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
Advancements in Arterial Stiffness: Novel Therapeutic Frontiers
Arterial stiffness, a hallmark of cardiovascular disease, poses significant challenges in contemporary healthcare. This thematic issue delves into the multifaceted landscape of arterial stiffness and explores cutting-edge therapeutic interventions aimed at mitigating its adverse effects. Within these pages, readers will find a comprehensive overview of the mechanisms underlying arterial stiffness, ...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
-
Glibenclamide Action on Myocardial Function and Arrhythmia Incidence in the Healthy and Diabetic Heart
Cardiovascular & Hematological Agents in Medicinal Chemistry Basic and Clinical Research Against Advanced Glycation End Products (AGEs): New Compounds to Tackle Cardiovascular Disease and Diabetic Complications
Recent Advances in Cardiovascular Drug Discovery (Discontinued) Regenerative Medicine: Does Erythropoietin have a Role?
Current Pharmaceutical Design Biology and Therapeutic Applications of Peroxisome Proliferator- Activated Receptors
Current Topics in Medicinal Chemistry Resveratrol and Its Analogues: Promising Antitumor Agents
Anti-Cancer Agents in Medicinal Chemistry Myocardial Revascularization for the Elderly: Current Options, Role of Off-pump Coronary Artery Bypass Grafting and Outcomes
Current Cardiology Reviews Cardiovascular Alterations After Spinal Cord Injury: An Overview
Current Medicinal Chemistry - Cardiovascular & Hematological Agents Cytomegalovirus Infections in Non-Immunocompromised and Immunocompromised Patients in the Intensive Care Unit
Infectious Disorders - Drug Targets PET Imaging of Adenosine Receptors in Diseases
Current Topics in Medicinal Chemistry The Role of the Methoxyphenol Apocynin, a Vascular NADPH Oxidase Inhibitor, as a Chemopreventative Agent in the Potential Treatment of Cardiovascular Diseases
Current Vascular Pharmacology Telomerase Therapeutics for Degenerative Diseases
Current Molecular Medicine Therapy Of Cardiac Arrhythmias In Children: An Emerging Role Of Electroanatomical Mapping Systems
Current Vascular Pharmacology Editorial [Hot Topic: Waiting for Action on the Osteoarthritis Front (Guest Editors: Virginia Byers Kraus and Thomas Aigner)]
Current Drug Targets Drug-Induced Liver Injury: Mechanisms, Types and Biomarkers
Current Medicinal Chemistry Resurgence of Herbal Antihypertensives in Management of Hypertension
Current Hypertension Reviews Regulatory Light Chains of Striated Muscle Myosin. Structure, Function and Malfunction
Current Drug Targets - Cardiovascular & Hematological Disorders Editorial (Thematic Issue: New Therapeutic Targets in Clinical Medicine)
Current Pharmaceutical Design Adverse Systemic Reactions of Antihistamines: Highlights in Sedating Effects, Cardiotoxicity and Drug Interactions
Current Medicinal Chemistry - Anti-Inflammatory & Anti-Allergy Agents The Pim Kinases: New Targets for Drug Development
Current Drug Targets Mini Heme-Proteins: Designability of Structure and Diversity of Functions
Current Protein & Peptide Science