Skip to main content

Pharmaceutical Treatment for Heart Failure

  • Chapter
  • First Online:
Coronary Artery Disease: Therapeutics and Drug Discovery

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1177))

Abstract

Heart failure (HF) is defined as a clinical syndrome resulting from structural or functional impairment of ventricular fillings or ejections of blood. Currently, HF is divided into three groups which include HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF) and HF with midrange EF (HFmrEF). Even though major advances have been made in treating HFrEF during the past decades, heart failure is a fatal disease. In this review, we briefly summarize the current advances in pharmaceutical managements for heart failure, which includes drugs used in acute heart failure as well as those that prevent heart failure progression, in each category major clinical trials are also described. In addition, information about some of potential new drugs are also mentioned. Traditional Chinese medicine also shows its potential in treating HF, and we are still lack of medicine to treat HFpEF.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Adamopoulos S, Parissis JT, Iliodromitis EK et al (2006) Effects of levosimendan versus dobutamine on inflammatory and apoptotic pathways in acutely decompensated chronic heart failure. Am J Cardiol 98:102–106

    Article  CAS  PubMed  Google Scholar 

  • Alexander P, Alkhawam L, Curry J et al (2015) Lack of evidence for intravenous vasodilators in ED patients with acute heart failure: a systematic review. Am J Emerg Med 33: 133–41

    Google Scholar 

  • Bowman BN, Nawarskas JJ, Anderson JR (2016) Treating diuretic resistance: an overview. Cardiol Rev 24:256–260

    Article  PubMed  Google Scholar 

  • Bui AL, Horwich TB, Fonarow GC (2011) Epidemiology and risk profile of heart failure. Nat Rev Cardiol 8:30–41

    Article  PubMed  Google Scholar 

  • Cohn JN, Johnson G, Ziesche S et al (1991) A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med 325:303–310

    Article  CAS  PubMed  Google Scholar 

  • Cohn JN, Tognoni G and Valsartan Heart Failure Trial I (2001) A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med 345:1667–1675

    Google Scholar 

  • den Uil CA, Brugts JJ (2015) Impact of intravenous nitroglycerin in the management of acute decompensated heart failure. Curr Heart Fail Rep 12:87–93

    Article  CAS  Google Scholar 

  • Dickstein K, Cohen-Solal A, Filippatos G et al (2008) ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the task force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European society of cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail 10:933–989

    Google Scholar 

  • Dokainish H, Teo K, Zhu J et al (2015) Heart failure in low- and middle-income countries: background, rationale, and design of the INTERnational Congestive Heart Failure Study (INTER-CHF). Am Heart J 170(627–34):e1

    Google Scholar 

  • Effect of metoprolol CR/XL in chronic heart failure (1999) Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 353:2001–2007

    Article  Google Scholar 

  • Felker GM (2012) Loop diuretics in heart failure. Heart Fail Rev 17:305–311

    Article  CAS  PubMed  Google Scholar 

  • Felker GM, Benza RL, Chandler AB et al (2003) Heart failure etiology and response to milrinone in decompensated heart failure: results from the OPTIME-CHF study. J Am Coll Cardiol 41:997–1003

    Article  CAS  PubMed  Google Scholar 

  • Finley JJt, Konstam MA, Udelson JE (2008) Arginine vasopressin antagonists for the treatment of heart failure and hyponatremia. Circulation 118:410–421

    Google Scholar 

  • Flather MD, Yusuf S, Kober L et al (2000) Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patientsACE-Inhibitor Myocardial Infarction Collaborative Group. Lancet 355:1575–1581

    Article  CAS  PubMed  Google Scholar 

  • Fonarow GC, Abraham WT, Albert NM et al (2008) Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE-HF. Arch Intern Med 168:847–854

    Article  PubMed  Google Scholar 

  • Gehlbach BK, Geppert E (2004) The pulmonary manifestations of left heart failure. Chest 125:669–682

    Article  PubMed  Google Scholar 

  • Gheorghiade M, Braunwald E (2009) Reconsidering the role for digoxin in the management of acute heart failure syndromes. JAMA 302:2146–2147

