الفهرس | Only 14 pages are availabe for public view |
Abstract HF is a major and growing public health problem with an estimated prevalence of 23 million people with HF world-wide. It is a leading cause of morbidity and mortality, it accounts for 5%- 8% of in-hospital mortality. Standard medical therapy of HF includes five classes of drugs: digitalis, diuretics, direct-acting vasodilators, neurohumoral antagonists, and beta-adrenergic receptor blockers. These drugs simply delay the progression of disease, but there are no existing drugs that ”cure” HF. Therefore, there is an ongoing need to develop effective new therapies for the management of this condition that might slow further progression of HF. Several drug classes have been tried in large-scale clinical trials and have approved efficacy. This include, selective aldosterone receptor antagonists, Nesiritide a recombinant form of human BNP, Statins, Erythropoietin analogues Another group of drugs was faltered in clinical trials; it includes Endothelin receptor antagonists, Neutral endopeptidase inhibitors, vasopeptidase inhibitor, Moxonidine; a novel anti-adrenergic agent, cytokine antagonists; infliximab, and etanercept, Pentoxifylline, a xanthine-derived agent, PDE3 inhibitors, adenosine receptor antagonist. There is a group of novel drug classes that have shown promising clinical development. It includes arginine vasopressin antagonists, direct renin inhibitors, and Ivabradine. Another group of drug classes which have shown a challenge in clinical development includes calcium sensitizers, immunomodulation therapy, and xanthine oxidase inhibition. Other novel targets of therapy include modulation of fatty acid and glucose metabolism; advanced glycosylation end-products cross-link breakers, matrix metalloproteinases Inhibitors, copper chelating therapy, and hormone replacement therapy. |