Recent advances in the treatment of heart failure.

Treatment strategies for patients with heart failure and left ventricular systolic dysfunction continue to evolve as the complex pathophysiology of this disease is better understood. A number of advances have been made in recent years, most notably the addition of beta-receptor antagonists. In addition, recent studies have provided important information regarding the utility of angiotensin receptor antagonists, aldosterone receptor antagonists, and natriuretic peptides in the management of heart failure. Nonpharmacologic advances include resynchronization therapy, which appears to confer symptomatic improvement in some patients, and improvements in ventricular assist device technology. As the importance of neurohormonal activation in the progression of heart failure becomes increasingly apparent, new therapeutic strategies targeting these neurohormonal systems are being investigated.