Neurohormonal interactions and adaptations in congestive heart failure.
CirculationPublished 1 April 1988Open access
Milton Packer
Citations538
SJR quartileQ1
SJR score8.67
SNIP8.30
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TL;DR
Physiologists have hypothesized that the sympathetic nervous and renin-angioten causes an increase in loading conditions in ventricle and may accelerate progression of lying disease, which may underlie the path ventricular arrhythmias.
Abstract
so ignorant I ure are identical to those triggered in response to intra- ut when I got vascular volume depletion, but with an important dif- e had learned ference.The release of neurohormones is generally
Keywords
MedicineNeuroscience
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Data suggest that neuroh hormonal systems may exert a deleterious effect on the survival of some patients with severe chronic heart failure, which may be favorably modified by long-term treatment with specific neurohormonal antagonists.
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In 63 patients with severe acute or chronic heart failure maximum cardiac performance was determined by calculation of the maximum hydraulic power output achieved by the heart during dobutamine challenge, all but 3 of the 23 patients with maximum cardiac power output less than the normal resting value had died of progressive heart failure after one year.
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Baroreceptor dysfunction may be a principal mechanism that contributes to neurohumoral activation and subsequent alteration in vascular resistance and sodium and water balance in congestive heart failure.
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Journal of the American College of CardiologyAbnormal neurohumoral response to nitroprusside infusion in congestive heart failure
108 Citations1983Maria Teresa Olivari, T. Barry Levine +1 more
Data indicate that a subset of patients with severe ventricular dysfunction have an abnormal humoral, reflex sympathetic response to changes in arterial or intracardiac pressure, or both and this alteration in the sympathetic response may be a marker of the severity and prognosis of heart failure.
American Journal of Physiology-Renal PhysiologyRelationship between renal hemodynamic and natriuretic effects of atrial natriuretic factor
107 Citations1986R. Ernest Sosa, Massimo Volpe +5 more
The data demonstrate that the natriuretic effect of ANF is abolished when its renal hemodynamic actions are impeded, and the results demonstrate that ANF antagonizes renal vasoconstriction in the dog.
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104 Citations1983GD Johnston, William R. Hiatt +4 more
It was found that furosemide significantly increased venous capacitance in the calf of the normal volunteers on a low salt diet, and indomethacin, high salt intake, or lack of renal function was sufficient to inhibit this effect.
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Converting-enzyme inhibition effectively abolished the pretreatment difference in renal function seen in the high- and low-renin subgroups.
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102 Citations1984Leonard S. Lilly, Victor J. Dzau +3 more
It is concluded that serum Na concentration serves as a useful index of activation of the sympathetic nervous system, renin-angiotensin system, and impairment of regional perfusion in patients with advanced CHF.
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It is concluded that the quantity of endogenous sympathetic neurotransmitter available for release by tyramine from nerve endings in the peripheral arteriolar bed in the calf is not reduced and may even be augmented in patients with heart failure, and that the elevated levels of plasma norepinephrine in the heart failure state are derived, at least in part, from labile adrenergic stores in the periphery vascular bed.
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It is concluded that the ANF endocrine system might function as an effective chronic compensatory mechanism to help promote sodium and water excretion in dogs with an AV fistula through the suppression of the renin-aldosterone system and possibly through its direct renal actions.
PubMedSensitization of cardiac vagal afferent reflexes at the sensory receptor level: an overview.
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Evidence that modulation of reflexes originating in the heart can also occur at the sensory or afferent level is reviewed, with implications for cardiovascular pharmacology and for pathophysiological states such as heart failure and hypertension.
The Journal of UrologyInteraction of Prostaglandins and Angiotensin II in the Modulation of Renal Function in Congestive Heart Failure
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Clinically, four specific factors have been identified that predispose patients with heart failure to the development of functional renal insufficiency after treatment with converting-enzyme or cyclo-oxygenase inhibitors: marked renal hypoperfusion, vigorous diuretic therapy, diabetes mellitus, and intensity of hormonal inhibition within the kidney.
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