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Neuroendocrine Response to Heart Failure

  • Chapter
Heart Function in Health and Disease

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 140))

Summary

The syndrome of congestive heart failure is characterized not only by impaired ventricular function, but also by an increase in some endogenous substances leading to vasoconstriction as well as water and salt retention. Although activation of the systems that release these substances is presumed to be compensatory, the sympathetic nervous system and renin-angiotensin-aldosterone system may contribute to the pathogenesis of the syndrome. Opposite to the effects of these two systems are those evoked by the release of atrial natriuretic peptide which exerts a potent direct vasodilation and natriuresis. In addition, atrial natriuretic peptide inhibits the release of norepinephrine from nerve terminals and suppresses the formation of renin. However, the natriuretic and vasodilator effects of the peptide in patients with congestive heart failure are outweighed by the sodium retention and vasoconstriction caused by sympathetic stimulation and activation of the renin-angiotensin-aldosterone system. The reasons for this are not entirely known. The atrial stretch receptors that are responsible for the release of the peptide become impaired, and it has been suggested that patients with heart failure may adapt to the physiological effects of atrial natriuretic peptide.

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Author information

Authors and Affiliations

  1. Cattedra di Cardiologia, University of Brescia, P. le Spedali Civili 1, 25123, Brescia, Italy

    R. Ferrari

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  1. R. Ferrari
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Editors and Affiliations

  1. Institute of Physiology, Czechoslovak Academy of Sciences, Prague, Czechoslovakia

    Bohuslav Ostadal (Director) (Director)

  2. Division of Cardiovascular Sciences, St. Boniface General Hospital Research Centre University of Manitoba, Winnipeg, Canada

    Naranjan S. Dhalla (Distinguished Professor and Head) (Distinguished Professor and Head)

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© 1993 Springer Science+Business Media New York

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Ferrari, R. (1993). Neuroendocrine Response to Heart Failure. In: Ostadal, B., Dhalla, N.S. (eds) Heart Function in Health and Disease. Developments in Cardiovascular Medicine, vol 140. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3090-9_23

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  • DOI: https://doi.org/10.1007/978-1-4615-3090-9_23

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-6350-7

  • Online ISBN: 978-1-4615-3090-9

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