NEW DRUGS IN THE TREATMENT OF HEART-FAILURE

1. Current therapy of heart failure relies on diuretics, positive inotropic compounds and vasodilators. The short-term haemodynamic benefits, especially of the cAMP generators, may be compromised by long-term limitations leading to an increased mortality, In contrast, some vasodilators, especially angiotensin converting enzyme inhibitors, improve survival even in severe heart failure. 2. Modulation of Na+- or K+-channels and calcium sensitization are positive inotropic mechanisms whose promise in treatment of heart failure needs to be fully explored. 3. The introduction of vasodilator therapy has been a significant advance. Newer compounds act to inhibit the endogenous vasoconstrictors angiotensin II and endothelin, or to potentiate the endogenous vasodilators atrial natriuretic factor and nitric oxide, The full potential of these compounds is yet to be realised.