Abstract
Background
Heart Failure continues to be a leading cause of mortality and morbidity worldwide. The dismal prognosis of patients in acute heart failure (AHF) can be altered only by exploring novel drug molecules. Although the treatment for chronic heart failure (CHF) has seen remarkable progress, there is still a need to develop molecules that could improve the long-term survival outcomes.
Purpose
To review the drug targets for acute and chronic heart failure and the molecules acting on these targets.
Methods
The article discusses on the mechanism of how the potential drug targets can be modulated to alter the pathophysiological processes in heart failure. Current evidence on molecules acting on these targets has also been described from published literature using the PubMed and Clinical Trials.gov databases.
Results
Some of the molecules that are currently being explored for AHF includeomecamtiv mecarbil which activates cardiac myosin ATPase, istaroxime an ionotropicagent that activates SERCA2a pump activity, ularitide and carperitide which are ANP(atrial natriuretic peptide) analogues and recombinant relaxin. Some of the targets forCHF include stabilization of ryanodine receptors, renin inhibition, neprilysin inhibition, neuregulins and SERCA2a gene therapy.
Conclusion
Clinical trials in heart failure must be designed to minimize the risk of “drug failures.” Nevertheless, it is hoped that in the days to come, drugs with superior efficacy and safety will eventually be produced from the surge of molecules that are in the pipeline.
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George, M., Rajaram, M., Shanmugam, E. et al. Novel drug targets in clinical development for heart failure. Eur J Clin Pharmacol 70, 765–774 (2014). https://doi.org/10.1007/s00228-014-1671-4
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DOI: https://doi.org/10.1007/s00228-014-1671-4