[Neurohumoral mechanisms in pathophysiology of chronic heart failure].
Pathogenic mechanisms of chronic systolic heart failure are constantly of great interest. In recent years the neurohumoral theory of heart failure has gained attraction. According to this theory, neurohumoral mechanisms play the main role in the pathogenesis of heart failure, especially in its progression. These mechanisms can be divided into 2 categories: vasoconstrictive, mitogenic and antinatriuretic on the one hand and vasodilative, antimitogenic and natriuretic on the other one. The former consists of sympathetic nervous system, renin-angiotensin-aldosterone system, vasopressin, endothelin, cytokines. The latter comprises natriuretic peptides, prostaglandins and nitric oxide. Undoubtedly unfavourable roles of sympathetic system and renin-angiotensin-aldosteron have been shown in the progression of heart failure. Data are being also gathered confirming harmful effects of endothelin and cytokines and possibly of neuropeptide Y and vasopressine. Extensive data exist that demonstrate beneficial influence of natriuretic peptide on heart failure. The roles of nitric oxide as well as recently discovered adrenomedullin and medullipin are far from clear.
Rubin
W
W
Katedra i Klinika Kardiologii Akademii Medycznej we Wrocławiu.
Kosmala
W
W
Kobusiak-Prokopowicz
M
M
D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism; D018450:Disease Progression; D019332:Endothelin-1 / Q000378:metabolism; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D045283:Natriuretic Agents / Q000378:metabolism; D009478:Neuropeptide Y / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism; D012084:Renin-Angiotensin System; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014667:Vasopressins / Q000378:metabolism
D016207:Cytokines; D019332:Endothelin-1; D045283:Natriuretic Agents; D009478:Neuropeptide Y; D014667:Vasopressins; D009569:Nitric Oxide