Holst-Hansen Amalie, Grimm Daniela, Wehland Markus
Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark.
Department of Microgravity and Translational Regenerative Medicine, Otto von Guericke University, 39106 Magdeburg, Germany.
Int J Mol Sci. 2024 Dec 22;25(24):13711. doi: 10.3390/ijms252413711.
This review will discuss heart failure, introduce a new drug finerenone, and discuss clinical studies with a focus on its effects on heart failure. Heart failure is a condition or syndrome characterized by an impairment of the pumping ability of the heart, thus no longer keeping up with the demands of the body. There are several types of heart failure; among them are heart failure with reduced ejection fraction, with mildly reduced ejection fraction and with preserved ejection fraction. Heart failure can be caused by several factors including lifestyle factors and diseases such as hypertension, type 2 diabetes mellitus and other cardiovascular diseases. Chronic kidney disease is also a risk factor of heart failure, as it leads to a state of inflammation that can impair the cardiovascular system over time. The novel nonsteroidal mineralocorticoid receptor antagonist finerenone antagonizes the mineralocorticoid receptor and thereby decreases the amount of fibrosis and inflammation that is observed in many heart failure patients. It shows an equal tissue distribution among heart and kidney, a high affinity and selectivity for the mineralocorticoid receptor and little risk of hyperkalemia and feminization. It also exhibits a reduction in the incidence of cardiovascular outcomes among patients with chronic kidney disease and type 2 diabetes mellitus. Therefore, finerenone has been proposed as a beneficial medication for reducing heart failure, especially in patients with diabetes and chronic kidney disease. Further studies are to be conducted to clarify the effects of finerenone alone and in combination with other drugs.
本综述将讨论心力衰竭，介绍一种新药非奈利酮，并重点讨论其对心力衰竭影响的临床研究。心力衰竭是一种以心脏泵血能力受损为特征的病症或综合征，因此无法再满足身体的需求。心力衰竭有几种类型，其中包括射血分数降低的心衰、射血分数轻度降低的心衰和射血分数保留的心衰。心力衰竭可由多种因素引起，包括生活方式因素以及诸如高血压、2型糖尿病和其他心血管疾病等疾病。慢性肾脏病也是心力衰竭的一个危险因素，因为它会导致炎症状态，随着时间的推移会损害心血管系统。新型非甾体类盐皮质激素受体拮抗剂非奈利酮可拮抗盐皮质激素受体，从而减少许多心力衰竭患者中观察到的纤维化和炎症程度。它在心脏和肾脏之间显示出相等的组织分布，对盐皮质激素受体具有高亲和力和选择性，且高钾血症和女性化风险很小。它还能降低慢性肾脏病和2型糖尿病患者心血管事件的发生率。因此，非奈利酮已被提议作为一种有益药物用于减轻心力衰竭，尤其是在糖尿病和慢性肾脏病患者中。还需进一步开展研究以阐明非奈利酮单独使用以及与其他药物联合使用的效果。
