Endothelin receptor antagonists and acute heart failure syndromes

Abstract

As noted in the preceding chapters, the acute heart failure syndrome (AHFS) has been largely ignored until recently, despite its role as the primary hospital discharge diagnosis in 1million patients per year and accounting for over $14 billion in hospital costs in the United States alone.1 The therapeutic approach to these patients has remained essentially unchanged for decades, despite, or perhaps due to, the relative absence of clinical trial evidence. Recent surveys have demonstrated that with current therapy, patients admitted for AHFS have a 45% chance of readmission2 and a 20% to 40% risk of death in the following 6 months. Given these poor outcomes, the medical community is reevaluating the current therapeutic approach and searching for new therapies to treat patients with AHFS. One result of this reassessment of acute heart failure (AHF) has been the recognition of AHF as a vascular disorder and the need to develop therapies that can provide vascular protection. Endothelin receptor antagonists provide a potential novel approach to the treatment of AHF by addressing the underlying pathophysiologic abnormalities in this syndrome. © 2008 Springer-Verlag London.