Les médicaments de l'insuffisance cardiaque : quoi de neuf ?

The treatment of acute cardiac failure has some limitations due to the risk of cardiac arythmias induced by dobutamine and phosphodiesterase inhibitors, and to an increase in mortality related to the use of these agents. New inotropic agents have been evaluated such as levosimedan that increases troponin C affinity for calcium, cardiac myosin activators, sarco-endoplasmic reticulum calcium-ATPase activators (istaroxim), NO synthase inhibitors (L-NAME). Other drugs have been developed such as cardiac peptides derivatives (neseritide, carperitide, uralitide) endothelin antagonists (tezosentan), vasopressin antagonists (tovaptan). Levosimedan and neseritide have been included in international guidelines although not yet available on most of the markets. Istaroxime and myosine activators document promising results but are still in development.