The treatment of heart failure—what next?

Abstract

1 Despite demonstrable benefits in terms of symptomatic relief and improvement in prognosis, even the best treatments of heart failure currently available fall short of being ideal. We review the basis for newer approaches to the treatment of heart failure and discuss some of the agents which capitalize on current understanding of the underlying patho-physiology. 2 Several drugs, old and new, are presently being investigated by major clinical trials.We also consider some of the difficulties related to the design and conduct of such trials and suggest how drugs might be better assessed in the future.Keywords heart failure medical therapyIn recent years there have been considerable advances in the treatment of cardiac failure and in the understanding of the mechanisms underlying the syndrome. This paper reviews the salient features of the important clinical trials to date and the rationale behind the use of the drugs most recently developed for the treatment of heart failure. We shall also consider the prospects for possible new treatments and the design of future trials.

Acute and chronic effects of flosequinan on resting and exercise haemodynamics in congestive heart failure

“…Despite these advances up to 40% of patients optimally treated may die within 4 years [2] and the use of ACE inhibitors may be limited by renal dysfunction, hyperkalaemia and other side effects. For these reasons further extensive trials of treatment for heart failure are planned or underway [9] using new or combined treatments.…”