Neurohumoral control mechanisms in congestive heart failure☆
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Cited by (134)
The historical evolution of knowledge of the involvement of neurohormonal systems in the pathophysiology and treatment of heart failure
2019, Revista Portuguesa de CardiologiaAdvanced (stage D) heart failure: A statement from the heart failure society of america guidelines committee
2015, Journal of Cardiac FailureCitation Excerpt :The Enhanced Feedback for Effective Care (EFFECT) study derived a multivariable risk model using vital signs, routine laboratories, and comorbidities at the time of admission to predict 30-day and 1-year mortality.36 The interplay of neurohormonal activation, inflammation, and myocardial remodeling in the pathophysiology of heart failure has been well described.37–40 In HFrEF, this insidious, variable, and persistent process ultimately overwhelms the benefits of conventional heart failure therapy and the disease progresses to an advanced stage.
Is thrombosis a contributor to heart failure pathophysiology? Possible mechanisms, therapeutic opportunities, and clinical investigation challenges
2013, International Journal of CardiologyCitation Excerpt :The understanding of heart failure pathophysiology has evolved considerably from an initial primary focus on low cardiac output and abnormal hemodynamics to the recognition that activated neurohormones promote cardiac remodeling and heart failure progression (both systolic and diastolic) and are associated with worse outcomes [1–5].
Bidirectional neuro-glial signaling modalities in the hypothalamus: Role in neurohumoral regulation
2013, Autonomic Neuroscience: Basic and ClinicalCitation Excerpt :By controlling these two major information processing systems, specific neuronal networks within the central nervous system (CNS) generate adaptive neurohumoral responses, which are necessary for proper cardiovascular, fluid and energy balance system regulation. Neurohumoral activation is not only important within the context of adaptive physiological responses, but it is now also recognized to be a critical pathophysiological component in numerous disease conditions, including hypertension, heart failure, stress, and the metabolic syndrome (Cohn et al., 1981; Haywood et al., 1985; Middlekauff and Mark, 1998; Brook and Julius, 2000; Felder et al., 2001; Perez-Tilve et al., 2006). In the case of heart failure, for example, a compelling correlation between neurohumoral activation, morbidity and mortality in heart failure patients has been established (Cohn et al., 1984).
The Pathophysiology of Heart Failure
2012, Muscle: Fundamental Biology and Mechanisms of DiseaseNatural History of End-stage LV Dysfunction: Has It Improved from the Classic Franciosa and Cohn Graph?
2011, Cardiology ClinicsCitation Excerpt :In the early 1970s, Drs Franciosa and Cohn showed acute improvement in hemodynamics, exercise capacity, and metabolic effects with vasodilation using nitroprusside, hydralazine, and isosorbide dinitrate in patients with advanced left ventricular (LV) systolic failure.30–32 The importance of neurohumoral regulation was further elucidated in the late 1970s with description of the role of sympathetic nervous system, renin-angiotensin system, and antidiuretic hormone, resulting in increased norepinephrine levels and hyponatremia.33 Several clinical trials followed, testing inhibition using angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), aldosterone receptor antagonists and β-blockers to sequentially counter neurohumoral activation, resulting in significant improvements in morbidity and mortality.
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Supported in part by grants from the National Heart, Lung and Blood Institute (HL22977) and from the Veterans Administration Research Service.