Neuroendocrine activation as a target of modern chronic heart failure pharmacotherapy

Acta Pol Pharm. 2011 May-Jun;68(3):307-16.

Abstract

At present, a constant progress in pathophysiology understanding and treatment of the chronic heart failure (CHF) is arising. The current CHF pharmacotherapy is complex, involving factors affecting the renin-angiotensin-aldosterone system (RAAS), beta-blockers, diuretics and vasodilatators. There are also significant efforts to introduce in CHF pharmacology novel therapeutic strategies, based on the other neurohormonal mechanisms activated in CHF. They include vasopressin receptor antagonists (VRA; vaptans), endothelin receptor antagonists (ERA; sentans), agents relating to the natriuretic peptides system (neutral endopeptidase inhibitors; NEPI and vasopeptidase inhibitors; VPI) and anticytokines agents (anti TNF-alpha immunoglobulin or TNF-alpha scavenger receptor; Etanercept). In this article we briefly describe the modem approach to CHF systemic treatment.

Publication types

  • Review

MeSH terms

  • Animals
  • Antidiuretic Hormone Receptor Antagonists
  • Cardiovascular Agents / therapeutic use*
  • Chronic Disease
  • Cytokines / antagonists & inhibitors
  • Cytokines / metabolism
  • Endothelin Receptor Antagonists
  • Heart Failure / drug therapy*
  • Heart Failure / metabolism
  • Heart Failure / physiopathology
  • Hormone Antagonists / therapeutic use
  • Humans
  • Neprilysin / antagonists & inhibitors
  • Neprilysin / metabolism
  • Neurosecretory Systems / drug effects*
  • Neurosecretory Systems / metabolism
  • Neurosecretory Systems / physiopathology
  • Protease Inhibitors / therapeutic use
  • Receptors, Endothelin / metabolism
  • Receptors, Vasopressin / metabolism
  • Renin-Angiotensin System / drug effects
  • Treatment Outcome

Substances

  • Antidiuretic Hormone Receptor Antagonists
  • Cardiovascular Agents
  • Cytokines
  • Endothelin Receptor Antagonists
  • Hormone Antagonists
  • Protease Inhibitors
  • Receptors, Endothelin
  • Receptors, Vasopressin
  • Neprilysin