Document Detail


Neuroendocrine changes in chronic cardiac failure.
MedLine Citation:
PMID:  8896739     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Numerous hormonal and neuroendocrine changes have been described in patients with chronic cardiac failure. These affect the balance of vasodilator and vasoconstrictor factors in favour of the latter, to the detriment of the circulation. Whether this is a reaction to central cardiac (haemodynamic) abnormalities, or is an integral part of the syndrome of heart failure, remains to be determined. Catecholamine levels are increased, especially in severe heart failure, and contribute to the vasoconstriction and probably also to lethal ventricular arrhythmias. The renin-angiotensin-aldosterone system (RAAS) is also activated, causing fluid retention and further vasoconstriction. In the earlier stages, some of this increase may be iatrogenic due to the use of loop diuretics or inhibitors of angiotensin converting enzyme, but there is evidence for independent RAAS activation in more severe grades of heart failure. The role of vasoconstrictor peptides such as neuropeptide Y and endothelin is briefly considered. Counterbalancing these are vasodilator peptides, in particular atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP). The possibility of therapeutic interventions to increase circulating natriuretic hormone levels is discussed.
Authors:
D P Nicholls; G N Onuoha; G McDowell; J S Elborn; M S Riley; A M Nugent; I C Steele; C Shaw; K D Buchanan
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Basic research in cardiology     Volume:  91 Suppl 1     ISSN:  0300-8428     ISO Abbreviation:  Basic Res. Cardiol.     Publication Date:  1996  
Date Detail:
Created Date:  1997-01-28     Completed Date:  1997-01-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0360342     Medline TA:  Basic Res Cardiol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  13-20     Citation Subset:  IM    
Affiliation:
Department of Medicine, Royal Victoria Hospital, Northern Ireland.
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MeSH Terms
Descriptor/Qualifier:
Atrial Natriuretic Factor / blood
Bombesin / blood
Chronic Disease
Glucagon / blood
Heart Failure / blood,  physiopathology*
Humans
Insulin / blood
Neuropeptide Y / blood
Neurosecretory Systems / physiopathology*
Neurotensin / blood
Renin-Angiotensin System
Chemical
Reg. No./Substance:
0/Neuropeptide Y; 11061-68-0/Insulin; 31362-50-2/Bombesin; 39379-15-2/Neurotensin; 85637-73-6/Atrial Natriuretic Factor; 9007-92-5/Glucagon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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