16 New Pharmacologic Therapies in Heart Failure: Immunotherapy, Endothelin-1 Antagonists, Brain Natriuretic Peptides, and Neurohormonal Interventions.
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Bradykinin-Prostaglandin and Other Pathways --; Effects on Hematocrit --; Electrophysiological and Autonomic Effects --; Uricosuric Effect --; Tolerability --; Will the Combination of ACE inhibitors and ARBs Prove Superior to Either Class Used Alone? --; The Question of Dose --; LANDMARK TRIALS AND META-ANALYSES PRINCIPALLY DESIGNED TO COMPARE ARBS WITH PLACEBO IN THE ABSENCE OF AN ACE INHIBITOR --; The Losartan Meta-Analysis --; The Candesartan Meta-Analysis --; CHARM-Alternative --; CHARM-Preserved --; I-PRESERVE --; LANDMARK TRIALS PRINCIPALLY DESIGNED TO COMPARE ARBS WITH PLACEBO IN THE PRESENCE OF AN ACE INHIBITOR --; RESOLVD --; Val-HeFT --; CHARM-Added --; VALIANT --; LANDMARK TRIALS PRINCIPALLY DESIGNED TO COMPARE ARBS WITH ACE INHIBITORS --; ELITE (Evaluation of Losartan in the Elderly Study) --; ELITE II --; RESOLVD --; OPTIMAAL --; VALIANT --; WHY USE AN ARB? To Improve Symptoms of Heart Failure --; To Reduce Hospitalization --; To Reduce Major Vascular Events --; To Reduce Mortality --; Adverse Effects --; Are the benefits and side effects of ARBs dose related? --; Are There Clinically Relevant Differences Between ARBs? --; Are There Important Interactions Between ARBs and Other Classes of Drug Used in Heart Failure? --; Heart Failure in the Absence of Left Ventricular Systolic Dysfunction --; CONCLUSIONS --; REFERENCES --; 15 Role of Mineralocorticoid Antagonists in Patients with Heart Failure --; SYNOPSIS --; INTRODUCTION --; THE EFFECT OF ALDOSTERONE RECEPTOR ANTAGONISTS ON SODIUM EXCRETION AND DIURESIS --; EFFECTS OF MR ANTAGONISTS ON VENTRICULAR REMODELING --; ALDOSTERONE AS AN INFLAMMATORY MEDIATOR --; EFFECTS OF MR ANTAGONISTS ON VASCULAR TONE --; PREVENTION OF SUDDEN CARDIAC DEATH --; EFFECTS ON THE AUTONOMIC NERVOUS SYSTEM --; MYOCARDIAL FIBROSIS --; EMERGING THEMES IN MR ANTAGONISM: IS IT THE LIGAND, THE RECEPTOR, OR BOTH? --; CONCLUSION --; REFERENCES.
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Front cover --; Preface --; Contents --; Contributors --; 1 The Genetics of Dilated and Hypertrophic Cardiomyopathies --; GENETIC METHODS --; Familial Aggregation --; Genetic Linkage --; Clinical Diagnosis and Genetic Mapping --; Positional Cloning --; Genetic Association Studies --; Locus and Allelic Heterogeneity --; Modifiers of Simple Traits --; USING GENETICS IN CLINICAL PRACTICE --; Family-Based Diagnosis --; Diagnosis-History --; Diagnosis-Clinical Evaluation --; Prognosis --; Management --; SPECIFIC DISORDERS-DILATED CARDIOMYOPATHY --; Etiology of DCM --; Clinical Genetics --; Genetic Mapping --; Molecular Genetics and Pathophysiology --; Disease Models --; HYPERTROPHIC CARDIOMYOPATHY Definitions and Clinical Features --; Clinical Genetics --; Molecular Genetics --; Disease Models --; CONCLUSION --; REFERENCES --; 2 Molecular Signaling Networks Underlying Cardiac Hypertrophy and Failure --; INTRODUCTION --; THE SIGNAL AT THE CELL MEMBRANE --; Mechanical Deformation --; Humoral Factors --; SIGNALING WITHIN THE CELL --; Reprogramming of Gene Expression --; In-Depth Evaluation of Calcineurin-Nuclear Factor of Activated T-Cell Signaling --; Use of CsA and FK506 in Animal Models of Cardiac Hypertrophy --; Targeted Inhibition of Calcineurin Attenuates Hypertrophy --; Calcineurin Targets Regulating the Hypertrophic Response --; Clinical Use of CsA and FK506 --; Regulation of Protein Synthesis --; Evaluation of mTOR --; The PI3-K Pathway --; Other Pathways Involved in Growth Regulation --; ALTERATIONS IN SIGNALING IN THE DISEASED HUMAN HEART --; REFERENCES --; 3 Mechanisms of Cell Death in Heart Failure --; MORPHOLOGIC FEATURES OF CELL DEATH --; CELL DEATH BY NECROSIS IN HEART FAILURE --; CELL DEATH BY APOPTOSIS IN THE FAILING MYOCARDIUM --; ROLE OF UBIQUITIN-PROTEOSOME PATHWAY IN MYOCYTE DEATH IN HEART FAILURE --; CROSS-TALK IN DEATH PATHWAYS --; CONCLUSIONS --; REFERENCES. 4 Excitation-Contraction Coupling Mechanisms in Heart Failure --; SUMMARY --; EXCITATION-CONTRACTION COUPLING --; Electrical Activity in the Heart --; Regulation of Contractility in the Heart --; CHANGES IN HEART FAILURE --; Action Potential and Repolarizing Currents in Heart Failure --; Calcium Handling in Failing Hearts --; Contractile Proteins --; Energetics --; Abnormal --; receptor Signaling --; CONCLUDING REMARKS --; REFERENCES --; 5 B- Adrenergic Signaling in Heart Failure --; INTRODUCTION --; ADRENERGIC RECEPTORS-MORE THAN REGULATORS OF CARDIAC CONTRACTILITY --; GRK Arr --; AC --; TARGETS OF --; ADRENERGIC RECEPTOR STIMULATION --; CHANGES OF --; ADRENERGIC SIGNAL TRANSDUCTION IN HEART FAILURE --; BLOCKERS AS THERAPEUTIC PRINCIPLE IN HEART FAILURE --; MUTATIONS IN ADRENERGIC RECEPTOR GENES LEADING TO ALTERED SIGNALING PROPERTIES --; ACKNOWLEDGEMENTS --; REFERENCES --; 6 Ventricular Remodeling and Secondary Valvular Dysfunction in Heart Failure Progression --; PATHOGENESIS OF VENTRICULAR REMODELING --; FUNCTIONAL CHANGES --; NEUROHORMONAL ACTIVATION --; CELLULAR AND SUBCELLULAR CHANGES IN REMODELING --; EXTRACELLULAR MATRIX DEGRADATION --; MYOCYTE HYPERTROPHY AND APOPTOSIS --; FIBROSIS --; REMODELING CHANGES ON THE MACROSCOPIC LEVEL --; SECONDARY VALVULAR DYSFUNCTION --; REMODELING AND VALVULAR DYSFUNCTION OF THE RIGHT VENTRICLE --; THERAPEUTIC TARGETS --; REFERENCES --; 7 Neurohormonal and Cytokine Activation in Heart Failure --; SYNOPSIS --; INTRODUCTION --; RENIN ANGIOTENSIN ALDOSTERONE SYSTEM --; SYMPATHETIC ACTIVATION --; INTERACTION OF RENIN ANGIOTENSIN AND SYMPATHETIC ACTIVATION --; CYTOKINE ACTIVATION --; REGULATION OF PLASMA VOLUME --; VASCULAR REACTIVITY --; CLINICAL HETEROGENEITY IN HEART FAILURE: IMPACT OF GENETIC DIVERSITY --; SUMMARY --; ACKNOWLEDGEMENT --; REFERENCES --; 8 Cardiomyopathies in the Adult (Dilated, Hypertrophic, and Restrictive) --; INTRODUCTION. DILATED CARDIOMYOPATHY Morphology and Pathology --; Epidemiology and Natural History --; Etiology --; Clinical Presentation --; Evaluation --; Treatment --; HYPERTROPHIC CARDIOMYOPATHY Morphology and Pathology --; Epidemiology and Natural History --; Etiology --; Clinical Presentation --; Evaluation --; Management --; RESTRICTIVE CARDIOMYOPATHY Morphology and Pathology --; Epidemiology, Natural History, and Etiology --; Clinical Presentation --; Evaluation --; Management --; SUMMARY --; REFERENCES --; 9 Heart Failure with Normal Systolic Function --; INTRODUCTION --; PATHOPHYSIOLOGY OF DIASTOLIC HEART FAILURE --; DIAGNOSING DIASTOLIC HEART FAILURE --; Objective Evidence of Congestive Heart Failure --; Objective Evidence of Normal Left Ventricular Systolic Function --; Objective Evidence of Left Ventricular Diastolic Dysfunction --; Clinical Improvement by Treating Precipitating Factors --; Diagnosing Diastolic Heart