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Neurohumoral activation in heart failure and the implications for treatment

June 2016 Br J Cardiol 2016;23(suppl 1):S1–S16 doi:10.5837/bjc.2016.s01

Neurohumoral activation in heart failure and the implications for treatment

Legate Philip, Paul R Kalra

Abstract

Introduction An acute pathological insult to the heart leads to a reduction in cardiac output (i.e. any cause of left ventricular systolic dysfunction [LVSD]), which activates a series of innate protective mechanisms. In the short term, activation of neurohumoral systems aim to preserve central arterial pressure and thereby vital organ perfusion, and include the sympathetic nervous system (SNS) and the renin–angiotensin–aldosterone system (RAAS). The net main effects of this process are: i) vasoconstriction; ii) sodium and water retention by the kidneys. While in the acute setting these adaptive responses may be beneficial, long-term over

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