[Neurohormonal mechanisms in cardiac insufficiency. Possible therapeutic implications].
Neurohormonal mechanisms play an important role in pathogenesis of left ventricular dysfunction. Analysis of traditional therapeutic strategies for heart failure used in the past is disappointing. Recent therapeutic strategy that aims to treat earlier patients with ventricular dysfunction with agents that counteract neurohormonal activation, seems to be more effective. However conventional drugs such as vasodilator agents, digitalis and diuretics are still useful for treatment of overt heart failure, due to their proven hemodynamic benefits. A lot of current clinical trials, in the future, can help us to solve this problem. In this issue evolving concepts of pathophysiology of chronic heart failure and how these pathophysiologic concepts lead to the rational treatment are discussed.
Servizio di Cardiologia-UTIC, Regione Liguria, USSL 17 Portofino, Presidio Ospedaliero di Rapallo, Genova.
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Iannetti
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Vallebona
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D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004071:Digitalis Glycosides / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006439:Hemodynamics / Q000187:drug effects; D006728:Hormones / Q000502:physiology; D006801:Humans; D008297:Male; D014665:Vasodilator Agents / Q000627:therapeutic use; D016277:Ventricular Function, Left / Q000187:drug effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D004071:Digitalis Glycosides; D004232:Diuretics; D006728:Hormones; D014665:Vasodilator Agents
Meccanismi neurormonali nell'insufficienza cardiaca. Possibili implicazioni terapeutiche.