[Pharmacological therapeutics based on molecular mechanisms].

Pharmacological treatment of chronic heart failure has considerably changed according as a shift of the pathophysiological concept. During the past two decades, it became clear that neurohumoral stimulations play an important role in the progression of heart failure by promoting cardiac remodeling. Administration of angiotensin-converting enzyme-inhibitors, angiotensin II receptor blockers, and beta blockers is now an essential treatment that reduces morbidity and mortality. In spite of an increase in available treatments, the prognosis of symptomatic heart failure remains to be poor. To establish newer and successful treatments, further advancement in our understanding of the molecular mechanisms underlying the pathogenesis of heart failure will be required. Currently, several novel approaches are being tested targeting prevention of cardiac remodeling and myocardial dysfunction. Cardiomyocyte protection by hematopoietic cytokines and stem cell-based therapy may have a promising therapeutic potential.