依瓦布拉定
医学
盐皮质激素受体
临床试验
心力衰竭
药理学
内科学
心脏病学
受体
血压
心率
作者
Michael E. Farkouh,Verghese Mathew
标识
DOI:10.1016/j.tcm.2022.02.004
摘要
Over the past 30 years, accumulating evidence has shown that three main therapies including angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, ß-blockers, and mineralocorticoid receptor antagonists are the standard treatment for patients with heart failure (HF) who exhibit reduced ejection fraction (EF). However, lessons learned from recent large-scale clinical trials have added a paradigm shift including angiotensin receptor-neprilysin inhibitor, sodium glucose co-transporter 2 inhibitor, and ivabradine. In addition, soluble guanyl cyclase stimulator and omecamtiv mecarbil are also suggested as next generation therapeutic measures for these patients. From these clinical trials, we learned some patients with preserved EF will benefit from certain agents, which has been one of the largest unmet needs over these decades. This article will review these paradigm shifts over the past 10 years and address a new therapeutic algorithm for patients with HF.
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