Pharmacogenomics in heart failure: where are we now and how can we reach clinical application?
Pharmacogenomics in heart failure: where are we now and how can we reach clinical application?
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DOI：
10.1097/crd.0000000000000028
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发表时间：
2014-09
影响因子：
2.1
通讯作者：
Lanfear DE
中科院分区：
文献类型：
--
作者：
Oni-Orisan A;Lanfear DE
心力衰竭在美国变得越来越普遍，并且是发病率和死亡率的重要原因。目前有几种治疗方法可用于治疗这种慢性疾病;然而，对这些治疗方案的临床反应显示出显著的患者间差异。现在已经清楚地认识到，遗传学是治疗反应多样性的关键因素，遗传多态性改变心力衰竭药物的药代动力学、药效学和临床反应的证据不断积累。这表明药物基因组学有可能帮助临床医生通过选择最安全和最有效的药物和剂量来改善心力衰竭的管理。不幸的是，尽管有很多支持性数据，心力衰竭治疗方案的药物遗传学优化尚未成为现实。为了减轻心力衰竭日益加重的负担，特别是在最近缺乏新的有效干预措施的背景下，迫切需要扩展药物遗传学知识并利用这些相关性，以提高现有心力衰竭治疗的有效性。本文综述了心力衰竭药物基因组学的现状，并对上述未来的需求进行了展望。
Heart failure is becoming increasingly prevalent in the United States and is a significant cause of morbidity and mortality. Several therapies are currently available to treat this chronic illness; however, clinical response to these treatment options exhibit significant interpatient variation. It is now clearly understood that genetics is a key contributor to diversity in therapeutic response, and evidence that genetic polymorphisms alter the pharmacokinetics, pharmacodynamics, and clinical response of heart failure drugs continues to accumulate. This suggests that pharmacogenomics has the potential to help clinicians improve the management of heart failure by choosing the safest and most effective medications and doses. Unfortunately, despite much supportive data, pharmacogenetic optimization of heart failure treatment regimens is not yet a reality. In order to attenuate the rising burden of heart failure, particularly in the context of the recent paucity of new effective interventions, there is an urgent need to extend pharmacogenetic knowledge and leverage these associations in order to enhance the effectiveness of existing heart failure therapies. The present review focuses on the current state of pharmacogenomics in heart failure and provides a glimpse of the aforementioned future needs.