Abstract
Congestive heart failure (CHF) is characterized not only by profound abnormalities in the haemodynamic profile but also by changes in sympathetic cardiovascular function. These neurogenic abnormalities are important features of the disease that can affect the prognosis of CHF and to become a target for therapeutic intervention. This article addresses 4 major issues. It will first examine the evidence that a hyperadrenergic state is a hallmark of CHF, based on data collected via indirect (plasma norepinephrine, power spectral analysis of the heart rate signal) and direct (microneurography, norepinephrine spillover, radioimaging techniques visualizing myocardial neural network) approaches. It will then provide an overview on the central, reflex and metabolic factors potentially responsible for the phenomenon. The review also analyses the clinical consequences of the adrenergic alteration, with particular emphasis on the effects of the sympathetic overdrive on disease progression, arrhythmogenic threshold, adverse clinical outcomes as well as sudden death. The final part of the review will examine the therapeutic implications of the above mentioned findings and discuss the effects of pharmacological and non- pharmacological interventions on the sympathetic abnormalities of the heart failure state.
Keywords: Heart failure, sympathetic nervous system, prognosis, baroreflex, drugs
Current Vascular Pharmacology
Title: Sympathetic Activation in Congestive Heart Failure: Evidence, Consequences and Therapeutic Implications
Volume: 7 Issue: 2
Author(s): Guido Grassi, Gino Seravalle, Fosca Quarti-Trevano and Raffaella Dell'Oro
Affiliation:
Keywords: Heart failure, sympathetic nervous system, prognosis, baroreflex, drugs
Abstract: Congestive heart failure (CHF) is characterized not only by profound abnormalities in the haemodynamic profile but also by changes in sympathetic cardiovascular function. These neurogenic abnormalities are important features of the disease that can affect the prognosis of CHF and to become a target for therapeutic intervention. This article addresses 4 major issues. It will first examine the evidence that a hyperadrenergic state is a hallmark of CHF, based on data collected via indirect (plasma norepinephrine, power spectral analysis of the heart rate signal) and direct (microneurography, norepinephrine spillover, radioimaging techniques visualizing myocardial neural network) approaches. It will then provide an overview on the central, reflex and metabolic factors potentially responsible for the phenomenon. The review also analyses the clinical consequences of the adrenergic alteration, with particular emphasis on the effects of the sympathetic overdrive on disease progression, arrhythmogenic threshold, adverse clinical outcomes as well as sudden death. The final part of the review will examine the therapeutic implications of the above mentioned findings and discuss the effects of pharmacological and non- pharmacological interventions on the sympathetic abnormalities of the heart failure state.
Export Options
About this article
Cite this article as:
Grassi Guido, Seravalle Gino, Quarti-Trevano Fosca and Dell'Oro Raffaella, Sympathetic Activation in Congestive Heart Failure: Evidence, Consequences and Therapeutic Implications, Current Vascular Pharmacology 2009; 7 (2) . https://dx.doi.org/10.2174/157016109787455699
DOI https://dx.doi.org/10.2174/157016109787455699 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Integrating Behavioral Health into a Transplantation Service-One Institution's Approach
Current Psychiatry Reviews Antiplatelet and Antileukocyte Effects of Cardiovascular,Immunomodulatory and Chemotherapeutic Drugs
Cardiovascular & Hematological Agents in Medicinal Chemistry Genetic Enhancement in Sport: Just Another Form of Doping?
Recent Patents on DNA & Gene Sequences Protein Kinase C and Prostate Carcinogenesis: Targeting the Cell Cycle and Apoptotic Mechanisms
Current Drug Targets Targeting MDM2 and MDMX in Retinoblastoma
Current Cancer Drug Targets Female Infertility and Assisted Reproduction: Impact of Oxidative Stress-- An Update
Current Women`s Health Reviews SARS-CoV-2 & Covid-19: Key-Roles of the ‘Renin-Angiotensin’ System / Vitamin D Impacting Drug and Vaccine Developments
Infectious Disorders - Drug Targets Impact of MCP -1 in Atherosclerosis
Current Pharmaceutical Design Localisation of Endothelin-1 and its Receptors in Vascular Tissue as Seen at the Electron Microscopic Level
Current Vascular Pharmacology Purinergic Signalling and Endothelium
Current Vascular Pharmacology Advanced Diabetes Care: Three Levels of Prediction, Prevention & Personalized Treatment
Current Diabetes Reviews Editorial (Thematic Issue: The Coronary Collateral Circulation – Past, Present and Future)
Current Cardiology Reviews Treating Hypertension in the Elderly: Common Problems and Solutions
Current Hypertension Reviews Mid-Aortic Syndrome: A Rare Cause of Renovascular Hypertension in Childhood Treated Percutaneously with an Unusual Vascular Access
Current Pediatric Reviews Effects of Elicitors, Viticultural Factors, and Enological Practices on Resveratrol and Stilbenes in Grapevine and Wine
Mini-Reviews in Medicinal Chemistry Management of Type 2 Diabetes: More Evidence is Required to Address the Clinical and Contextual Facets
Current Diabetes Reviews Stem Cell Therapy for the Treatment of Acute Myocardial Infarction and Chronic Ischemic Heart Disease
Current Pharmaceutical Biotechnology Optimizing the Management of Uncontrolled Hypertension: What do Triple Fixed-Dose Drug Combinations Add?
Current Vascular Pharmacology Coarctation of the Aorta - The Current State of Surgical and Transcatheter Therapies
Current Cardiology Reviews Patent Selections
Recent Patents on Cardiovascular Drug Discovery