Physiology and Pharmacology of the Transplanted Heart

  • J. B. Young


Heart failure is an extraordinarily complicated milieu. However, at the center of the difficulty is substantive impairment of cardiac pump function. Though the heart failure syndrome is characterized by profound perturbation of hormonal, humoral, neurologic, and cytokine systems, the root difficulty is impaired cardiac filling, decreased forward blood flow with peripheral organ hypoperfusion, and structural remodeling (hypertrophy and chamber dilatation) [1]–[3]. Many diseases cause myocardial injury that can impair normal cardiac contraction and relaxation. Therapies today have focused largely on ameliorating background difficulties prompting cardiac injury, and a great number of treatments used today attempt to interdict effects on perturbed humoral systems[4],[5]. However, it has become clear that attenuation of peripheral physiologic abnormalities engendered by advanced heart failure cannot, alone, dramatically alter prognosis[6]. Replacement of the malfunctioning pump is necessary to significantly change long-term outlook.


Atrial Natriuretic Peptide Cardiac Allograft Heart Transplant Recipient Sinus Node Dysfunction Heart Failure Syndrome 
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© Kluwer Academic Publishers 1996

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  • J. B. Young

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