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window.loswp.shouldDetectTimezone = true; window.loswp.shouldShowBulkDownload = true; window.loswp.showSignupCaptcha = false window.loswp.willEdgeCache = false; window.loswp.work = {"work":{"id":101651366,"created_at":"2023-05-11T23:44:37.816-07:00","from_world_paper_id":233548291,"updated_at":"2024-11-23T13:27:08.089-08:00","_data":{"publisher":"Elsevier BV","grobid_abstract":"Heart failure is a major health problem, affecting an estimated 38 million persons worldwide, accounting for more than a million hospital admissions per year in the United States and Europe, and carrying a prognosis worse than many cancers. 1 Although it has been commonly assumed that most patients with cardiac failure have reduced left ventricular function (referred to as heart failure with reduced ejection fraction [HFrEF]), there is increasing evidence that many patients can have symptoms and signs of cardiac failure with normal left ventricular function (heart failure with preserved ejection fraction [HFpEF]). 2 With increasing understanding of the important role of the adverse effect of neurohumoral factors in heart failure, the focus of pharmacologic attention has moved away from the seemingly logical task of stimulating the heart with inotropic agents 3 to blocking the neurohumoral mediators of the syndrome. Although recent development of innovative approaches to inotropic therapy with inodilation with calcium-sensitizing therapy in with levosimendan 4 and omecantiv mecarbil 5 may yet have the potential to improve systolic performance without increasing the heart's demand for energy, advances in other areas of drug, device, and transplant currently occupy prominence in heart failure management. This Special Issue reviews these exciting recent advances in the treatment of heart failure.","publication_date":"2015,,","publication_name":"Clinical Therapeutics","grobid_abstract_attachment_id":"102133594"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"Heart Failure: A Major Management Challenge With Encouraging Recent Progress","broadcastable":false,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [212372087]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "control"; window.loswp.useOptimizedScribd4genScript = false; window.loswp.appleClientId = 'edu.academia.applesignon';</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":102133594,"attachmentType":"pdf"}"><img alt="First page of “Heart Failure: A Major Management Challenge With Encouraging Recent Progress”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/102133594/mini_magick20230512-1-vzgsrk.png?1683873987" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/assets/single_work_splash/adobe.icon-574afd46eb6b03a77a153a647fb47e30546f9215c0ee6a25df597a779717f9ef.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Heart Failure: A Major Management Challenge With Encouraging Recent Progress</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="212372087" href="https://independent.academia.edu/PeterMacdonald29"><img alt="Profile image of Peter Macdonald" class="ds-work-card--author-avatar" src="https://0.academia-photos.com/212372087/71500633/59946471/s65_peter.macdonald.png" />Peter Macdonald</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2015, Clinical Therapeutics</p></div><div class="ds-work-card--button-container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--work-card","attachmentId":102133594,"attachmentType":"pdf","workUrl":"https://www.academia.edu/101651366/Heart_Failure_A_Major_Management_Challenge_With_Encouraging_Recent_Progress"}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--work-card","attachmentId":102133594,"attachmentType":"pdf","workUrl":"https://www.academia.edu/101651366/Heart_Failure_A_Major_Management_Challenge_With_Encouraging_Recent_Progress"}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div></div><div data-auto_select="false" data-client_id="331998490334-rsn3chp12mbkiqhl6e7lu2q0mlbu0f1b" data-doc_id="102133594" data-landing_url="https://www.academia.edu/101651366/Heart_Failure_A_Major_Management_Challenge_With_Encouraging_Recent_Progress" data-login_uri="https://www.academia.edu/registrations/google_one_tap" data-moment_callback="onGoogleOneTapEvent" id="g_id_onload"></div><div class="ds-top-related-works--grid-container"><div class="ds-related-content--container ds-top-related-works--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="0" data-entity-id="67595269" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/67595269/Developing_New_Treatments_for_Heart_Failure_Focus_on_the_Heart">Developing New Treatments for Heart Failure: Focus on the Heart</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32259114" href="https://independent.academia.edu/MicheleSenni">Michele Senni</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Circulation. 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studies","attachmentId":66424685,"attachmentType":"pdf","work_url":"https://www.academia.edu/47211550/Review_of_novel_therapeutic_targets_for_improving_heart_failure_treatment_based_on_experimental_and_clinical_studies","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/47211550/Review_of_novel_therapeutic_targets_for_improving_heart_failure_treatment_based_on_experimental_and_clinical_studies"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="71868993" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/71868993/Pharmacologic_Support_of_the_Failing_Heart">Pharmacologic Support of the Failing Heart</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="54541517" href="https://independent.academia.edu/HaifaLyster">Haifa Lyster</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2020</p><p class="ds-related-work--abstract ds2-5-body-sm">Heart failure (HF), the inability of the heart to achieve adequate blood supply to meet the metabolic needs of the organs, is classified based on the left ventricular ejection fraction (LVEF) into HF with reduced LVEF (HFrEF) and HF with preserved LVEF (HFpEF). The pharmacological treatment of HF mainly consists of medications that suppress the maladaptive mechanisms leading to myocardial dysfunction. In HFrEF the treatment mainly focusses on the inhibition of the sympathetic nervous system and renin-angiotensin-aldosterone system, whereas in HFpEF the main goal is to control the comorbidities. The backbone of treatment of HFrEF is neurohormonal consisting of an angiotensin converting enzyme inhibitor, a beta blocker and a mineralocorticoid receptor antagonist. Randomised controlled clinical trials have shown this approach to be effective in improving both mortality and quality of life and these drugs have been included in current guidelines. Relatively newer drugs, such as ivabradi...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Pharmacologic Support of the Failing Heart","attachmentId":81039092,"attachmentType":"pdf","work_url":"https://www.academia.edu/71868993/Pharmacologic_Support_of_the_Failing_Heart","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/71868993/Pharmacologic_Support_of_the_Failing_Heart"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="83692473" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/83692473/Current_and_emerging_drug_targets_in_heart_failure_treatment">Current and emerging drug targets in heart failure treatment</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38759171" href="https://independent.academia.edu/SilviaBurchielli">Silvia Burchielli</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Heart Failure Reviews, 2021</p><p class="ds-related-work--abstract ds2-5-body-sm">After initial strategies targeting inotropism and congestion, the neurohormonal interpretative model of heart failure (HF) pathophysiology has set the basis for current pharmacological management of HF, as most of guideline recommended drug classes, including beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and mineralocorticoid receptor antagonists, blunt the activation of detrimental neurohormonal axes, namely sympathetic and renin–angiotensin–aldosterone (RAAS) systems. More recently, sacubitril/valsartan, a first-in-class angiotensin receptor neprilysin inhibitor, combining inhibition of RAAS and potentiation of the counter-regulatory natriuretic peptide system, has been consistently demonstrated to reduce mortality and HF-related hospitalization. A number of novel pharmacological approaches have been tested during the latest years, leading to mixed results. Among them, drugs acting directly at a second messenger level, such as the soluble ...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Current and emerging drug targets in heart failure treatment","attachmentId":88953669,"attachmentType":"pdf","work_url":"https://www.academia.edu/83692473/Current_and_emerging_drug_targets_in_heart_failure_treatment","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/83692473/Current_and_emerging_drug_targets_in_heart_failure_treatment"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":102133594,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":102133594,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_102133594" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. 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