Pharmacologic treatment of chronic systolic heart failure

Past, present, and future

Ishak A. Mansi, Jian Huang, Donna Carden

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

PURPOSE: To review the pharmacologic management of chronic systolic heart failure (HF). EPIDEMIOLOGY: Approximately 550 000 new cases of HF are diagnosed each year with a mortality rate of 20.1 per 100 000 population. REVIEW SUMMARY: Early clinical trials in HF focused on the use of inotropic and antiarrhythmic agents for the most common modes of mortality in chronic systolic HF: progressive pump failure and sudden cardiac death. The fact that these agents not only failed to improve survival but actually increased mortality led to an improved understanding of the neurohormonal compensatory mechanisms operative in HF. This, in turn, led to the current concept that interrupting these compensatory mechanisms improves outcomes in chronic HF. TYPE OF AVAILABLE EVIDENCE: Unstructured review, randomized-controlled clinical trials, cohort studies, case series. GRADE OF AVAILABLE EVIDENCE: Good. CONCLUSION: Early clinical HF trials aimed at reducing direct modes of mortality in HF. Presently, HF trials are chiefly focused on antagonizing the neurohormonal compensatory mechanisms activated in this disorder. Future therapeutic interventions may be directed at strategies to avoid activation of the neurohormonal system altogether.

Original languageEnglish (US)
Pages (from-to)81-89
Number of pages9
JournalAdvanced Studies in Medicine
Volume5
Issue number2
StatePublished - Feb 1 2005

Fingerprint

Systolic Heart Failure
Heart Failure
Mortality
Sudden Cardiac Death
Cohort Studies
Randomized Controlled Trials
Clinical Trials

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pharmacologic treatment of chronic systolic heart failure : Past, present, and future. / Mansi, Ishak A.; Huang, Jian; Carden, Donna.

In: Advanced Studies in Medicine, Vol. 5, No. 2, 01.02.2005, p. 81-89.

Research output: Contribution to journalReview article

@article{0a17ce2575fd4a898bc43a94f89a1bb8,
title = "Pharmacologic treatment of chronic systolic heart failure: Past, present, and future",
abstract = "PURPOSE: To review the pharmacologic management of chronic systolic heart failure (HF). EPIDEMIOLOGY: Approximately 550 000 new cases of HF are diagnosed each year with a mortality rate of 20.1 per 100 000 population. REVIEW SUMMARY: Early clinical trials in HF focused on the use of inotropic and antiarrhythmic agents for the most common modes of mortality in chronic systolic HF: progressive pump failure and sudden cardiac death. The fact that these agents not only failed to improve survival but actually increased mortality led to an improved understanding of the neurohormonal compensatory mechanisms operative in HF. This, in turn, led to the current concept that interrupting these compensatory mechanisms improves outcomes in chronic HF. TYPE OF AVAILABLE EVIDENCE: Unstructured review, randomized-controlled clinical trials, cohort studies, case series. GRADE OF AVAILABLE EVIDENCE: Good. CONCLUSION: Early clinical HF trials aimed at reducing direct modes of mortality in HF. Presently, HF trials are chiefly focused on antagonizing the neurohormonal compensatory mechanisms activated in this disorder. Future therapeutic interventions may be directed at strategies to avoid activation of the neurohormonal system altogether.",
author = "Mansi, {Ishak A.} and Jian Huang and Donna Carden",
year = "2005",
month = "2",
day = "1",
language = "English (US)",
volume = "5",
pages = "81--89",
journal = "Johns Hopkins Advanced Studies in Medicine",
issn = "1530-3004",
publisher = "Galen Publishing LLC",
number = "2",

}

TY - JOUR

T1 - Pharmacologic treatment of chronic systolic heart failure

T2 - Past, present, and future

AU - Mansi, Ishak A.

AU - Huang, Jian

AU - Carden, Donna

PY - 2005/2/1

Y1 - 2005/2/1

N2 - PURPOSE: To review the pharmacologic management of chronic systolic heart failure (HF). EPIDEMIOLOGY: Approximately 550 000 new cases of HF are diagnosed each year with a mortality rate of 20.1 per 100 000 population. REVIEW SUMMARY: Early clinical trials in HF focused on the use of inotropic and antiarrhythmic agents for the most common modes of mortality in chronic systolic HF: progressive pump failure and sudden cardiac death. The fact that these agents not only failed to improve survival but actually increased mortality led to an improved understanding of the neurohormonal compensatory mechanisms operative in HF. This, in turn, led to the current concept that interrupting these compensatory mechanisms improves outcomes in chronic HF. TYPE OF AVAILABLE EVIDENCE: Unstructured review, randomized-controlled clinical trials, cohort studies, case series. GRADE OF AVAILABLE EVIDENCE: Good. CONCLUSION: Early clinical HF trials aimed at reducing direct modes of mortality in HF. Presently, HF trials are chiefly focused on antagonizing the neurohormonal compensatory mechanisms activated in this disorder. Future therapeutic interventions may be directed at strategies to avoid activation of the neurohormonal system altogether.

AB - PURPOSE: To review the pharmacologic management of chronic systolic heart failure (HF). EPIDEMIOLOGY: Approximately 550 000 new cases of HF are diagnosed each year with a mortality rate of 20.1 per 100 000 population. REVIEW SUMMARY: Early clinical trials in HF focused on the use of inotropic and antiarrhythmic agents for the most common modes of mortality in chronic systolic HF: progressive pump failure and sudden cardiac death. The fact that these agents not only failed to improve survival but actually increased mortality led to an improved understanding of the neurohormonal compensatory mechanisms operative in HF. This, in turn, led to the current concept that interrupting these compensatory mechanisms improves outcomes in chronic HF. TYPE OF AVAILABLE EVIDENCE: Unstructured review, randomized-controlled clinical trials, cohort studies, case series. GRADE OF AVAILABLE EVIDENCE: Good. CONCLUSION: Early clinical HF trials aimed at reducing direct modes of mortality in HF. Presently, HF trials are chiefly focused on antagonizing the neurohormonal compensatory mechanisms activated in this disorder. Future therapeutic interventions may be directed at strategies to avoid activation of the neurohormonal system altogether.

UR - http://www.scopus.com/inward/record.url?scp=14844323106&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=14844323106&partnerID=8YFLogxK

M3 - Review article

VL - 5

SP - 81

EP - 89

JO - Johns Hopkins Advanced Studies in Medicine

JF - Johns Hopkins Advanced Studies in Medicine

SN - 1530-3004

IS - 2

ER -