Neurohormones, inflammatory mediators, and cardiovascular injury in the setting of heart failure

Liza Grosman-Rimon, Filio Billia, Evan Wright, Shemy Carasso, Gabby Elbaz-Greener, Erez Kachel, Vivek Rao, David Cherney

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations

Abstract

Neurohormones and inflammatory mediators have effects in both the heart and the peripheral vasculature. In patients with heart failure (HF), neurohormonal activation and increased levels of inflammatory mediators promote ventricular remodeling and development of HF, as well as vascular dysfunction and arterial stiffness. These processes may lead to a vicious cycle, whereby arterial stiffness perpetuates further ventricular remodeling leading to exacerbation of symptoms. Although significant advances have been made in the treatment of HF, currently available treatment strategies slow, but do not halt, this cycle. The current treatment for HF patients involves the inhibition of neurohormonal activation, which can reduce morbidity and mortality related to this condition. Beyond benefits associated with neurohormonal blockade, other strategies have focused on inhibition of inflammatory pathways implicated in the pathogenesis of HF. Unfortunately, attempts to target inflammation have not yet been successful to improve prognosis of HF. Further work is required to interrupt key maladaptive mechanisms involved in disease progression.

Original languageEnglish
Pages (from-to)685-701
Number of pages17
JournalHeart Failure Reviews
Volume25
Issue number5
DOIs
StatePublished - 1 Sep 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Arterial stiffness
  • Inflammatory mediators and cardiovascular injury in the setting of heart failure
  • Neurohormones
  • Vascular dysfunction
  • Ventricular remodeling

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