“…Nitrates are an alternative that might accomplish the same goal of increasing both titin and MyBP-C phosphorylation. The results of the ongoing Nitrate's Effect on Activity Tolerance in Heart Failure with Preserved Ejection Fraction (NEAT) trial of the effects of isosorbide mononitrate on exercise capacity in HFpEF 49 are therefore eagerly anticipated.…”
Section: Implications For Human Disease and Future Directionsmentioning
“…Nitrates are an alternative that might accomplish the same goal of increasing both titin and MyBP-C phosphorylation. The results of the ongoing Nitrate's Effect on Activity Tolerance in Heart Failure with Preserved Ejection Fraction (NEAT) trial of the effects of isosorbide mononitrate on exercise capacity in HFpEF 49 are therefore eagerly anticipated.…”
Section: Implications For Human Disease and Future Directionsmentioning
“…In contrast, there is no tolerance with inorganic nitrite, and, because conversion of nitrite to NO occurs preferentially during exercise, there may be less sodium retention and less risk of excessive BP reduction at rest, which can be problematic in those with HFpEF(15). The effect of organic nitrates on activity tolerance and exercise capacity is currently being investigated in the NEAT-HFpEF (Nitrate's Effect on Activity Tolerance in Heart Failure With Preserved Ejection Fraction) trial(38). LIMITATIONS.…”
Acute sodium nitrite infusion favorably attenuates hemodynamic derangements of cardiac failure that develop during exercise in individuals with HFpEF. Prospective trials testing long-term nitrite therapy in this population are warranted. (Acute Effects of Inorganic Nitrite on Cardiovascular Hemodynamics in Heart Failure With Preserved Ejection Fraction; NCT01932606).
“…These devices capture patients overall daily functional capacity in a more "holistic manner" because they reflect longitudinal changes rather than episodically assessments. The clinical feasibility of activity assessment by wearable accelerometers has already been shown in clinical trials [39].…”
Section: Monitoring Effects Of Therapeutic Interventionsmentioning
Although a large number of pharmaceutical therapies are available to treat cardiovascular diseases like heart failure, in many medical conditions treatment is still not optimal and, therefore, the need for innovative, safe and efficacious drugs is still very high in this indication. Biomarkers are an important tool in the preclinical and clinical drug development process; they allow patient selection for clinical studies as well as therapy monitoring during studies. Biomarker concepts in cardiovascular indications differ very much from those in oncology and are very diverse. The present article gives an overview of the pathomechanisms of heart failure and describes the socioeconomic impact of the disease and the biomarker strategies being applied in the development of new heart failure drugs. The focus lies on protein biomarkers that can be measured in the blood and on functional biomarkers that can be derived from implanted and wearable medical devices.
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