Failure at the Bedside --; PREVALENCE --; THE ETIOLOGY --; Hypertension --; Left Ventricular Hypertrophy --; Myocardial Fibrosis --; Coronary Artery Disease --; Diabetes --; Obesity --; Aging --; Aortic Stenosis --; Hypertrophic Cardiomyopathy --; Restrictive Cardiomyopathy --; Constrictive Pericarditis --; Hypothyroidism --; PROGNOSIS OF DIASTOLIC HEART FAILURE --; SUMMARY --; REFERENCES --; 10 The Clinical Syndrome of Heart Failure --; INTRODUCTION --; EPIDEMIOLOGY Definition --; Classification --; Incidence and Prevalence --; Economics --; Risk Factors --; PATHOPHYSIOLOGY Normal Integrated Function of the Heart --; Heart Failure --; Systolic Heart Failure --; Diastolic Heart Failure --; DIAGNOSIS OF HEART FAILURE Symptoms and Signs --; Classification and Interpretation of the Clinical Presentation --; Diagnostic Laboratory Modalities --; COMMON CLINICAL FEATURES AND COMPLICATIONS --; Arrhythmias --; Functional Limitation and Exercise Capacity. Clinical Assessment of Functional and Exercise Capacity --; Mitral Regurgitation --; Sleep Apnea --; ''Cardiorenal'' Phenomena --; Cardiac Cachexia --; Anemia --; Psychiatric --; PROGNOSIS --; PREDICTION OF SURVIVAL --; CONCLUSION --; REFERENCES --; 11 Clinical Profiles and Prognosis in Heart Failure --; PURPOSES OF PROGNOSTIC FACTORS/FEATURES --; MAJOR OUTCOMES PREDICTED --; CLASSIFYING PROGNOSTIC FACTORS AND FEATURES --; MICROSCOPIC FEATURES --; VENTRICULAR STRUCTURE AND FUNCTION --; CENTRAL HEMODYNAMICS --; Filling Pressures --; Cardiac Output --; Clinical Assessment --; Biochemical Markers --; Markers of Dysrhythmia Risk --; CLINICAL INTEGRATORS Clinical Class --; FUNCTIONAL ASSESSMENT --; RESPONSES AFTER THERAPY --; SELECTION FOR END-STAGE THERAPIES --; THE PROGNOSIS FOR CHANGE --; REFERENCES --; 12 Conventional Therapy of Chronic Heart Failure: Diuretics, Angiotensin-Converting Enzyme Inhibitors, and Digoxin --; TREATMENT GOALS --; PHARMACOLOGIC THERAPY FOR SYSTOLIC HEART FAILURE Diuretics --; Vasodilator Therapy --; Digitalis --; REFERENCES --; 13 Conventional Therapy of Chronic Heart Failure: Beta-Adrenergic Blockers --; BENEFICIAL EFFECTS OF BETA ADRENERGIC BLOCKERS --; Exercise Tolerance --; Ventricular Remodeling --; DRUG CLASSES OF BETA BLOCKERS: ARE THESE DRUGS INTERCHANGEABLE? --; Effects on Mortality --; BETA BLOCKER USE IN SPECIAL POPULATIONS --; CLINICAL CONSIDERATIONS IN SELECTION OF A SPECIFIC BETA BLOCKER --; UNANSWERED QUESTIONS REGARDING BETA BLOCKER ADMINISTRATION Asymptomatic Left Ventricular Dysfunction --; Cardiac Pacemaker Implantation --; Concomitant Use with Inotropic Therapy --; CONCLUSION --; REFERENCES --; 14 Angiotensin Receptor Blockers for Heart Failure --; INTRODUCTION --; RATIONALE FOR THE USE OF ARBS IN HEART FAILURE --; WHY MIGHT THE EFFECTS OF ARBs AND ACE INHIBITORS DIFFER? ACE ''Breakthrough'' --; AT2 Receptor Stimulation.
SUMMARY OR ABSTRACT
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This impressive guide authoritatively summarizes the fundamental cellular and molecular abnormalities associated with heart failure, as well as current invasive and noninvasive diagnostic techniques, the latest pharmacological advances, device-based therapies, surgical options, and evolving molecular treatments-surpassing any other text on the topic with concise discussions of recent molecular discoveries in pathophysiology alongside practical clinical approaches to the diagnosis and treatment of heart failure patients.