Current concepts of neurohormonal activation in heart failure: Mediators and mechanisms

Christopher S. Lee, Nancy C. Tkacs

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)364-385
Number of pages22
JournalAACN advanced critical care
Volume19
Issue number4
DOIs
StatePublished - Oct 1 2008

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Keywords

  • Cardiac physiology
  • Heart failure
  • Neurohormonal activation

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care

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