    Article  PubMed  Google Scholar 

  • Gheorghiade M, Teerlink JR, Mebazaa A (2005) Pharmacology of new agents for acute heart failure syndromes. Am J Cardiol 96:68G–73G

    Article  CAS  PubMed  Google Scholar 

  • Gheorghiade M, Konstam MA, Burnett JC Jr et al (2007) Short-term clinical effects of tolvaptan, an oral vasopressin antagonist, in patients hospitalized for heart failure: the EVEREST clinical status trials. JAMA 297:1332–1343

    Article  CAS  PubMed  Google Scholar 

  • Gheorghiade M, Follath F, Ponikowski P et al (2010) Assessing and grading congestion in acute heart failure: a scientific statement from the acute heart failure committee of the heart failure association of the European society of cardiology and endorsed by the European society of intensive care medicine. Eur J Heart Fail 12:423–433

    Article  PubMed  Google Scholar 

  • Gheorghiade M, Greene SJ, Filippatos G et al (2012) Cinaciguat, a soluble guanylate cyclase activator: results from the randomized, controlled, phase IIb COMPOSE programme in acute heart failure syndromes. Eur J Heart Fail 14:1056–1066

    Article  CAS  PubMed  Google Scholar 

  • Gheorghiade M, Greene SJ, Ponikowski P et al (2013) Haemodynamic effects, safety, and pharmacokinetics of human stresscopin in heart failure with reduced ejection fraction. Eur J Heart Fail 15:679–689

    Article  CAS  PubMed  Google Scholar 

  • Ghostine S, Caussin C, Habis M et al (2008) Non-invasive diagnosis of ischaemic heart failure using 64-slice computed tomography. Eur Heart J 29:2133–2140

    Article  PubMed  Google Scholar 

  • Group CTS (1987) Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 316:1429–35

    Google Scholar 

  • Gustafsson F, Rogers JG (2017) Left ventricular assist device therapy in advanced heart failure: patient selection and outcomes. Eur J Heart Fail 19:595–602

    Article  PubMed  Google Scholar 

  • Hao P, Jiang F, Cheng J, Ma L, Zhang Y, Zhao Y (2017) Traditional chinese medicine for cardiovascular disease: evidence and potential mechanisms. J Am Coll Cardiol 69:2952–2966

    Article  PubMed  Google Scholar 

  • Harada K, Yamamoto T, Okumura T et al (2017) Intravenous nicorandil for treatment of the urgent phase acute heart failure syndromes: a randomized, controlled trial. Eur Heart J Acute Cardiovasc Care 6:329–338

    Article  PubMed  Google Scholar 

  • Hasenfuss G, Teerlink JR (2011) Cardiac inotropes: current agents and future directions. Eur Heart J 32:1838–1845

    Article  CAS  PubMed  Google Scholar 

  • Heart Failure Society of A, Lindenfeld J, Albert NM et al (2010) HFSA 2010 Comprehensive Heart Failure Practice Guideline. J Card Fail 16:e1–194

    Google Scholar 

  • Heidenreich PA, Albert NM, Allen LA et al (2013) Forecasting the impact of heart failure in the United States: a policy statement from the American heart association. Circ Heart Fail 6:606–619

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hjalmarson A, Goldstein S, Fagerberg B et al (2000) Effects of controlled-release metoprolol on total mortality, hospitalizations, and well-being in patients with heart failure: the Metoprolol CR/XL Randomized Intervention Trial in congestive heart failure (MERIT-HF) MERIT-HF study group. JAMA 283:1295–1302

    Article  CAS  PubMed  Google Scholar 

  • Jaarsma T, Beattie JM, Ryder M et al (2009) Palliative care in heart failure: a position statement from the palliative care workshop of the heart failure association of the European society of cardiology. Eur J Heart Fail 11:433–443

    Article  PubMed  Google Scholar 

  • Jessup M, Abraham WT, Casey DE et al (2009) 2009 focused update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults: a report of the American college of cardiology foundation/American heart association task force on practice guidelines: developed in collaboration with the international society for heart and lung transplantation. Circulation 119:1977–2016

