Neurohumoral control mechanisms in congestive heart failure

Jay N Cohn, T. Barry Levine, Gary S Francis, Steven Goldsmith

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

Neurohumoral vasoconstrictor systems may play an important role in the hemodynamic derangement and natural history of congestive heart failure (CHF) by raising impedance to left ventricular ejection and shifting blood centrally to augment cardiac filling. Activation of the sympathetic nervous system, the renin-angiotensin system, and the antidiuretic hormone-vasopressin system can be demonstrated in clinical CHF by increased plasma levels of norepinephrine, renin activity, and arginine vasopressin. Because the magnitude of increase in each of these hormones varies widely from patient to patient, profiling of the neurohumoral response might provide new insight into the mechanisms of regulation of the circulation in CHF and into specific management with drugs to inhibit or reverse the vasoconstrictor process. Preliminary encouraging experience with converting-enzyme inhibitors to block formation of angiotensin II and alpha-receptor blockers to inhibit norepinephrine-induced vasoconstriction raise the possibility that selective therapy may eventually have a place in long-term management of CHF. Controlled trials in a larger patient population are now required.

Original languageEnglish (US)
Pages (from-to)509-514
Number of pages6
JournalAmerican Heart Journal
Volume102
Issue number3 PART 2
DOIs
StatePublished - Jan 1 1981

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Heart Failure
Vasoconstrictor Agents
Vasopressins
Norepinephrine
Arginine Vasopressin
Angiotensin Receptor Antagonists
Sympathetic Nervous System
Enzyme Inhibitors
Renin-Angiotensin System
Vasoconstriction
Electric Impedance
Renin
Hemodynamics
Hormones
Pharmaceutical Preparations
Population
Therapeutics

Cite this

Neurohumoral control mechanisms in congestive heart failure. / Cohn, Jay N; Levine, T. Barry; Francis, Gary S; Goldsmith, Steven.

In: American Heart Journal, Vol. 102, No. 3 PART 2, 01.01.1981, p. 509-514.

Research output: Contribution to journalArticle

Cohn, Jay N ; Levine, T. Barry ; Francis, Gary S ; Goldsmith, Steven. / Neurohumoral control mechanisms in congestive heart failure. In: American Heart Journal. 1981 ; Vol. 102, No. 3 PART 2. pp. 509-514.
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