Review of Vasodilators in Acute Decompensated Heart Failure: The Old and the New

Abstract Despite substantial improvements in treatment for chronic heart failure, morbidity and mortality for acute decompensated heart failure (ADHF) remain high. Treatment of ADHF is focused on controlling symptoms rather than improving long-term outcomes. The vasodilators nitroglycerin (NTG) and...

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Bibliographic Details
Published in:Journal of cardiac failure 2013-07, Vol.19 (7), p.478-493
Main Authors: Carlson, Michelle D., MD, Eckman, Peter M., MD
Format: Article
Language:English
Subjects:
Acute Disease
Animals
Cardiovascular
Heart Failure - diagnosis
Heart Failure - drug therapy
Heart Failure - epidemiology
Humans
natriuretic peptide
Nitroglycerin
Randomized Controlled Trials as Topic - methods
sodium nitroprusside
Vasodilator Agents - therapeutic use
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Summary:Abstract Despite substantial improvements in treatment for chronic heart failure, morbidity and mortality for acute decompensated heart failure (ADHF) remain high. Treatment of ADHF is focused on controlling symptoms rather than improving long-term outcomes. The vasodilators nitroglycerin (NTG) and sodium nitroprusside (SNP) have been used in ADHF for decades, but, since the development of nesiritide 10 years ago, interest in new vasodilators has grown. Therapies that improve not only hemodynamics and symptoms but also long-term outcomes are in high demand, and numerous new vasodilatory agents have been investigated, including various natriuretic peptides, soluble guanylyl cyclase agents, renin-angiotensin-aldosterone system–modifying agents, and others. A review of the literature shows that few of them rise to the challenge set by NTG and SNP.
ISSN:1071-9164
1532-8414
DOI:10.1016/j.cardfail.2013.05.007