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Clin Med Insights Cardiol. 2015 Oct 11;9:57-64. doi: 10.4137/CMC.S29735. eCollection 2015.

Emerging Novel Therapies for Heart Failure.

Clinical Medicine Insights. Cardiology

Anthony M Szema, Sophia Dang, Jonathan C Li

Affiliations

  1. Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, NY, USA. ; Department of Occupational Medicine, Preventive Medicine, and Epidemiology, Hofstra North Shore-LIJ School of Medicine, Hofstra University, Hempstead, NY, USA. ; The Stony Brook Medicine SUNY, Stony Brook Internal Medicine Residency Program, John T. Mather Memorial Hospital, Port Jefferson, NY, USA. ; Three Village Allergy and Asthma, PLLC South Setauket, NY, USA.
  2. Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
  3. Three Village Allergy and Asthma, PLLC South Setauket, NY, USA. ; Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.

PMID: 26512208 PMCID: PMC4603524 DOI: 10.4137/CMC.S29735

Abstract

Heart function fails when the organ is unable to pump blood at a rate proportional to the body's need for oxygen or when this function leads to elevated cardiac chamber filling pressures (cardiogenic pulmonary edema). Despite our sophisticated knowledge of heart failure, even so-called ejection fraction-preserved heart failure has high rates of mortality and morbidity. So, novel therapies are sorely needed. This review discusses current standard therapies for heart failure and launches an exploration into emerging novel treatments on the heels of recently-approved sacubitril and ivbradine. For example, Vasoactive Intestinal Peptide (VIP) is protective of the heart, so in the absence of VIP, VIP knockout mice have dysregulation in key heart failure genes: 1) Force Generation and Propagation; 2) Energy Production and Regulation; 3) Ca(+2) Cycling; 4) Transcriptional Regulators. VIP administration leads to coronary dilation in human subjects. In heart failure patients, VIP levels are elevated as a plausible endogenous protective effect. With the development of elastin polymers to stabilize VIP and prevent its degradation, VIP may therefore have a chance to satisfy the unmet need as a potential treatment for acute heart failure.

Keywords: VIP; genes; heart failure; ivbradine; knockout mice; novel therapies; sacubitri; vasoactive intestinal peptide

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