MANAGEMENT OF CONGESTIVE-HEART-FAILURE - NEUROENDOCRINE APPROACH

被引:0
|
作者
SHMUELY, H
SCLAROVSKY, S
ROSENFELD, JB
机构
[1] BEILINSON MED CTR, DEPT CARDIOL, IL-49100 PETAH TIQWA, ISRAEL
[2] TEL AVIV UNIV, SACKLER FAC MED, IL-69978 TEL AVIV, ISRAEL
来源
ISRAEL JOURNAL OF MEDICAL SCIENCES | 1993年 / 29卷 / 01期
关键词
CONGESTIVE HEART FAILURE; NEUROENDOCRINE DISTURBANCES; MANAGEMENT;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The term heart failure is a complex of clinical syndromes caused by ''neuroendocrine'' compensatory responses that are renal, neural, hormonal and hemodynamic in nature. Activation of these multiple systems - as a result of renin, angiotensin II and the action of circulatory catecholamines - causes the release of norepinephrine vasopressin and aldosterone. These responses contribute to the arteriolar constriction and salt and water retention that promote central pooling with an increase in pre- and afterload of the already failing heart, causing deterioration of the congestive heart failure (CHF). Therapy for this clinical syndrome is aimed at reducing both pre- and afterload with vasodilators, which produce a profoundly favorable effect on left ventricular performances. Beta blocking agents, which inhibit the increased sympathetic mediated vasoconstriction, up-regulate beta receptors and thus restore responsiveness to the failing heart. Inotropic agents, such as digitalis and amrinone/milrinone are reserved for patients with dilated failing heart and impaired systolic function; recently a synthetic atrial natriuretic factor has been developed for potential use in CHF. Ultrafiltration is also used in refractory preoperative CHF with cardiac abnormalities. Neuroendocrine responses to CHF are treated today directly by improving central hemodynamic imbalance in these patients.
引用
收藏
页码:6 / 10
页数:5
相关论文
共 50 条
  • [31] DIGITALIS IN CONGESTIVE-HEART-FAILURE
    DEMEIJER, PHEM
    NETHERLANDS JOURNAL OF MEDICINE, 1994, 45 (05): : 225 - 232
  • [32] HYPOCALCEMIC CONGESTIVE-HEART-FAILURE
    ROWELL, WG
    KREISBERG, RA
    SOUTHERN MEDICAL JOURNAL, 1987, 80 (03) : 396 - 398
  • [33] NITRATES IN CONGESTIVE-HEART-FAILURE
    DUPUIS, J
    CARDIOVASCULAR DRUGS AND THERAPY, 1994, 8 (03) : 501 - 507
  • [34] CONGESTIVE-HEART-FAILURE AND THORACENTESIS
    KUPFER, Y
    TESSLER, S
    ANNALS OF INTERNAL MEDICINE, 1986, 104 (04) : 584 - 585
  • [35] CONGESTIVE-HEART-FAILURE AND BRADYCARDIA
    BERCZELLER, PH
    HOSPITAL PRACTICE, 1994, 29 (01): : 111 - &
  • [36] CONGESTIVE-HEART-FAILURE IN CANINES
    RAJAN, TSS
    JAYATHANGARAJ, MG
    PATTABIRAMAN, SR
    INDIAN VETERINARY JOURNAL, 1995, 72 (08): : 864 - 866
  • [37] PATHOPHYSIOLOGY OF CONGESTIVE-HEART-FAILURE
    PARMLEY, WW
    CLINICAL CARDIOLOGY, 1992, 15 (09) : I5 - I12
  • [38] ENALAPRIL FOR CONGESTIVE-HEART-FAILURE
    DENNICK, LG
    MASKIN, CS
    MEYER, JH
    SCHOTZ, WE
    BROWN, BW
    NEW ENGLAND JOURNAL OF MEDICINE, 1987, 317 (21): : 1350 - 1350
  • [39] PROGNOSIS IN CONGESTIVE-HEART-FAILURE
    RECTOR, TS
    COHN, JN
    ANNUAL REVIEW OF MEDICINE, 1994, 45 : 341 - 350
  • [40] BAROREFLEXES AND CONGESTIVE-HEART-FAILURE
    AUMONT, MC
    HIMBERT, D
    CZITROM, D
    ARCHIVES DES MALADIES DU COEUR ET DES VAISSEAUX, 1995, 88 (04): : 555 - 558