The pathophysiology of heart failure:a tale of two old paradigms revisited

Ashrafian, Houman, Williams, Lynne and Frenneaux, Michael P (2008) The pathophysiology of heart failure:a tale of two old paradigms revisited. Clinical Medicine, 8 (2). pp. 192-197. ISSN 1470-2118

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Abstract

Although our current appreciation of the detrimental role of neurohumoral activation in heart failure (HF) has been intellectually appealing and has led to neurohumoral antagonism that has reduced morbidity and mortality from HF, the persisting disability and death rates remain unacceptably high. In the search for novel strategies to improve on these outcomes, we must reacquaint ourselves with basic cardiac physiology at levels ranging from the molecular to the systemic in order to identify new targets for the treatment of HF. This approach has already begun to yield results; in this review, two such aspects will be focused on: diastolic ventricular interaction and cardiac energetics. These two examples will be used to illuminate how fundamental research has elucidated age-old, although mechanistically elusive, principles (for example, the Frank-Starling law), explained why existing and emerging therapeutic approaches (for example, biventricular pacing in HF) have proved successful, and successfully identified novel therapy modes (for example, perhexiline as an energy augmentation agent).

Item Type: Article
Uncontrolled Keywords: cardiovascular agents,cardiovascular physiological phenomena,clinical trials as topic,heart failure,humans,metabolic networks and pathways,perhexiline,trimetazidine,vasodilator agents
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 09 Mar 2015 07:28
Last Modified: 21 Apr 2020 23:53
URI: https://ueaeprints.uea.ac.uk/id/eprint/52404
DOI: 10.7861/clinmedicine.8-2-192

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