Current Approaches to Worsening Heart Failure: Pathophysiological and Molecular Insights.
Andrea D'AmatoSilvia ProsperiPaolo SeverinoVincenzo MyftariAurora Labbro FranciaClaudia CestièNicola PierucciStefanie Marek-IannucciMarco Valerio MarianiRosanna GermanòFrancesca FanisioCarlo LavalleViviana MaestriniRoberto BadagliaccaMassimo ManconeFrancesco FedeleCarmine Dario VizzaPublished in: International journal of molecular sciences (2024)
Worsening heart failure (WHF) is a severe and dynamic condition characterized by significant clinical and hemodynamic deterioration. It is characterized by worsening HF signs, symptoms and biomarkers, despite the achievement of an optimized medical therapy. It remains a significant challenge in cardiology, as it evolves into advanced and end-stage HF. The hyperactivation of the neurohormonal, adrenergic and renin-angiotensin-aldosterone system are well known pathophysiological pathways involved in HF. Several drugs have been developed to inhibit the latter, resulting in an improvement in life expectancy. Nevertheless, patients are exposed to a residual risk of adverse events, and the exploration of new molecular pathways and therapeutic targets is required. This review explores the current landscape of WHF, highlighting the complexities and factors contributing to this critical condition. Most recent medical advances have introduced cutting-edge pharmacological agents, such as guanylate cyclase stimulators and myosin activators. Regarding device-based therapies, invasive pulmonary pressure measurement and cardiac contractility modulation have emerged as promising tools to increase the quality of life and reduce hospitalizations due to HF exacerbations. Recent innovations in terms of WHF management emphasize the need for a multifaceted and patient-centric approach to address the complex HF syndrome.
Keyphrases
- acute heart failure
- heart failure
- left ventricular
- healthcare
- case report
- ejection fraction
- chronic obstructive pulmonary disease
- newly diagnosed
- angiotensin ii
- pulmonary hypertension
- cystic fibrosis
- angiotensin converting enzyme
- prognostic factors
- stem cells
- cardiac resynchronization therapy
- atrial fibrillation
- early onset
- physical activity
- single molecule
- binding protein
- single cell
- depressive symptoms
- replacement therapy