title: Pathophysiologic Mechanisms in Heart Failure: Role of the Sympathetic Nervous System.
abstract: The syndrome of heart failure involves complex pathophysiologic mechanisms and is associated with extremely high-morbidity, mortality and economic costs. This growing global epidemic has diverse etiologies and is fundamentally characterized by dyshomeostasis between heart and kidneys, leading to development and progression of the cardiorenal syndrome. Excessive and sustained sympathoexcitation has emerged as a single prominent factor involved in the structural and functional dysfunction of multiple organ systems during this disease. Studies in experimental models of heart failure indicate that ablation of the renal nerves may help restore renal sodium and water equilibrium as well as the attenuation of adverse cardiac remodeling. With the recent development of minimally invasive endovascular renal denervation in humans, it is anticipated that this technology would become a novel and important paradigm shift in the management of heart failure.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Steve
authors.initials: S
authors.lastname: Antoine
authors.affiliation: Division of Cardiology, Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Gaurang
authors.initials: G
authors.lastname: Vaidya
authors.affiliation: Division of Cardiology, Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Haider
authors.initials: H
authors.lastname: Imam
authors.affiliation: Division of Cardiology, Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York; Veterans Affairs Medical Center, Syracuse, New York. Electronic address: villarrd@upstate.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Villarreal
mesh_terms: D000818:Animals; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D007668:Kidney / Q000294:innervation / Q000503:physiopathology; D013562:Sympathectomy; D013564:Sympathetic Nervous System / Q000503:physiopathology*
keywords: Cardiac peptides; Diuresis; Natriuresis; Renal denervation