Neurohumoral Abnormalities and Adrenoceptor Changes in Chronic Heart Failure

  • Masatsugu Hori
  • Katsuomi Iwakura
  • Akira Kitabatake
  • Takenobu Kamada


In congestive heart failure, sympathetic activity is excessively enhanced, partly due to blunted baroreceptor sensitivity. Renin-angiotensin and arginine-vasopressin levels are also elevated. These neurohumoral factors accelerate systemic vasoconstriction which impedes the cardiac output, and may exert a direct toxic effect on the myocardium. Sustained sympathetic stimulation also induces the down-regulation of myocardial βl-adrenergic receptors which may cause a manifestation of overt heart failure, whereas β-adrenergic receptors in compensatory periods are increased in the experimental animal models. Thus, down-regulation of β -receptors indicates a loss of a compensatory mechanism for cardiac dysfunction. A long-term treatment with β-blocking drugs is effective for some patients with advanced dilated cardiomyopathy. Beneficial effects of β-blocker therapy may be attributed in part to the up-regulation of β -adrenergic receptors, although improvement of symptoms and cardiac function are not directly related to β-receptor changes.


Heart Failure Congestive Heart Failure Chronic Heart Failure Plasma Norepinephrine Lower Body Negative Pressure 
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Copyright information

© Springer-Verlag Tokyo 1989

Authors and Affiliations

  • Masatsugu Hori
  • Katsuomi Iwakura
  • Akira Kitabatake
  • Takenobu Kamada
    • 1
  1. 1.The First Department of MedicineOsaka University School of MedicineOsakaJapan

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