Innovative Strategies in Heart Failure: Present and Future

Arch Med Res. 2018 Nov;49(8):558-567. doi: 10.1016/j.arcmed.2018.12.011. Epub 2018 Dec 31.

Abstract

Heart failure (HF) is a progressively debilitating disease that considerably decreases the life expectancy and quality of life. It has become an important area of focus since it remains one of the most common reasons for admission in patients over the age of 65. Importantly, the incidence of HF has not declined within the past 20 years, but the survival after onset has increased in younger patients and men. This has been in part due to the growing interest in therapies that may decrease morbidity, mortality, along with the substantial health care expenditures associated with the disease. It can be said that over the past 50 years, there have been three distinct eras relating to HF management; a) the non-pharmacologic era, focused its treatments on fluid restriction; b) the pharmacologic era, marked by the increased use of inotropes and diuretics and the discovery of vasodilators, and the posterior discovery of medications relating to neurohormonal pathways; c) the device era, with the discovery, acceptance, and increased use of implantable cardioverter defibrillators, cardiac resynchronization therapy (CRT), and left ventricular assist devices (LVADs) among others. A new forth era could be about to arrive, with the advent of regenerative therapies. In this review article will discuss new therapeutic discoveries as well as provide insight into future therapies.

Keywords: Cardiac resynchronization therapy; Heart failure; His bundle pacing; Left ventricular ejection fraction; Sodium glucose cotransporter 2 inhibitor.

Publication types

  • Review

MeSH terms

  • Aged
  • Cardiac Resynchronization Therapy / methods*
  • Cardiotonic Agents / therapeutic use*
  • Defibrillators, Implantable*
  • Diuretics / therapeutic use
  • Female
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Heart Transplantation
  • Hospitalization
  • Humans
  • Life Expectancy
  • Male
  • Quality of Life
  • Regenerative Medicine / methods*
  • Treatment Outcome
  • Vasodilator Agents / therapeutic use

Substances

  • Cardiotonic Agents
  • Diuretics
  • Vasodilator Agents