TY - JOUR
T1 - Current concepts of neurohormonal activation in heart failure
T2 - Mediators and mechanisms
AU - Lee, Christopher S.
AU - Tkacs, Nancy C.
PY - 2008/10/1
Y1 - 2008/10/1
N2 - Neurohormonal activation is a commonly cited array of phenomena in the body's physiologic response to heart failure. Although various neurohormones and pharmacologic agents that moderate their pathophysiologic effects have been reviewed in the nursing literature, both the mechanisms of neurohormonal system activation and cellular and organ system effects have been described only in brief. Accordingly, this article reviews mechanisms of neurohormonal activation and describes cellular and cardiovascular effects of the (1) sympathetic nervous system, (2) renin-angiotensin-aldosterone system, (3) kallikrein-kininogen- kinin system, (4) vasopressinergic system, (5) natriuretic peptide systems, and (6) endothelin in the context of heart failure. This article implicitly details the physiologic basis for numerous current and potential future pharmacologic agents used in the management of heart failure. It is intended that this article be used as a reference for advanced clinical nursing practice, research, and education.
AB - Neurohormonal activation is a commonly cited array of phenomena in the body's physiologic response to heart failure. Although various neurohormones and pharmacologic agents that moderate their pathophysiologic effects have been reviewed in the nursing literature, both the mechanisms of neurohormonal system activation and cellular and organ system effects have been described only in brief. Accordingly, this article reviews mechanisms of neurohormonal activation and describes cellular and cardiovascular effects of the (1) sympathetic nervous system, (2) renin-angiotensin-aldosterone system, (3) kallikrein-kininogen- kinin system, (4) vasopressinergic system, (5) natriuretic peptide systems, and (6) endothelin in the context of heart failure. This article implicitly details the physiologic basis for numerous current and potential future pharmacologic agents used in the management of heart failure. It is intended that this article be used as a reference for advanced clinical nursing practice, research, and education.
KW - Cardiac physiology
KW - Heart failure
KW - Neurohormonal activation
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U2 - 10.1097/01.AACN.0000340718.93742.c4
DO - 10.1097/01.AACN.0000340718.93742.c4
M3 - Article
C2 - 18981739
AN - SCOPUS:58849149084
VL - 19
SP - 364
EP - 385
JO - AACN Advanced Critical Care
JF - AACN Advanced Critical Care
SN - 1559-7768
IS - 4
ER -