Abstract
Heart failure (HF) is a syndrome characterized by upregulation of the sympathetic nervous system and abnormal responsiveness of the parasympathetic nervous system. Studies in the 1980s and 1990s demonstrated that inhibition of the renin-angiotensin-aldosterone system with angiotensin-converting enzyme inhibitors improved symptoms and mortality in HF resulting from systolic dysfunction, thus providing a framework to consider the use of β-blockers for HF therapy, contrary to the prevailing wisdom of the time. Against this backdrop, this article reviews the contemporary understanding of the sympathetic nervous system and the failing heart.
Keywords:
Heart failure; Neurohormone; Renin-angiotensin-aldosterone; Sympathetic nervous system.
Copyright © 2014 Elsevier Inc. All rights reserved.
MeSH terms
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Adrenergic alpha-Antagonists / therapeutic use
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Adrenergic beta-Antagonists / therapeutic use
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Afferent Pathways / physiology
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Angiotensin Receptor Antagonists
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Autonomic Nervous System Diseases / complications*
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Autonomic Nervous System Diseases / drug therapy
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Autonomic Nervous System Diseases / physiopathology
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Brain / physiology
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Cardiac Imaging Techniques
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Cardiotonic Agents / therapeutic use
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Digoxin / therapeutic use
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Efferent Pathways / physiology
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Exercise Therapy
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Exercise Tolerance / physiology
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Forecasting
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Heart Failure / drug therapy
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Heart Failure / etiology*
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Heart Failure / physiopathology
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Humans
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Kidney Failure, Chronic / complications
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Muscle, Skeletal / physiology
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Myocardial Infarction / complications
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Norepinephrine / physiology
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Oxidative Stress / physiology
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Polymorphism, Genetic / genetics
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Receptors, Adrenergic / physiology
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Receptors, Adrenergic, beta / genetics
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Reflex / physiology
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Renin-Angiotensin System / physiology
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Sleep Apnea, Obstructive / complications
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Sympathetic Nervous System / anatomy & histology
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Sympathetic Nervous System / physiology
Substances
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Adrenergic alpha-Antagonists
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Adrenergic beta-Antagonists
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Angiotensin Receptor Antagonists
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Cardiotonic Agents
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Receptors, Adrenergic
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Receptors, Adrenergic, beta
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Digoxin
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Norepinephrine