Document Detail


The treatment of heart failure: the role of neurohumoral activation.
MedLine Citation:
PMID:  9550589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neurohumoral activation refers to increased activity of the sympathetic nervous system, renin-angiotensin system, vasopressin and atrial natriuretic peptide. It is now known that neurohumoral activation contributes to the transition from ventricular dysfunction to clinical heart failure, and is an independent predictor of poor prognosis in heart failure. Although the treatment of heart failure has traditionally focused on drugs to improve ventricular function, there is increasing evidence that therapeutic modulation of neurohumoral activation is a key to successful treatment of heart failure. For example, there is mounting evidence that angiotensin converting enzyme inhibitors (the unquestioned cornerstone for treatment of heart failure), beta receptor blockers, digitalis, and endurance exercise training exert their benefit in heart failure in large part through neurohumoral modulation. This observation--discussed in this brief review--highlights the concept that compensatory neurohumoral activation to decreased cardiac function may itself contribute to the development of heart failure and its poor prognosis.
Authors:
H R Middlekauff; A L Mark
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Internal medicine (Tokyo, Japan)     Volume:  37     ISSN:  0918-2918     ISO Abbreviation:  Intern. Med.     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-06-17     Completed Date:  1998-06-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9204241     Medline TA:  Intern Med     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  112-22     Citation Subset:  IM    
Affiliation:
UCLA School of Medicine, Department of Medicine, Los Angeles, California 90095, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Clinical Trials as Topic
Digoxin / therapeutic use
Exercise Therapy
Heart Failure / drug therapy*,  physiopathology*,  therapy
Humans
Myocardial Infarction / drug therapy,  physiopathology
Neurotransmitter Agents / physiology*
Receptors, Angiotensin / antagonists & inhibitors
Sympathetic Nervous System / drug effects,  physiopathology
Ventricular Dysfunction, Left / drug therapy,  physiopathology
Grant Support
ID/Acronym/Agency:
1R29HL56796/HL/NHLBI NIH HHS; 5 P50 HL55006-02/HL/NHLBI NIH HHS; 5 R37 HL24962-18/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Neurotransmitter Agents; 0/Receptors, Angiotensin; 20830-75-5/Digoxin

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