Over the last several decades, heart failure (HF) treatment has made considerable strides. In patients affected by HF with reduced left ventricular ejection fraction (HFrEF), neuro-hormonal modulation by angiotensin receptor neprilysin inhibitors, beta-blockers and mineralocorticoid receptor antagonists along with cardiorenal protection by type 2 sodium–glucose cotransporter inhibitors (SGLT2i) are currently recommended in order to modify the clinical course of this entity and improve life expectancy. Aside from these 4 classes of drugs, new molecules (e.g., vericiguat, omecamtiv mecarbil and ferric carboxymaltose) have recently been shown to be capable of further reducing hospitalization, thus making the HF therapeutic approaches even more complex. In this scenario, there is a need to better define how to tailor HFrEF medical treatment as well as how to evaluate therapeutic targets and patients’ responses.
Recent trials have demonstrated the efficacy of SGLT2i in improving outcome of HF patients with mildly reduced (HFmrEF) or preserved (HFpEF) left ventricular ejection fraction. Although these beneficial effects are proven, the mechanisms by which SGLT2i are able to improve prognosis throughout the whole range of left ventricular ejection fraction have not been fully clarified.
Finally, in patients affected by HFpEF, the research continues to study novel drugs for HF treatment, some of which have recently demonstrated the ability to target specific etiological mechanisms such as in hypertrophic cardiomyopathy of cardiac amyloidosis.
The Special Issue "Advances of Drug Therapy in Heart Failure" aims to collect high-quality original research papers and comprehensive reviews on recent evidence in relation to the therapeutic treatment of heart failure. The topics of interest include, but are not limited to:
• Acute and chronic heart failure
• Myocardial fibrosis/remodeling
• Cardiorenal syndrome and metabolism
• Cardiovascular imaging
• Pathophysiological mechanisms
Dr. Massimo Iacoviello
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