Chapter 7. Advances in the understanding and treatment of congestive heart failure (HF)

Abstract

This chapter focuses on advances in the understanding and treatment of congestive heart failure (HF). HF is a chronic, expensive, and fatal disease. It occurs when cardiac output fails to meet end organ needs for blood flow. Many different classes of drugs are used in the treatment of HF with varied results. The disease is best treated with several drugs of multiple actions, but the exact combination of agents is an ever shifting landscape. Congestive heart failure is one of the single largest causes of death in industrialized countries. The severe syndrome of congestive heart failure involves shortness of breath (dyspenia), pulmonary edema, pulmonary hypertension and edema in the periphery. The chapter summarizes the major physiological and biochemical mechanisms of heart failure that current drug therapies modify. Included in the discussion are descriptions of the drugs used to treat HF, recent clinical trials with those drugs, and new molecular entities into the different classes of drugs. Novel, untested molecules and approaches to the treatment of congestive heart failure are also discussed.