BOOK
Pharmacologic Approaches to Heart Failure, An Issue of Heart Failure Clinics, E-Book
(2014)
Additional Information
Book Details
Abstract
This issue of Heart Failure Clinics examines the pharmacologic approaches to heart failure: optimizing established therapy with a look toward future agents. Topics include the pathophysiologic foundation for the pharmacologic treatment of heart failure, treatment of heart failure with reducted ejection fraction and preserved ejection fraction, treatment of acute heart failure, investigational treatments, and the role of congestive heart failure medications following left ventricular assist device.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Pharmacologic Approachesto Heart Failure | i | ||
| copyright\r | ii | ||
| Contributors | iii | ||
| Contents | v | ||
| Heart Failure Clinics\r | viii | ||
| Foreword | ix | ||
| Time and Technology Will Tell | 543 | ||
| Key points | 543 | ||
| The sympathetic nervous system and cardiovascular physiology | 544 | ||
| The SNS and HF pathophysiology | 544 | ||
| Inhibitors of the SNS | 546 | ||
| Mechanisms of β-Blocker Benefit in the Human Heart | 546 | ||
| Hemodynamics | 546 | ||
| Reverse remodeling | 547 | ||
| Antiarrhythmic effects | 547 | ||
| Molecular changes in human heart | 547 | ||
| Digoxin and the SNS | 547 | ||
| Risks of sympatholysis in HF | 548 | ||
| The renin-angiotensin-aldosterone system and cardiovascular physiology | 548 | ||
| The RAAS and HF pathophysiology | 548 | ||
| Inhibitors of the RAAS | 549 | ||
| Mechanisms of RAAS Blockade Benefit in Human HF | 550 | ||
| Hemodynamics | 550 | ||
| Reverse remodeling | 550 | ||
| Antiarrhythmic effects | 550 | ||
| Other effects | 550 | ||
| ACE (aldosterone) escape | 550 | ||
| Natriuretic peptides and cardiovascular physiology | 551 | ||
| Targeting Natriuretic Peptides for HF Therapy | 551 | ||
| Vasopressin in HF pathophysiology and pharmacotherapy | 551 | ||
| Summary | 552 | ||
| References | 552 | ||
| Mineralcorticoid Antagonists in Heart Failure | 559 | ||
| Key points | 559 | ||
| Introduction | 559 | ||
| Role of aldosterone in HF | 560 | ||
| MRAs in HF clinical trials | 561 | ||
| Spironolactone | 561 | ||
| Canrenone | 561 | ||
| Eplerenone | 562 | ||
| MRAs in HF with preserved ejection fraction (HFPEF) | 562 | ||
| Novel approaches to MR blockade in HF | 562 | ||
| Nonsteroidal MRAs | 562 | ||
| Aldosterone Synthase Inhibitors | 562 | ||
| Summary | 563 | ||
| References | 563 | ||
| Current Perspectives on Hydralazine and Nitrate Therapies in Heart Failure | 565 | ||
| Key points | 565 | ||
| Introduction | 565 | ||
| Historical perspectives: the randomized controlled clinical trials of H+ISDN | 567 | ||
| Vasodilators-Heart Failure Trial I—1986 | 567 | ||
| Vasodilator-Heart Failure II—1991 | 567 | ||
| African-American Heart Failure Trial—2004 | 567 | ||
| The H+ISDN benefit: hemodynamic effects or fundamental pathophysiology? | 568 | ||
| Who should take hydralazine? Does race matter? Does gender matter? Does age matter? | 568 | ||
| Race and H+ISDN | 568 | ||
| Gender and H+ISDN | 569 | ||
| Age and H+ISDN | 570 | ||
| The role of H+ISDN outside of chronic HF | 570 | ||
| Acutely Decompensated Systolic Heart Failure | 570 | ||
| Secondary Pulmonary Hypertension in Heart Failure | 571 | ||
| Maintaining the nitroso-redox balance: is hydralazine necessary? | 571 | ||
| ACEIs + Nitrates | 571 | ||
| Other Agents + Nitrates | 571 | ||
| H+ISDN in clinical practice | 572 | ||
| Summary | 573 | ||
| References | 573 | ||
| Polypharmacy in Heart Failure | 577 | ||
| Key points | 577 | ||
| Introduction | 577 | ||
| Evidence-based combination therapy in heart failure with reduced ejection fraction | 577 | ||
| Determination of Volume Status | 577 | ||
| Addition of ACE Inhibitor or Angiotensin Receptor Blocker | 578 | ||
| Addition of BB | 578 | ||
| Addition of ARA and/or Nitrates Plus Hydralazine | 578 | ||
| Additional Pharmacologic Therapies for Heart Failure with Reduced Ejection Fraction | 579 | ||
| Combination Renin-Angiotensin-Aldosterone System Blockade | 579 | ||
| Renin Inhibitors | 579 | ||
| Pharmacologic management of common comorbidities | 579 | ||
| Conditions Requiring Use of Antiplatelet and Anticoagulant Therapy | 579 | ||
| Chronic Obstructive Pulmonary Disease | 581 | ||
| Diabetes Mellitus | 581 | ||
