Document Detail

Novel mechanisms of sympatho-excitation in chronic heart failure.
MedLine Citation:
PMID:  12634882     Owner:  NLM     Status:  MEDLINE    
Chronic heart failure (CHF) is associated with an increase in the production and secretion of various regulatory hormones that are initially beneficial, but become deleterious when elevated for prolonged periods. The neurohumoral excitation that occurs in the CHF state is mediated, in part, by abnormal inhibitory cardiovascular reflexes, such as the arterial baroreflex and the cardiopulmonary reflex. In addition, two sympatho-excitatory reflexes have been shown to be enhanced in CHF: the arterial chemoreflex and the cardiac sympathetic afferent reflex. While these reflexes may play a role in the sympatho-excitation of the CHF state, there is an important central modulation of sympathetic outflow by a variety of hormones that are elevated in CHF and have been shown to have neural effects. These include angiotensin II (Ang II), nitric oxide (NO), and endothelin-1. In fact, experimental animal data suggest that a central reciprocal relationship exists between Ang II and NO in their ability to modulate sympathetic outflow. These substances may also participate in the beneficial effects of exercise training in the CHF state. Exercise training lowers sympathetic nerve activity and plasma Ang II, and enhances arterial baroreflex function. This review emphasizes the neurohormonal and reflex regulation of sympathetic outflow in heart failure. While abnormal reflex regulation may predict a poor outcome, new treatment options may emerge from a better understanding of reflex regulation in CHF.
Irving H Zucker; Rainer U Pliquett
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Heart failure monitor     Volume:  3     ISSN:  1470-8590     ISO Abbreviation:  Heart Fail Monit     Publication Date:  2002  
Date Detail:
Created Date:  2003-03-13     Completed Date:  2003-05-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101140283     Medline TA:  Heart Fail Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  2-7     Citation Subset:  IM    
Department of Physiology and Biophysics, University of Nebraska Medical Center, Omaha, NE 68198-4575, USA.
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MeSH Terms
Angiotensin II / metabolism
Baroreflex / physiology
Endothelin-1 / metabolism
Excitatory Postsynaptic Potentials / physiology
Heart Failure / metabolism,  physiopathology*
Nitric Oxide / metabolism
Sympathetic Nervous System / metabolism,  physiopathology*
Reg. No./Substance:
0/Endothelin-1; 10102-43-9/Nitric Oxide; 11128-99-7/Angiotensin II

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