Therapeutic Progress and Knowledge Basis on the Natriuretic Peptide System in Heart Failure
| Autor: | Zhenyu Chang, Shihui Fu, Leiming Luo, Juelin Deng |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Angiotensin receptor Sympathetic nervous system medicine.drug_class 030204 cardiovascular system & hematology Pharmacology Natriuresis Renin-Angiotensin System 03 medical and health sciences 0302 clinical medicine Drug Discovery medicine Vasopeptidase Inhibitors Natriuretic peptide Animals Humans Enzyme Inhibitors Natriuretic Peptides Adverse effect Neprilysin Heart Failure business.industry General Medicine medicine.disease 030104 developmental biology medicine.anatomical_structure Heart failure business |
| Zdroj: | Current Topics in Medicinal Chemistry. 19:1850-1866 |
| ISSN: | 1568-0266 |
| DOI: | 10.2174/1568026619666190826163536 |
| Popis: | Notwithstanding substantial improvements in diagnosis and treatment, Heart Failure (HF) remains a major disease burden with high prevalence and poor outcomes worldwide. Natriuretic Peptides (NPs) modulate whole cardiovascular system and exhibit multiple cardio-protective effects, including the counteraction of the Renin–Angiotensin–Aldosterone System (RAAS) and Sympathetic Nervous System (SNS), promotion of vasodilatation and natriuresis, and inhibition of hypertrophy and fibrosis. Novel pharmacological therapies based on NPs may achieve a valuable shift in managing patients with HF from inhibiting RAAS and SNS to a reversal of neurohormonal imbalance. Enhancing NP bioavailability through exogenous NP administration and inhibiting Neutral Endopeptidase (NEP) denotes valuable therapeutic strategies for HF. On the one hand, NEP-resistant NPs may be more specific as therapeutic choices in patients with HF. On the other hand, NEP Inhibitors (NEPIs) combined with RAAS inhibitors have proved to exert beneficial effects and reduce adverse events in patients with HF. Highly effective and potentially safe Angiotensin Receptor Blocker Neprilysin Inhibitors (ARNIs) have been developed after the failure of NEPIs and Vasopeptidase Inhibitors (VPIs) due to lacking efficacy and safety. Therapeutic progress and knowledge basis on the NP system in HF are summarized in the current review. |
| Databáze: | OpenAIRE |
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