New therapies for heart failure: is thalidomide the answer? NLM AIDSLINE Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.

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New therapies for heart failure: is thalidomide the answer?

QJM. 2000 May;93(5):305-11. Unique Identifier : AIDSLINE MED/20286658
Davey PP; Ashrafian H; Nuffield Department of Medicine, Oxford University, John; Radcliffe Hospital, Oxford, UK. patrick.davey@ndm.ox.ac.uk

Abstract: The syndrome of advanced heart failure is associated with considerable morbidity and mortality. Ideas about the reasons for the progressive nature of the heart failure syndrome have changed over the years, with the initial view that progression was principally due to pump failure (the 'haemodynamic' hypothesis), giving way to more modern views, which implicate neuro-endocrine activation (including catecholamine excess, renin-angiotensin system activation, etc.). More recently, an excess of inflammatory cytokines has been found in advanced heart failure and implicated in the progression of the disease. Amongst the cytokines found, TNF-alpha seems to be particularly important. The principle therapeutic action of thalidomide appears to be reduction of TNF-alpha levels. We therefore suggest that there may be a role for thalidomide, or its derivatives, in the management of advanced heart failure.
Keywords: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL Heart Failure, Congestive/*DRUG THERAPY Human Immunosuppressive Agents/*THERAPEUTIC USE Thalidomide/*THERAPEUTIC USE Tumor Necrosis Factor/ANTAGONISTS & INHIB/PHYSIOLOGYKWDjournalarticlereviewreview,tutorialheartfailure,congestive/KWDdrugtherapyhumanimmunosuppressiveagents/KWDtherapeuticusethalidomide/KWDtherapeuticusetumornecrosisfactor/antagonists&inhib/physiology
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