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

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World Journal of Cardiology 2020年第8期12卷 373-408页

作者： Josip Anđelo Borovac Domenico D'Amario Josko Bozic Duska Glavas Department of Pathophysiology University of Split School of MedicineSplit 21000Croatia Working Group on Heart failure of Croatian Cardiac Society Zagreb 10000Croatia Department of Cardiovascular and Thoracic Sciences IRCCS Fondazione Policlinico A.GemelliUniversita Cattolica Sacro CuoreRome 00168Italy Clinic for Cardiovascular Diseases University Hospital of SplitSplit 21000Croatia

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 *** 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 *** 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 *** detrimental effects of SNS activity on outcomes in HF warrant adequate diagnostic and treatment ***,this review summarizes basic physiological concepts about the interaction of SNS with the cardiovascular system and highlights key pathophysiological mechanisms of SNS derangement in ***,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

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