Sympathetic nervous system activation and heart failure:Current state of evidence and the pathophysiology in the light of novel biomarkers  

作　　者：Josip Anđelo Borovac Domenico D'Amario Josko Bozic Duska Glavas 

机构地区：[1]Department of Pathophysiology,University of Split School of Medicine,Split 21000,Croatia [2]Working Group on Heart Failure of Croatian Cardiac Society,Zagreb 10000,Croatia [3]Department of Cardiovascular and Thoracic Sciences,IRCCS Fondazione Policlinico A.Gemelli,Universita Cattolica Sacro Cuore,Rome 00168,Italy [4]Clinic for Cardiovascular Diseases,University Hospital of Split,Split 21000,Croatia

出　　处：《World Journal of Cardiology》2020年第8期373-408,共36页世界心脏病学杂志（英文版）（电子版）

摘　　要：Heart failure(HF)is a complex clinical syndrome characterized by the activation of at least several neurohumoral pathways that have a common role in maintaining cardiac output and adequate perfusion pressure of target organs and tissues.The sympathetic nervous system(SNS)is upregulated in HF as evident in dysfunctional baroreceptor and chemoreceptor reflexes,circulating and neuronal catecholamine spillover,attenuated parasympathetic response,and augmented sympathetic outflow to the heart,kidneys and skeletal muscles.When these sympathoexcitatory effects on the cardiovascular system are sustained chronically they initiate the vicious circle of HF progression and become associated with cardiomyocyte apoptosis,maladaptive ventricular and vascular remodeling,arrhythmogenesis,and poor prognosis in patients with HF.These detrimental effects of SNS activity on outcomes in HF warrant adequate diagnostic and treatment modalities.Therefore,this review summarizes basic physiological concepts about the interaction of SNS with the cardiovascular system and highlights key pathophysiological mechanisms of SNS derangement in HF.Finally,special emphasis in this review is placed on the integrative and up-to-date overview of diagnostic modalities such as SNS imaging methods and novel laboratory biomarkers that could aid in the assessment of the degree of SNS activation and provide reliable prognostic information among patients with HF.

关 键 词：Autonomic nervous system Biomarkers CATECHOLAMINES CATESTATIN Chromaffin system EPINEPHRINE Heart failure Myocardial failure NOREPINEPHRINE Sympathetic nervous system 

分 类 号：R73[医药卫生—肿瘤]