Emerging Therapies for Heart Failure: A Review of Novel Pharmacological Agents, Device-Based Therapies, and Gene Therapy Approaches

Research Article

Abstract

Heart failure (HF) remains a major global public health challenge associated with high morbidity, mortality, recurrent hospitalization, and escalating healthcare costs despite significant advances in conventional treatment strategies. The growing limitations of standard pharmacological and supportive therapies have accelerated the development of innovative therapeutic approaches aimed at improving cardiac function, reducing disease progression, and enhancing patient quality of life. This review examines emerging therapies for heart failure, with emphasis on novel pharmacological agents, device-based interventions, and gene therapy strategies. Recent pharmacological advancements, including sodium–glucose cotransporter-2 (SGLT2) inhibitors, angiotensin receptor–neprilysin inhibitors (ARNIs), soluble guanylate cyclase stimulators, and cardiac myosin activators, have demonstrated substantial clinical benefits in reducing cardiovascular mortality and hospitalization rates. In parallel, device-based therapies such as cardiac resynchronization therapy, implantable cardioverter defibrillators, left ventricular assist devices, and remote monitoring technologies continue to transform the management of advanced HF through improved hemodynamic support and early disease surveillance. Furthermore, gene therapy and regenerative approaches, including SERCA2a gene transfer, CRISPR-mediated genome editing, and stem cell-based cardiac repair, represent promising frontiers targeting the molecular and genetic basis of HF. However, challenges related to long-term safety, clinical efficacy, accessibility, cost, and ethical considerations remain significant barriers to widespread implementation. The review highlights the potential of integrating pharmacological innovation, precision medicine, and advanced biotechnology to redefine future HF management and improve long-term cardiovascular outcomes.