Pathophysiologic Mechanisms in Heart Failure. Role of the Sympathetic Nervous System

• Published in: The American journal of the medical sciences Vol. 353; no. 1; pp. 27 - 30
• Main Authors: Antoine, Steve, MD, Vaidya, Gaurang, MD, Imam, Haider, MD, Villarreal, Daniel, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-01-2017
• Subjects: Animals; Cardiac peptides; Diuresis; Heart Failure - physiopathology; Humans; Internal Medicine; Kidney - innervation; Kidney - physiopathology; Natriuresis; Renal denervation; Sympathectomy; Sympathetic Nervous System - physiopathology; Diuresis; Natriuresis; Renal Denervation; Cardiac Peptides; Renal denervation; Cardiac peptides
• ISSN: 0002-9629; 1538-2990
• DOI: 10.1016/j.amjms.2016.06.016

Abstract The syndrome of heart failure involves complex pathophysiologic mechanisms and is associated with an 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 cardio-renal syndrome. Excessive and sustained sympatho-excitation has emerged as one 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.