    Article  PubMed  Google Scholar 

  • Jhund PS, McMurray JJ (2016) The neprilysin pathway in heart failure: a review and guide on the use of sacubitril/valsartan. Heart 102:1342–1347

    Article  CAS  PubMed  Google Scholar 

  • Jones J, McDermott CM et al (2012) The experience of fatigue as a distressing symptom of heart failure. Heart Lung 41:484–491

    Article  PubMed  Google Scholar 

  • Khan H, Metra M, Blair JE et al (2009) Istaroxime, a first in class new chemical entity exhibiting SERCA-2 activation and Na-K-ATPase inhibition: a new promising treatment for acute heart failure syndromes? Heart Fail Rev 14:277–287

    Article  CAS  PubMed  Google Scholar 

  • Konstam MA, Gheorghiade M, Burnett JC Jr et al (2007) Effects of oral tolvaptan in patients hospitalized for worsening heart failure: the EVEREST outcome trial. JAMA 297:1319–1331

    Article  CAS  PubMed  Google Scholar 

  • Li X, Zhang J, Huang J et al (2013) A multicenter, randomized, double-blind, parallel-group, placebo-controlled study of the effects of qili qiangxin capsules in patients with chronic heart failure. J Am Coll Cardiol 62:1065–1072

    Article  PubMed  Google Scholar 

  • Mahrholdt H, Wagner A, Judd RM, Sechtem U, Kim RJ (2005) Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathies. Eur Heart J 26:1461–1474

    Article  PubMed  Google Scholar 

  • Mann DL, Zipes DP, Libby P and Bonow RO (2014) Braunwald’s heart disease: a textbook of cardiovascular medicine, Elsevier Health Sciences

    Google Scholar 

  • Marieb EN and Hoehn K (2007) Human anatomy and physiology, Pearson Education

    Google Scholar 

  • McMurray JJ, Teerlink JR, Cotter G et al (2007) Effects of tezosentan on symptoms and clinical outcomes in patients with acute heart failure: the VERITAS randomized controlled trials. JAMA 298:2009–2019

    Article  CAS  PubMed  Google Scholar 

  • McMurray JJ, Adamopoulos S, Anker SD et al (2012) ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the task force for the diagnosis and treatment of acute and chronic heart failure 2012 of the European society of cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 14:803–869

    Google Scholar 

  • McMurray JJ, Packer M, Desai AS et al (2014) PARADIGM-HF investigators and committees. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med 371:993–1004. https://doi.org/10.1056/nejmoa1409077

  • McQuade CN, Mizus M, Wald JW et al (2017) Brain-Type Natriuretic Peptide and Amino-Terminal Pro-Brain-Type Natriuretic Peptide discharge thresholds for acute decompensated heart failure: a systematic review. Ann Intern Med 166:180–190

    Article  PubMed  Google Scholar 

  • Mebazaa A, Nieminen MS, Packer M et al (2007) Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial. JAMA 297:1883–1891

    Article  CAS  PubMed  Google Scholar 

  • Metra M, Teerlink JR, Voors AA et al (2009) Vasodilators in the treatment of acute heart failure: what we know, what we don’t. Heart Fail Rev 14:299–307

    Article  CAS  PubMed  Google Scholar 

  • Michael Felker G (2010) Diuretic management in heart failure. Congest Heart Fail 16(Suppl 1):S68–S72

    Article  Google Scholar 

  • Micheletti R, Palazzo F, Barassi P et al (2007) Istaroxime, a stimulator of sarcoplasmic reticulum calcium adenosine triphosphatase isoform 2a activity, as a novel therapeutic approach to heart failure. Am J Cardiol 99:24A–32A

    Article  CAS  PubMed  Google Scholar 

  • Mitter SS, Yancy CW (2017) Contemporary approaches to patients with heart failure. Cardiol Clin 35:261–271

    Article  PubMed  Google Scholar 

  • Mortality GBD and Causes of Death C (2015) Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 385:117–171

