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Baroreceptor function in congestive heart failure: effect on neurohumoral activation and regional vascular resistance.

Publication ,  Journal Article
Hirsch, AT; Dzau, VJ; Creager, MA
Published in: Circulation
May 1987

A series of neurohumoral systems are activated in congestive heart failure that contribute to the increased vascular resistance and sodium retention that characterize this disorder. Abnormalities in baroreceptor function are intrinsic to the pathophysiology of heart failure and may subserve the vasoconstrictive and volume overloaded state that defines patient morbidity. Blunted baroreceptor responses to high cardiac filling pressures or depressed cardiac function reduce afferent signals that normally inhibit sympathetic efferent activity, vasopressin release, and indirectly, renin secretion. The resulting increase in neurohumoral activity mediates the redistribution of blood flow that occurs in this disorder. Limb blood flow is usually reduced and may be responsible for exercise intolerance. Decreased renal blood flow and altered intrarenal hemodynamics contribute to sodium retention. In addition, renal vasoconstriction and elevated circulating levels of angiotensin II and vasopressin may contribute to hyponatremia by influencing free water intake and excretion. Hence, baroreceptor dysfunction may be a principal mechanism that contributes to neurohumoral activation and subsequent alteration in vascular resistance and sodium and water balance in congestive heart failure. It may not be coincidental that two principal markers of an unfavorable prognosis in patients with heart failure, high plasma norepinephrine levels and hyponatremia, share baroreceptor dysfunction as a common theme.

Duke Scholars

Published In

Circulation

ISSN

0009-7322

Publication Date

May 1987

Volume

75

Issue

5 Pt 2

Start / End Page

IV36 / IV48

Location

United States

Related Subject Headings

  • Vascular Resistance
  • Regional Blood Flow
  • Pressoreceptors
  • Neurotransmitter Agents
  • Humans
  • Heart Failure
  • Cardiovascular System & Hematology
  • Animals
  • 4207 Sports science and exercise
  • 3202 Clinical sciences
 

Citation

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MLA
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Hirsch, A. T., Dzau, V. J., & Creager, M. A. (1987). Baroreceptor function in congestive heart failure: effect on neurohumoral activation and regional vascular resistance. Circulation, 75(5 Pt 2), IV36–IV48.
Hirsch, A. T., V. J. Dzau, and M. A. Creager. “Baroreceptor function in congestive heart failure: effect on neurohumoral activation and regional vascular resistance.Circulation 75, no. 5 Pt 2 (May 1987): IV36–48.
Hirsch, A. T., et al. “Baroreceptor function in congestive heart failure: effect on neurohumoral activation and regional vascular resistance.Circulation, vol. 75, no. 5 Pt 2, May 1987, pp. IV36–48.

Published In

Circulation

ISSN

0009-7322

Publication Date

May 1987

Volume

75

Issue

5 Pt 2

Start / End Page

IV36 / IV48

Location

United States

Related Subject Headings

  • Vascular Resistance
  • Regional Blood Flow
  • Pressoreceptors
  • Neurotransmitter Agents
  • Humans
  • Heart Failure
  • Cardiovascular System & Hematology
  • Animals
  • 4207 Sports science and exercise
  • 3202 Clinical sciences