Leveraging signaling pathways to treat heart failure with reduced ejection fraction: past, present, and future

M Pinilla-Vera, VS Hahn, DA Kass - Circulation research, 2019 - Am Heart Assoc
Circulation research, 2019Am Heart Assoc
Advances in the treatment of heart failure with reduced ejection fraction due to systolic
dysfunction are engaging an ever-expanding compendium of molecular signaling targets.
Well established approaches modifying hemodynamics and cell biology by neurohumoral
receptor blockade are evolving, exploring the role and impact of modulating intracellular
signaling pathways with more direct myocardial effects. Even well-tread avenues are being
reconsidered with new insights into the signaling engaged and thus opportunity to treat …
Advances in the treatment of heart failure with reduced ejection fraction due to systolic dysfunction are engaging an ever-expanding compendium of molecular signaling targets. Well established approaches modifying hemodynamics and cell biology by neurohumoral receptor blockade are evolving, exploring the role and impact of modulating intracellular signaling pathways with more direct myocardial effects. Even well-tread avenues are being reconsidered with new insights into the signaling engaged and thus opportunity to treat underlying myocardial disease. This review explores therapies that have proven successful, those that have not, those that are moving into the clinic but whose utility remains to be confirmed, and those that remain in the experimental realm. The emphasis is on signaling pathways that are tractable for therapeutic manipulation. Of the approaches yet to be tested in humans, we chose those with a well-established experimental history, where clinical translation may be around the corner. The breadth of opportunities bodes well for the next generation of heart failure therapeutics.
Am Heart Assoc