Current And Future Therapeutic Perspective In Chronic Heart Failure

The incidence of heart failure is primarily flat or declining for a presumably reflecting better management cardiovascular diseases, but that with preserved ejection fraction (HFpEF) probably increasing the lack an established effective treatment. Moreover, there no specific pharmacological treatment patients mildly reduced (HFmrEF) since substantial prospective randomized clinical trial has been performed exclusively in such population. According to recent 2021 European Society Cardiology (ESC) guidelines, triad composed Angiotensin Converting Enzyme inhibitor Receptor-Neprilysin Inhibitor (ARNI), beta-blocker, and Mineralcorticoid Receptor Antagonist cornerstone therapy all (HFrEF) gap exists HFpEF/HFmrEF. Despite important role Renin- Angiotensin-Aldosterone System (RAAS) pathophysiology, RAAS blockers were found ineffective HFpEF patients. Indeed, even new drug class ARNI was only HFrEF In this regard, therapeutic alternative may be represented by stimulating non-classic (ACE2 A1–7) as well other emerging classes (such SGLT2 inhibitors). Reflecting on global health burden treatments among phenotypes, we summarize leading players available each phenotype, future development.