Efficacy of the New Inotropic Agent Istaroxime in Acute Heart Failure
Current therapeutic strategies for acute heart failure (AHF) are based on traditional inotropic agents that are often associated with untoward effects; therefore, finding new effective approaches with a safer profile is dramatically needed. Istaroxime is a novel compound, chemically unrelated to car...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/24/7503 |
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| author | Imma Forzano Pasquale Mone Gaetano Mottola Urna Kansakar Luigi Salemme Antonio De Luca Tullio Tesorio Fahimeh Varzideh Gaetano Santulli |
| author_facet | Imma Forzano Pasquale Mone Gaetano Mottola Urna Kansakar Luigi Salemme Antonio De Luca Tullio Tesorio Fahimeh Varzideh Gaetano Santulli |
| author_sort | Imma Forzano |
| collection | DOAJ |
| description | Current therapeutic strategies for acute heart failure (AHF) are based on traditional inotropic agents that are often associated with untoward effects; therefore, finding new effective approaches with a safer profile is dramatically needed. Istaroxime is a novel compound, chemically unrelated to cardiac glycosides, that is currently being studied for the treatment of AHF. Its effects are essentially related to its inotropic and lusitropic positive properties exerted through a dual mechanism of action: activation of the sarcoplasmic reticulum Ca<sup>2+</sup> ATPase isoform 2a (SERCA2a) and inhibition of the Na<sup>+</sup>/K<sup>+</sup>-ATPase (NKA) activity. The advantages of istaroxime over the available inotropic agents include its lower arrhythmogenic action combined with its capability of increasing systolic blood pressure without augmenting heart rate. However, it has a limited half-life (1 hour) and is associated with adverse effects including pain at the injection site and gastrointestinal issues. Herein, we describe the main mechanism of action of istaroxime and we present a systematic overview of both clinical and preclinical trials testing this drug, underlining the latest insights regarding its adoption in clinical practice for AHF. |
| first_indexed | 2024-03-09T16:15:56Z |
| format | Article |
| id | doaj.art-8dad28399e2b41e2b2c17374dcf87616 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T16:15:56Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-8dad28399e2b41e2b2c17374dcf876162023-11-24T15:46:45ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-011124750310.3390/jcm11247503Efficacy of the New Inotropic Agent Istaroxime in Acute Heart FailureImma Forzano0Pasquale Mone1Gaetano Mottola2Urna Kansakar3Luigi Salemme4Antonio De Luca5Tullio Tesorio6Fahimeh Varzideh7Gaetano Santulli8Division of Cardiology, Department of Advanced Biomedical Sciences, “<i>Federico II</i>” University, 80131 Naples, ItalyDivision of Cardiology, Department of Medicine, Wilf Family Cardiovascular Research Institute, Einstein Institute for Aging Research, Albert Einstein College of Medicine, New York, NY 10461, USACasa di Cura “<i>Montevergine</i>”, Mercogliano, 83013 Avellino, ItalyDivision of Cardiology, Department of Advanced Biomedical Sciences, “<i>Federico II</i>” University, 80131 Naples, ItalyCasa di Cura “<i>Montevergine</i>”, Mercogliano, 83013 Avellino, ItalyDepartment of Mental and Physical Health and Preventive Medicine, University of Campania “<i>Vanvitelli</i>”, 81100 Caserta, ItalyCasa di Cura “<i>Montevergine</i>”, Mercogliano, 83013 Avellino, ItalyDivision of Cardiology, Department of Advanced Biomedical Sciences, “<i>Federico II</i>” University, 80131 Naples, ItalyDivision of Cardiology, Department of Advanced Biomedical Sciences, “<i>Federico II</i>” University, 80131 Naples, ItalyCurrent therapeutic strategies for acute heart failure (AHF) are based on traditional inotropic agents that are often associated with untoward effects; therefore, finding new effective approaches with a safer profile is dramatically needed. Istaroxime is a novel compound, chemically unrelated to cardiac glycosides, that is currently being studied for the treatment of AHF. Its effects are essentially related to its inotropic and lusitropic positive properties exerted through a dual mechanism of action: activation of the sarcoplasmic reticulum Ca<sup>2+</sup> ATPase isoform 2a (SERCA2a) and inhibition of the Na<sup>+</sup>/K<sup>+</sup>-ATPase (NKA) activity. The advantages of istaroxime over the available inotropic agents include its lower arrhythmogenic action combined with its capability of increasing systolic blood pressure without augmenting heart rate. However, it has a limited half-life (1 hour) and is associated with adverse effects including pain at the injection site and gastrointestinal issues. Herein, we describe the main mechanism of action of istaroxime and we present a systematic overview of both clinical and preclinical trials testing this drug, underlining the latest insights regarding its adoption in clinical practice for AHF.https://www.mdpi.com/2077-0383/11/24/7503acute heart failurecalciuminotropic agentsistaroximelusitropic agentsNa<sup>+</sup>/K<sup>+</sup>-ATPase |
| spellingShingle | Imma Forzano Pasquale Mone Gaetano Mottola Urna Kansakar Luigi Salemme Antonio De Luca Tullio Tesorio Fahimeh Varzideh Gaetano Santulli Efficacy of the New Inotropic Agent Istaroxime in Acute Heart Failure Journal of Clinical Medicine acute heart failure calcium inotropic agents istaroxime lusitropic agents Na<sup>+</sup>/K<sup>+</sup>-ATPase |
| title | Efficacy of the New Inotropic Agent Istaroxime in Acute Heart Failure |
| title_full | Efficacy of the New Inotropic Agent Istaroxime in Acute Heart Failure |
| title_fullStr | Efficacy of the New Inotropic Agent Istaroxime in Acute Heart Failure |
| title_full_unstemmed | Efficacy of the New Inotropic Agent Istaroxime in Acute Heart Failure |
| title_short | Efficacy of the New Inotropic Agent Istaroxime in Acute Heart Failure |
| title_sort | efficacy of the new inotropic agent istaroxime in acute heart failure |
| topic | acute heart failure calcium inotropic agents istaroxime lusitropic agents Na<sup>+</sup>/K<sup>+</sup>-ATPase |
| url | https://www.mdpi.com/2077-0383/11/24/7503 |
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