title: Time and technology will tell: the pathophysiologic basis of neurohormonal modulation in heart failure.
abstract: The central roles of neurohormonal abnormalities in the pathobiology of heart failure have been defined in recent decades. Experiments have revealed both systemic involvement and intricate subcellular regulation by circulating effectors of the sympathetic nervous system, the renin-angiotensin-aldosterone system, and others. Randomized clinical trials substantiated these findings, establishing neurohormonal antagonists as cornerstones of heart failure pharmacotherapy, and occasionally offering further insight on mode of benefit. This review discusses the use of β-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and aldosterone receptor antagonists in the treatment of heart failure, with particular attention to the pathophysiologic basis and mechanisms of action.
authors.affiliation: Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, 20 North Pine Street, Baltimore, MD 21201, USA.
authors.forename: Brent N
authors.initials: BN
authors.lastname: Reed
authors.affiliation: Department of Cell Biology and Physiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Street
authors.affiliation: Division of Cardiology and McAllister Heart Institute, University of North Carolina School of Medicine, 160 Dental Circle, Chapel Hill, NC 27599-7075, USA. Electronic address: bcjensen@med.unc.edu.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Jensen
mesh_terms: D020811:Biomedical Technology; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D018377:Neurotransmitter Agents / Q000502:physiology*; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D013564:Sympathetic Nervous System / Q000503:physiopathology; D013997:Time Factors
chemical_list: D018377:Neurotransmitter Agents
keywords: Adrenergic beta-antagonists; Angiotensin-converting enzyme inhibitors; Drug therapy; Heart failure; Neurotransmitter agents; Physiology; Renin-angiotensin system; Sympathetic nervous system