PMID- 27976514
OWN - NLM
STAT- MEDLINE
DCOM- 20171121
LR  - 20180210
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 19
IP  - 4
DP  - 2017 Apr
TI  - Silent disease progression in clinically stable heart failure.
PG  - 469-478
LID - 10.1002/ejhf.705 [doi]
AB  - Heart failure with reduced ejection fraction (HFrEF) is a progressive disorder
      whereby cardiac structure and function continue to deteriorate, often despite the
      absence of clinically apparent signs and symptoms of a worsening disease state.
      This silent yet progressive nature of HFrEF can contribute to the increased risk 
      of death-even in patients who are 'clinically stable', or who are asymptomatic or
      only mildly symptomatic-because it often goes undetected and/or undertreated.
      Current therapies are aimed at improving clinical symptoms, and several agents
      more directly target the underlying causes of disease; however, new therapies are
      needed that can more fully address factors responsible for underlying progressive
      cardiac dysfunction. In this review, mechanisms that drive HFrEF, including
      ongoing cardiomyocyte loss, mitochondrial abnormalities, impaired calcium
      cycling, elevated LV wall stress, reactive interstitial fibrosis, and
      cardiomyocyte hypertrophy, are discussed. Additionally, limitations of current HF
      therapies are reviewed, with a focus on how these therapies are designed to
      counteract the deleterious effects of compensatory neurohumoral activation but do
      not fully prevent disease progression. Finally, new investigational therapies
      that may improve the underlying molecular, cellular, and structural abnormalities
      associated with HF progression are reviewed.
CI  - (c) 2016 The Authors. European Journal of Heart Failure published by John Wiley &
      Sons Ltd on behalf of European Society of Cardiology.
FAU - Sabbah, Hani N
AU  - Sabbah HN
AD  - Henry Ford Health System, Detroit, MI, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Research Support, Non-U.S. Gov't
DEP - 20161214
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
RN  - 0 (Aminobutyrates)
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Diuretics)
RN  - 0 (LCZ 696)
RN  - 0 (Natriuretic Agents)
RN  - 0 (Peptide Fragments)
RN  - 0 (Tetrazoles)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 740Y5J48Z8 (Ularitide)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
RN  - EC 3.4.24.11 (Neprilysin)
RN  - SY7Q814VUP (Calcium)
SB  - IM
MH  - Aminobutyrates/therapeutic use
MH  - Angiotensin Receptor Antagonists/therapeutic use
MH  - Apoptosis
MH  - Atrial Natriuretic Factor/therapeutic use
MH  - Calcium/metabolism
MH  - Disease Progression
MH  - Diuretics/therapeutic use
MH  - Fibrosis
MH  - Heart Failure/drug therapy/metabolism/*physiopathology
MH  - Humans
MH  - Mitochondria, Heart/*metabolism
MH  - Myocardium/*pathology
MH  - Myocytes, Cardiac
MH  - Natriuretic Agents/therapeutic use
MH  - Natriuretic Peptide, Brain/therapeutic use
MH  - Neprilysin/antagonists & inhibitors
MH  - Peptide Fragments/therapeutic use
MH  - Stress, Mechanical
MH  - *Stroke Volume
MH  - Tetrazoles/therapeutic use
MH  - Ventricular Dysfunction, Left/metabolism/*physiopathology
PMC - PMC5396296
OTO - NOTNLM
OT  - *Heart failure
OT  - *Mechanism
OT  - *Progressive deterioration
OT  - *Stable heart failure
OT  - *Treatment
EDAT- 2016/12/16 06:00
MHDA- 2017/11/29 06:00
CRDT- 2016/12/16 06:00
PHST- 2016/05/13 00:00 [received]
PHST- 2016/10/21 00:00 [revised]
PHST- 2016/11/02 00:00 [accepted]
PHST- 2016/12/16 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2016/12/16 06:00 [entrez]
AID - 10.1002/ejhf.705 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2017 Apr;19(4):469-478. doi: 10.1002/ejhf.705. Epub 2016 Dec
      14.