    Google Scholar 

  • Mozaffarian D, Benjamin EJ, Go AS et al (2015) Heart disease and stroke statistics–2015 update: a report from the American Heart Association. Circulation 131:e29–322

    PubMed  Google Scholar 

  • Mysliwiec M, Bonita RE (2017) Outpatient emergencies: acute heart failure. Med Clin North Am 101:507–519

    Article  PubMed  Google Scholar 

  • Nagueh SF, Smiseth OA, Appleton CP et al (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American society of echocardiography and the European association of cardiovascular imaging. J Am Soc Echocardiogr 29:277–314

    Article  PubMed  Google Scholar 

  • Nauman D, Greenberg B (1993) Studies of Left Ventricular Dysfunction (SOLVD). Am J Geriatr Cardiol 2:28–36

    PubMed  Google Scholar 

  • Nieminen MS, Bohm M, Cowie MR et al (2005) Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the task force on acute heart failure of the European society of cardiology. Eur Heart J 26:384–416

    Article  PubMed  Google Scholar 

  • O’Connor CM, Starling RC, Hernandez AF et al (2011) Effect of nesiritide in patients with acute decompensated heart failure. N Engl J Med 365:32–43

    Article  PubMed  Google Scholar 

  • Packer M, Coats AJ, Fowler MB et al (2001) Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 344:1651–1658

    Article  CAS  PubMed  Google Scholar 

  • Packer M, Fowler MB, Roecker EB et al (2002) Effect of carvedilol on the morbidity of patients with severe chronic heart failure: results of the carvedilol prospective randomized cumulative survival (COPERNICUS) study. Circulation 106:2194–2199

    Article  PubMed  Google Scholar 

  • Packer M, McMurray JJ, Desai AS et al (2015) Angiotensin receptor neprilysin inhibition compared with enalapril on the risk of clinical progression in surviving patients with heart failure. Circulation 131:54–61

    Article  CAS  PubMed  Google Scholar 

  • Pfeffer MA (1993) The Survival and Ventricular Enlargement (SAVE) study: rationale and perspective. Herz 18(Suppl 1):430–435

    PubMed  Google Scholar 

  • Ponikowski P, Mitrovic V, Ruda M et al (2014) A randomized, double-blind, placebo-controlled, multicentre study to assess haemodynamic effects of serelaxin in patients with acute heart failure. Eur Heart J 35:431–441

    Article  CAS  PubMed  Google Scholar 

  • 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 J Heart Fail 18: 891–975

    Google Scholar 

  • Porter TR, Xie F (2010) Myocardial perfusion imaging with contrast ultrasound. JACC Cardiovasc Imaging 3:176–187

    Article  PubMed  Google Scholar 

  • Santaguida PL, Don-Wauchope AC, Ali U et al (2014) Incremental value of natriuretic peptide measurement in acute decompensated heart failure (ADHF): a systematic review. Heart Fail Rev 19:507–519

    Article  CAS  PubMed  Google Scholar 

  • Schumann J1, Henrich EC, Strobl H et al (2018) Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome. Cochrane Database Syst Rev:1

    Google Scholar 

  • Shah SJ, Blair JE, Filippatos GS et al (2009) Effects of istaroxime on diastolic stiffness in acute heart failure syndromes: results from the Hemodynamic, Echocardiographic, and Neurohormonal Effects of Istaroxime, a novel intravenous inotropic and lusitropic agent: a Randomized Controlled Trial in Patients Hospitalized with Heart Failure (HORIZON-HF) trial. Am Heart J 157:1035–1041

    Article  CAS  PubMed  Google Scholar 

  • Shen H (2007) Illustrated pharmacology memory cards: pharmnemonics. Minireview, LLC

    Google Scholar 

  • Sica DA (2003) Metolazone and its role in edema management. Congest Heart Fail 9:100–105

    Article  CAS  PubMed  Google Scholar 

  • Solomonica A, Burger AJ, Aronson D (2013) Hemodynamic determinants of dyspnea improvement in acute decompensated heart failure. Circ Heart Fail 6:53–60

