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Pharmacologic Therapy of Chronic Heart Failure

  • Therapy in Practice
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Abstract

Over the past 2 decades, investigators have learned more about the pathophysiologic changes that occur in systolic and diastolic dysfunction. Ironically, in some cases, the biologic pathways that have protected the heart during acute dysfunction are the same pathways that cause progressive deleterious effects with chronic activation. In particular, it is the activation of the neurohormonal system that has a significant impact on disease progression. As a result, the neurohormonal system has provided a key target for pharmacologic therapy in patients with heart failure secondary to systolic dysfunction. These targets include the renin-angiotensin-aldosterone system as well as the sympathetic nervous system. Neurohormonal manipulation, however, is often ineffective in the pharmacologic therapy of patients with endstage heart failure, therefore other treatment strategies — including the use of inotropic agents to improve pump function and diuretics to control fluid balance are needed.

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Acknowledgments

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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  1. Advanced Heart Failure and Cardiac Transplant Center at the Jefferson Heart Institute, Jefferson Medical College of Thomas Jefferson University, Mezzanine, 925 Chestnut Street, Philadelphia, Pennsylvania, 19107, USA

    Eman Hamad,  Paul J. Mather, Siva Srinivasan, Sharon Rubin, David J. Whellan & Arthur M. Feldman

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  1. Eman Hamad
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  2. Paul J. Mather
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Correspondence to Paul J. Mather.

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Hamad, E., Mather, P.J., Srinivasan, S. et al. Pharmacologic Therapy of Chronic Heart Failure. Am J Cardiovasc Drugs 7, 235–248 (2007). https://doi.org/10.2165/00129784-200707040-00002

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