Venous Congestion, Endothelial and Neurohormonal Activation in Acute Decompensated Heart Failure: Cause or Effect?

被引：44

作者：

Colombo P.C. ^{[1
]}

Doran A.C. ^{[1
]}

Onat D. ^{[2
]}

Wong K.Y. ^{[3
]}

Ahmad M. ^{[3
]}

Sabbah H.N. ^{[4
]}

Demmer R.T. ^{[5
]}

机构：

[1] Division of Cardiology, College of Physicians & Surgeons, Department of Medicine, Columbia University, 622 West 168th Street, PH 12-134, New York, 10032, NY

[2] Division of Cardiology, College of Physicians & Surgeons, Department of Medicine, Columbia University, 630 West 168th Street, P&S 17-401, New York, 10032, NY

[3] Division of Cardiology, College of Physicians & Surgeons, Department of Medicine, Columbia University, 630 West 168th Street, P&S 8-510, New York, 10032, NY

[4] Division of Cardiovascular Medicine, Department of Medicine, Henry Ford Heart and Vascular Institute, 2799 West Grand Boulevard, Detroit, 48202, MI

[5] Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, 7th floor, New York, 10032, NY

来源：

Current Heart Failure Reports | 2015年 / 12卷 / 3期

基金：

美国国家卫生研究院;

关键词：

Endothelial; Heart failure;

D O I：

10.1007/s11897-015-0254-8

中图分类号：

学科分类号：

摘要：

Venous congestion and endothelial and neurohormonal activation are known to occur in acute decompensated heart failure (ADHF), yet the temporal role of these processes in the pathophysiology of decompensation is not fully understood. Conventional wisdom presumes congestion to be a consequence of worsening cardiovascular function; however, the biomechanically driven effects of venous congestion are biologically plausible contributors to ADHF that remain largely unexplored in vivo. Recent experimental evidence from human models suggests that fluid accumulation and venous congestion are not simply consequences of poor cardiovascular function, but rather are fundamental pro-oxidant, pro-inflammatory, and hemodynamic stimuli that contribute to acute decompensation. The latest advances in the monitoring of volume status using implantable devices allow for the detection of venous congestion before symptoms arise. This may ultimately lead to improved treatment strategies including not only diuretics, but also specific, adjuvant interventions to counteract endothelial and neurohormonal activation during early preclinical decompensation. © 2015, Springer Science+Business Media New York.

引用

页码：215 / 222

页数：7

共 74 条

[1] Allen L.A., Metra M., Milo-Cotter O., Filippatos G., Reisin L.H., Bensimhon D.R., Et al., Improvements in signs and symptoms during hospitalization for acute heart failure follow different patterns and depend on the measurement scales used: an international, prospective registry to evaluate the evolution of Measures of Disease Severity in Acute Heart Failure (MEASURE-AHF), J Card Fail, 14, 9, pp. 777-784, (2008)
[2] Damman K., van Deursen V.M., Navis G., Voors A.A., van Veldhuisen D.J., Hillege H.L., Increased central venous pressure is associated with impaired renal function and mortality in a broad spectrum of patients with cardiovascular disease, J Am Coll Cardiol, 53, 7, pp. 582-588, (2009)
[3] Felker G.M., Adams K.F., Konstam M.A., O'Connor C.M., Gheorghiade M., The problem of decompensated heart failure: nomenclature, classification, and risk stratification, Am Heart J, 145, pp. 18-25, (2003)
[4] Fonarow G.C., Abraham W.T., Albert N.M., Gattis Stough W., Gheorghiade M., Greenberg B.H., Et al., Influence of a performance-improvement initiative on quality of care for patients hospitalized with heart failure: results of the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF), Arch Intern Med, 167, 14, pp. 1493-1502, (2007)
[5] Fonarow G.C., Heywood J.T., Heidenreich P.A., Lopatin M., Yancy C.W., Temporal trends in clinical characteristics, treatments, and outcomes for heart failure hospitalizations, 2002 to 2004: findings from Acute Decompensated Heart Failure National Registry (ADHERE), Am Heart J, 153, 6, pp. 1021-1028, (2007)
[6] Gheorghiade M., Filippatos G., De Luca L., Burnett J., Congestion in acute heart failure syndromes: an essential target of evaluation and treatment, Am J Med, 119, pp. 3-10, (2006)
[7] Gheorghiade M., Gattis W.A., O'Connor C.M., Adams K.F., Elkayam U., Barbagelata A., Et al., Effects of tolvaptan, a vasopressin antagonist, in patients hospitalized with worsening heart failure: a randomized controlled trial, JAMA, 291, 16, pp. 1963-1971, (2004)
[8] Gheorghiade M., Zannad F., Sopko G., Klein L., Pina I.L., Konstam M.A., Et al., Acute heart failure syndromes: current state and framework for future research, Circulation, 112, 25, pp. 3958-3968, (2005)
[9] Lucas C., Johnson W., Hamilton M.A., Fonarow G.C., Woo M.A., Flavell C.M., Et al., Freedom from congestion predicts good survival despite previous class IV symptoms of heart failure, Am Heart J, 140, 6, pp. 840-847, (2000)
[10] Cotter G., Metra M., Milo-Cotter O., Dittrich H.C., Gheorghiade M., Fluid overload in acute heart failure—re-distribution and other mechanisms beyond fluid accumulation, Eur J Heart Fail, 10, 2, pp. 165-169, (2008)

← 1 2 3 4 5 6 7 8 →