Pharmacologic Approaches to Heart Failure

Fore w ord P h a r m a c o t h e r a p y fo r H e a r t F a i l u re: Th e M o re We G e t to K n o w, t h e M o re We N e e d t o Know

Mandeep R. Mehra, MD

Javed Butler, MD, MPH

To know, is to know that you know nothing. That is the meaning of true knowledge. —Socrates It was not long ago, even in the early 1980s, that the treatment for patients with heart failure was largely restricted to the use of diuretics and digoxin. The past 3 decades have seen phenomenal progress in our understanding of heart failure pathophysiology, ranging across the spectrum of cardiac structural and functional abnormalities, neurohormonal activation, and systemic hemodynamic changes, to the effects of comorbidities on the progression of heart failure. These insights have led to targeted discoveries of novel therapies that have altered the entire natural history for patients suffering from heart failure. As exhilarating as this rapid progress has been, scientific progress has raised many new poignant questions as well. Thus, ironically despite this progress, we have more questions about the management of heart failure patients than we did a couple of decades ago. Or perhaps this is due to the progress itself! These questions include the nature of interaction between emerging therapies,

their importance in subpopulations of heart failure patients, issues related to more personalized medicine, the impact of technology to discern the “omics” of heart failure patients, and obviously, the still unconquered frontier in heart failure with preserved ejection fraction. In this issue of Heart Failure Clinics titled, “Pharmacologic Approaches to Heart Failure,” Dr Kirkwood Adams has assembled highly experienced investigators and authors to address ten such discrete issues where, despite recent progress, several questions remained unanswered. This necessitated not only summarizing the existing data but also carefully extracting the themes and knowledge from these data, and their unique interpretation in light of the authors’ experience. These topics include articles on existing therapies that are widely accepted, therapies that remain controversial, subpopulations for whom no known therapies exist, future direction in the “omics” era, and management challenges in patients taking multiple medications. We are certain that this issue of Heart Failure Clinics will be an invaluable source for the readership in terms of improving care of the patients with

Heart Failure Clin 10 (2014) ix–x http://dx.doi.org/10.1016/j.hfc.2014.07.011 1551-7136/14/$ – see front matter Ó 2014 Elsevier Inc. All rights reserved.

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Consulting Editors

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Foreword heart failure as well as a guide for future research in this field. Mandeep R. Mehra, MD Harvard Medical School BWH Heart and Vascular Center Center for Advanced Heart Disease Brigham and Women’s Hospital 75 Francis Street, A Building 3rd Floor, Room AB324 Boston, MA 02115, USA

Javed Butler, MD, MPH Heart Failure Research Emory Clinical Cardiovascular Research Institute Emory University 1462 Clifton Road NE, Suite 504 Atlanta, GA 30322, USA E-mail addresses: [email protected] (M.R. Mehra) [email protected] (J. Butler)

Pharmacotherapy for heart failure: the more we get to know, the more we need to know. Foreword.

Pharmacotherapy for heart failure: the more we get to know, the more we need to know. Foreword. - PDF Download Free
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