    Article  PubMed  Google Scholar 

  • Swedberg K, Komajda M, Bohm M et al (2012) Effects on outcomes of heart rate reduction by ivabradine in patients with congestive heart failure: is there an influence of beta-blocker dose?: findings from the SHIFT (Systolic Heart failure treatment with the I(f) inhibitor ivabradine Trial) study. J Am Coll Cardiol 59:1938–1945

    Article  CAS  PubMed  Google Scholar 

  • Tacon CL, McCaffrey J, Delaney A (2012) Dobutamine for patients with severe heart failure: a systematic review and meta-analysis of randomised controlled trials. Intensive Care Med 38:359–367

    Article  CAS  PubMed  Google Scholar 

  • Teerlink JR, Metra M, Zaca V et al (2009) Agents with inotropic properties for the management of acute heart failure syndromes. Traditional agents and beyond. Heart Fail Rev 14:243–53

    Google Scholar 

  • Teerlink JR, Cotter G, Davison BA et al (2013) Serelaxin, recombinant human relaxin-2, for treatment of acute heart failure (RELAX-AHF): a randomised, placebo-controlled trial. Lancet 381:29–39

    Article  CAS  PubMed  Google Scholar 

  • Teerlink JR, Felker GM, McMurray JJ et al (2016) Acute treatment with Omecamtiv Mecarbil to increase contractility in acute heart failure: the ATOMIC-AHF study. J Am Coll Cardiol 67:1444–1455

    Article  CAS  PubMed  Google Scholar 

  • The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet 353:9–13 (1999)

    Google Scholar 

  • Uchida K, Nakano S, Kigoshi T (2005) Randomized Aldactone Evaluation Study (RALES). Nihon Rinsho. 63(Suppl 3):330–335

    PubMed  Google Scholar 

  • Vaduganathan M, Greene SJ, Ambrosy AP et al (2013) The disconnect between phase II and phase III trials of drugs for heart failure. Nat Rev Cardiol 10:85–97

    Article  CAS  PubMed  Google Scholar 

  • Vos T, Flaxman AD, Naghavi M et al (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet 380:2163–2196

    Article  PubMed  PubMed Central  Google Scholar 

  • Wang DJ, Dowling TC, Meadows D et al (2004) Nesiritide does not improve renal function in patients with chronic heart failure and worsening serum creatinine. Circulation 110:1620–1625

    Article  CAS  PubMed  Google Scholar 

  • Writing Committee M, Yancy CW, Jessup M et al (2013) 2013 ACCF/AHA guideline for the management of heart failure: a report of the American college of cardiology Foundation/American heart association task force on practice guidelines. Circulation 128:e240–e327

    Google Scholar 

  • Yancy CW, Jessup M, Bozkurt B et al (2013) 2013 ACCF/AHA guideline for the management of heart failure: a report of the American college of cardiology foundation/American heart association task force on practice guidelines. J Am Coll Cardiol 62:e147–e239

    Article  PubMed  Google Scholar 

  • Yancy CW, Jessup M, Bozkurt B et al (2017) ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart failure society of America. J Card Fail

    Google Scholar 

  • Zannad F, McMurray JJ, Krum H et al (2011) Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med 364:11–21

    Article  CAS  PubMed  Google Scholar 

  • Zile MR, Claggett BL, Prescott MF et al (2016) Prognostic implications of changes in N-Terminal Pro-B-Type Natriuretic Peptide in patients with heart failure. J Am Coll Cardiol 68:2425–2436

    Article  CAS  PubMed  Google Scholar 

  • Zou Xu, Pan GM, Sheng XG et al (2010) Double blinded randomized and controlled study on treatment of chronic heart failure by nuanxin capsul. Chin J Integr Trad West Med 31(1):19–22

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ligang Fang .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lin, X., Fang, L. (2020). Pharmaceutical Treatment for Heart Failure. In: Wang, M. (eds) Coronary Artery Disease: Therapeutics and Drug Discovery. Advances in Experimental Medicine and Biology, vol 1177. Springer, Singapore. https://doi.org/10.1007/978-981-15-2517-9_7

Download citation

Publish with us

Policies and ethics