New drugs in heart failure therapy

Prof. Dr. István Édes was a student of medicine at the University of Szeged and took a degree of MD in 1977. He is currently a distinguished professor and head of the Department of Cardiology at University of Debrecen. The research interests turned Prof. Édes towards the experimentaland preclinical studies with Ca2+-sensitizers andpositive inotropic agents, as well as to the regulation of myocardial contractility. The outstanding publication achievements of his research include more than 100 articles in peer-reviewed international journals and over 200 publications in different Hungarian medical journals. Prof. Édes takes an active part also in the training of colleges at graduate and postgraduate levels, which includes lectures in clinical physiology and cardiology. He is currently an editorial memberof the Journal of Molecular Cellular Cardiology and the Journal of Cardiologia Hungarica.

Treatment of heart failure in the past has traditionally focused on the modification of haemodynamic alterations that occur in the failing heart. Unfortunately, the development of new positive inotropic drugs (to improve haemodynamics), has yielded disappointing results. On the other hand, the development of new drugs intended to modulate: 1) neurohormonal activation, 2) the metabolism of the myocardium or 3) the Ca2+ sensitivity of the myofibrils, may slow disease progression. Despite these theoretical advancements, morbidity and mortality of heart failure remains high and the development of alternative pharmacological strategies is obviously needed. Promising results have been obtained on animal experiments and/or on limited number of heart failure patients with the following drugs: a) renin inhibitors; b) fatty acid metabolism inhibitors; and c) Ca2+ sensitizers. The recent results on the statin therapy and human heart failure will also be discussed.