| Renal Dysfunction | 581 | ||
| Anemia and Iron Deficiency | 582 | ||
| Depression | 582 | ||
| Arthritis and Gout | 582 | ||
| Infectious Diseases | 582 | ||
| Medications to avoid | 583 | ||
| Prescription Medications | 583 | ||
| Nonprescription Medications | 585 | ||
| Complementary and Alternative Medicine | 586 | ||
| Drug-Drug Interactions | 586 | ||
| References | 587 | ||
| Management Strategies for Heart Failure with Preserved Ejection Fraction | 591 | ||
| Key points | 591 | ||
| Introduction | 591 | ||
| Management goals | 592 | ||
| Treatment of Fluid Retention | 592 | ||
| Maintenance and Restoration of Atrial Contraction | 592 | ||
| Optimization and Treatment of Comorbidities | 592 | ||
| Pharmacologic strategies | 593 | ||
| ACE Inhibitors and ARBs | 593 | ||
| β-Blockers | 593 | ||
| Digoxin | 595 | ||
| Calcium Antagonists | 595 | ||
| Aldosterone Antagonist | 595 | ||
| Studies of Novel Therapies | 595 | ||
| Nonpharmacologic strategies | 596 | ||
| Summary | 596 | ||
| References | 596 | ||
| Potential Applications of Pharmacogenomics to Heart Failure Therapies | 599 | ||
| Key points | 599 | ||
| Background | 599 | ||
| The unmet need for optimization of HF drug regimen | 600 | ||
| β-Blockers | 601 | ||
| RAAS | 601 | ||
| Prevention of sudden cardiac death | 602 | ||
| Pulmonary arterial hypertension | 603 | ||
| Bringing theory into reality | 603 | ||
| Summary | 605 | ||
| References | 605 | ||
| Potential Roles of Vaptans in Heart Failure | 607 | ||
| Key points | 607 | ||
| Overview | 607 | ||
| Role of AVP in hyponatremia and HF | 608 | ||
| Development of AVP receptor antagonists (“vaptans”) | 609 | ||
| ADHF | 609 | ||
| Review of Clinical Evidence for Vaptans Approved in the United States | 610 | ||
| Conivaptan | 610 | ||
| Tolvaptan | 611 | ||
| Tolvaptan in HF | 611 | ||
| Tolvaptan—phase III EVEREST program and analyses | 614 | ||
| Tolvaptan—favorable safety, tolerability, and hemodynamic profiles | 615 | ||
| Targeted clinical trial design and future studies of tolvaptan in HF | 615 | ||
| Summary | 617 | ||
| References | 618 | ||
| Lipid-Modifying Treatments for Heart Failure | 621 | ||
| Key points | 621 | ||
| Introduction | 621 | ||
| Fibrates | 622 | ||
| Omega-3 fatty acids or polyunsaturated fatty acids | 623 | ||
| Statins (3-hydroxy-3-methylglutaryl-coenzyme-A reductase inhibitors) | 625 | ||
| GISSI-HF | 626 | ||
| CORONA | 627 | ||
| PEARL | 628 | ||
| Summary | 632 | ||
| References | 632 | ||
| Current Approaches to Antiarrhythmic Therapy in Heart Failure | 635 | ||
| Key points | 635 | ||
| Introduction | 635 | ||
| Supraventricular arrhythmia | 635 | ||
| AF: epidemiology and pathophysiology | 635 | ||
| Acute management of AF in patients with HF | 637 | ||
| Long-term management of AF in patients with HF | 637 | ||
| Is rhythm control ever the right answer? | 637 | ||
| Medical therapy with rate control: beta-blockers, calcium channel blockers, and digoxin | 639 | ||
| How low to go? | 639 | ||
| Rhythm control | 639 | ||
| Nonpharmacologic approaches to rhythm control | 642 | ||
| Ventricular arrhythmias in HF | 643 | ||
| Mechanisms for ventricular arrhythmia and antiarrhythmic drug therapy in HF | 643 | ||
| Antiarrhythmic drug therapy for primary prophylaxis of ventricular arrhythmia in patients with HF | 643 | ||
| Beta-blockers | 644 | ||
| Sotalol | 644 | ||
| Amiodarone | 644 | ||
| Dronedarone | 645 | ||
| Dofetilide | 645 | ||
| Azimilide | 645 | ||
| Acute management of unstable ventricular arrhythmia in patients with HF | 645 | ||
| Management of stable ventricular arrhythmia in patients with HF | 645 | ||
| Antiarrhythmic drugs for secondary prevention of ICD shocks | 646 | ||
| Other effects of antiarrhythmic drug therapy in ICD patients | 647 | ||
| Summary | 647 | ||
| References | 647 | ||
| The Role of Heart Failure Pharmacotherapy After Left Ventricular Assist Device Support | 653 | ||
| Key points | 653 | ||
| Introduction | 653 | ||
| Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers | 654 | ||
| Aldosterone antagonists | 655 | ||
| β-blockers | 655 | ||
| Digoxin | 656 | ||
| Diuretics | 656 | ||
| Therapies for pulmonary hypertension | 656 | ||
| Clenbuterol | 657 | ||
| Inotropes | 657 | ||
| Management of hypertension | 657 | ||
| Summary | 658 | ||
| References | 658 | ||
| Index | 661 |