostudies-literature

Update on heart failure management and future directions.

Project description:Heart failure (HF) is an important cardiovascular disease because of its increasing prevalence, significant morbidity, high mortality, and rapidly expanding health care cost. The number of HF patients is increasing worldwide, and Korea is no exception. There have been marked advances in definition, diagnostic modalities, and treatment of HF over the past four decades. There is continuing effort to improve risk stratification of HF using biomarkers, imaging and genetic testing. Newly developed medications and devices for HF have been widely adopted in clinical practice. Furthermore, definitive treatment for end-stage heart failure including left ventricular assist device and heart transplantation are rapidly evolving as well. This review summarizes the current state-of-the-art management for HF and the emerging diagnostic and therapeutic modalities to improve the outcome of HF patients.

| S-EPMC6325445 | biostudies-literature

Gene transfer for congestive heart failure: update 2013.

Project description:Congestive heart failure is a major cause of morbidity and mortality with increasing social and economic costs. There have been no new high impact therapeutic agents for this devastating disease for more than a decade. However, many pivotal regulators of cardiac function have been identified using cardiac-directed transgene expression and gene deletion in preclinical studies. Some of these increase function of the failing heart. Altering the expression of these pivotal regulators using gene transfer is now either being tested in clinical gene transfer trials, or soon will be. In this review, we summarize recent progress in cardiac gene transfer for clinical congestive heart failure.

| S-EPMC3602385 | biostudies-literature

Recent advances in pharmacological treatment of heart failure.

Project description:BackgroundOver the last years, several trials offered new evidence on heart failure (HF) treatment.Design and resultsFor HF with reduced left ventricular ejection fraction, type 2 sodium-glucose cotransporter inhibitors, aside from sacubitril-valsartan, demonstrated extraordinary efficacy in ameliorating patients' prognosis. Some new molecules (eg vericiguat, omecamtiv mecarbil and ferric carboxymaltose) correct iron deficiency and have shown to be capable of furthering reducing the burden of HF hospitalisation. Finally, there is new evidence on the possible therapeutic approaches of HF patients with mid-range or preserved left ventricular ejection fraction.ConclusionsThis review aimed to revise the main novelties in the field of HF therapy and focus on how the daily clinical approach to patient treatment is changing.

| S-EPMC8596398 | biostudies-literature

Editorial: Advances in the imaging and treatment of valvular heart disease: "rising to the challenge".

Project description: Not available

| S-EPMC10513464 | biostudies-literature

Heart Failure with Preserved Ejection Fraction: a Pharmacotherapeutic Update.

Project description:While guidelines for management of heart failure with reduced ejection fraction (HFrEF) are consensual and have led to improved survival, treatment options for heart failure with preserved ejection fraction (HFpEF) remain limited and aim primarily for symptom relief and improvement of quality of life. Due to the shortage of therapeutic options, several drugs have been investigated in multiple clinical trials. The majority of these trials have reported disappointing results and have suggested that HFpEF might not be as simply described by ejection fraction as previously though. In fact, HFpEF is a complex clinical syndrome with various comorbidities and overlapping distinct phenotypes that could benefit from personalized therapeutic approaches. This review summarizes the results from the most recent phase III clinical trials for HFpEF and the most promising drugs arising from phase II trials as well as the various challenges that are currently holding back the development of new pharmacotherapeutic options for these patients.

| S-EPMC8801287 | biostudies-literature

Editorial: Transitional Care Clinics to Reduce 30-day Readmissions in Heart Failure Patients.

Project description:Heart failure (HF) is one of the most prevalent chronic diseases in the United States (U.S.), with an estimated prevalence of five million patients in the U.S. and an annual healthcare cost of greater than 30 billion dollars. Readmission rates for HF patients are astronomically high, with up to 25% of hospitalized patients with HF requiring readmission within 30 days of discharge. The Hospital Readmissions Reduction Program (HRRP) of the Patient Protection and Affordable Care Act aims to address these concerns by financially penalizing institutions with unacceptably high risk-adjusted 30-day readmission rates for HF patients. The introduction of the HRRP contributed to increased efforts of healthcare systems to reduce their 30-day readmission rates, often by the utilization of "transitional care clinics." Although the motivation for the creation of these programs is understandable, there exists a paucity of robust clinical trials supporting the efficacy of these programs to reduce 30-day readmission rates for HF patients. There is even less evidence to support the use of these programs in the unique healthcare environment of the U.S. Large, multicenter randomized controlled trials should be conducted to evaluate these interventions before more resources are dispersed toward their implementation. Alternatively, resources could be used to evaluate other interventions that may be more efficacious at reducing 30-day readmissions, such as implantable hemodynamic monitoring devices.

| S-EPMC5854320 | biostudies-literature

Advances in the Genetics and Genomics of Heart Failure.

Project description:Purpose of reviewThe purpose of this review is to provide an update on the recent advances in the genetics and genomics of dilated cardiomyopathy and heart failure.Recent findingsOver the last decade, the approach to the discovery of the genetic contribution to heart failure has evolved from investigation of rare variants implicated in Mendelian cardiomyopathies through linkage studies and candidate gene studies to the exploration of the contribution of common variants through large-scale genome-wide association and genome-first studies. The combination and integration of multiple of case-control heart failure cohorts, refinement of the heart failure phenotype, and utilization of large biobanks linked to electronic health records have advanced the understanding of the heritability of heart failure.

| S-EPMC7713504 | biostudies-literature

Editorial: Recent advances in medical radiation technology.

Project description: Not available

| S-EPMC10808739 | biostudies-literature