Heart failure therapy at a crossroad: are there limits to the neurohormonal model?

摘要: The advent of neurohormonal blockade in heart failure (HF) has been an overwhelming success, but current evidence points to a ceiling effect as newer targets are exploited incremental manner. This lead us question whether the model HF can be sustained by simply stacking multiple or cytokine blockers together treatment. A unifying theme some these disparate trials relates either lack efficacy or, more importantly, adversity resulting regression already achieved benefits. It is our contention that available uncovered remarkable complexity interaction within context construct. As we stand at crossroad and begin fervently pursue non-neurohormonal therapeutic targets, must also direct attention navigating multifaceted labyrinth led imbroglio.