[Neurohormonal factors in congestive heart failure]

Abstract

Congestive heart failure is characterized by peripheral circulatory abnormalities including arterial and venous vasoconstriction and redistribution of regional blood flow. These peripheral factors are consecutive to a neurohumoral activation of sympathetic, renin-angiotensin-aldosterone and arginine-vasopressin systems. Clinical consequences of these neurohumoral changes are: excessive increase of aortic impedance and myocardial work, salt and water retention a processus which is angiotensin II-dependent, and eventually, hyponatremia. A growing body of evidences suggests that pharmacological blockade of this neurohumoral activation improves clinical and hemodynamic status in patients with congestive heart failure.