Vnitr Lek 2019, 65(10):611-619 | DOI: 10.36290/vnl.2019.107

Innovations in pharmacological treatment of heart failure

Jiří Vítovec1,*, Jindřich ©pinar2, Lenka ©pinarová1
1 I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně
2 LF MU, Brno

The main goal of the heart failure treatment is the decrease of mortality and morbidity, especially improvement of quality of life and decrease of hospitalisations. ACE inhibitors are the cornerstone of the treatment, MRA should be added to ACEI. Angiotensin receptor blockers (ARB) are indicated in the case of ACE inhibitors intolerance. Betablockers in maximal tolerated doses should be added to the renin angiotensin blockade. Diuretics are given to the symptoms relieve - dyspnoe or oedema. Digoxin is indicated in selected patients. There are 3 new promising groups of drugs: (1) Angiotensin Receptor-Neprilysin Inhibitor - ARNI - Sacubitril/Valsartan can replace the ACEI according to the results of the PARADIGM-HF trial. (2) Sodium-glucose co-transporter-2 (SGLT2) inhibitors in patients with diabetes mellitus. (3) A hughe clinical research is done with omecamtiv mecarbil and others perspective drugs.

Keywords: ACE inhibitors; heart failure; inhibitors SGLT2; new drugs; omecamtiv mecarbil; pharmacotherapy; sacubitril, valsartan

Received: March 13, 2019; Accepted: September 23, 2019; Published: October 1, 2019  Show citation

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Vítovec J, ©pinar J, ©pinarová L. Innovations in pharmacological treatment of heart failure. Vnitr Lek. 2019;65(10):611-619. doi: 10.36290/vnl.2019.107.
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    References

    1. Ponikowski P, Voors AA, Anker SD et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016; 37(27): 2129-2200. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehw128>. Erratum in Erratum [Eur Heart J 2018]. Go to original source... Go to PubMed...
    2. ©pinar J, Hradec J, ©pinarová L et al. Summary of the 2016 ESC Guidelines on the diagnosis and treatment of acute and chronic heart failure. Prepared by the Czech Society of Cardiology. Cor Vasa 2016; 58(5): e530-e568. Dostupné z DOI: <http://dx.doi.org/10.1016/j.crvasa.2016.09.004>. Go to original source...
    3. Souček F, Novák J. Novinky v léčbě srdečního selhání. Vnitř Lék 2017; 63(4): 255-264. Go to original source... Go to PubMed...
    4. Pfeffer MA, Swedberger K, Granger CB et al. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM - Overall programme. Lancet 2003; 362(9386): 759-766. Dostupné z DOI: <http://dx.doi.org/10.1016/s0140-6736(03)14282-1>. Go to original source... Go to PubMed...
    5. Vítovec J. Vazodilatační léčba aneb 20 let klinických studií srdečního selhání. Cor Vasa 2006; 48(11): 373-375. Dostupné z DOI: <http://dx.doi.org/10.33678/cor.2006.121>. Go to original source...
    6. McMurray JJV, Packer M, Desai AS et al. Angiotensin-Neprilysin Inhibition versus Enalapril in Heart Failure. N Engl J Med 2014; 371(11): 993-1004. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1409077>. Go to original source... Go to PubMed...
    7. ©pinar J, ©pinarová L, Vítovec J. Studie PARADIGM-HF moľná změní léčbu srdečního selhání? Hypertenze a KV prevence 2014; 3(2): 25-26.
    8. ©pinarová L, ©pinar J, Vítovec L. Co nám přináąí studie PARADIGM-HF. Kardiol Rev Int Med 2014; 16(5): 395-397.
    9. Kvapil M. EMPA REG OUTCOME. Důkaz, ľe populace pacientů s diabetem se mění. Remedia 2016; 26(1): 67-72.
    10. McGill JB. The SGLT2 Inhibitor Empagliflozin for the Treatment of Type 2 Diabetes Mellitus: a Bench to Bedside Review. Diabetes Ther 2014; 5(1): 43-63. Dostupné z DOI: <http://dx.doi.org/10.1007/s13300-014-0063-1>. Go to original source... Go to PubMed...
    11. Vítovec J, ©pinar J, ©pinarová L. Empagliflozin a srdeční selhání. Hypertenze a KV prevence 2016; 5(2): 19-23.
    12. Zinman B, Wanner CH, Lachin JM et al. [EMPA-REG OUTCOME Investigators]. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373(22): 2117-2128. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1504720>. Go to original source... Go to PubMed...
    13. Neal B, Perkovic V, Mahaffey KV et al. [CANVAS Program Collaborative Group]. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med 2017; 377(7): 644-657. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1611925>. Go to original source... Go to PubMed...
    14. Wiviott SD, Raz I, Bonaca MP et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2019; 380(4): 347-357. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1812389>. Go to original source... Go to PubMed...
    15. Kosiborod M, Lam CSP, Kohsaka S et al. Cardiovascular events associated with SGLT-2 inhibitors versus other glucose-lowering drugs: the CVD-REAL 2 study. J Am Coll Cardiol 2018; 71(23): 2628-2639. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2018.03.009>. Go to original source... Go to PubMed...
    16. ©pinar J, Vítovec J, ©pinarová L. Diabetes mellitus a srdeční selhání: úloha inhibitorů SGLT2. AtheroRev 2018; 3(1): 40-45.
    17. Malik FI, Hertman JJ, Elias KA et al. Cardiac Myosin Activation: A Potential Therapeutic Approach For Systolic Heart Failure. Science 2011; 331(6023): 1439-1443. Dostupné z DOI: <http://dx.doi.org/10.1126/science.1200113>. Go to original source... Go to PubMed...
    18. Teerling JR, Felker GM, MsMurray JV et al. Chronic Oral Study of Myosin Activation to Increase Contractility in Heart Failure (COSMIC-HF): a phase 2, pharmacokinetic, randomised, placebo-controlled trial. Lancet 2016; 388(10062): 2895-2903. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140-6736(16)32049-9>. Go to original source... Go to PubMed...
    19. Teerlink JR, Felker GM, McMurray JJV et al. [ATOMIC-AHF Investigators]. Acute treatment with omecamtiv mecarbil to increase contractility in acute heart failure: the ATOMIC-AHF study. J Am Coll Cardiol 2016; 67(12): 1444-1455. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2016.01.031>. Go to original source... Go to PubMed...
    20. Vítovec J, ©pinar J, ©pinarová L et al. Léčba kardiovaskulárních onemocnění. Grada Praha: 2018. ISBN 978-80-271-0624-0.
    21. Rossignol P, Hernandez AF, Solomon SD et al. Heart failure drug treatment. Lancet 2019; 393(10175): 1034-1044. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140-6736(18)31808-7>. Go to original source... Go to PubMed...

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