Neurohormonal blockade targeting the autonomic and renin-angiotensin-aldosterone systems is a cornerstone therapy that reduces morbidity and mortality in chronic HFrEF.
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Supports dual neurohormonal blockade in HFrEF sinus rhythm; confirms benefits but leaves open optimization in contemporary cohorts.
A key feature of chronic heart failure (HF) is the sustained activation of endogenous neurohormonal systems in response to impaired cardiac pumping and/or filling properties. The clinical use of neurohormonal blockers has revolutionised the care of HF patients over the past three decades. Drug therapy that is active against imbalance in both the autonomic and renin-angiotensin-aldosterone systems consistently reduces morbidity and mortality in chronic HF with reduced left ventricular ejection fraction and in sinus rhythm. This article provides an assessment of the major neurohormonal systems and their therapeutic blockade in patients with chronic HF.
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Lueder et al. (2017) studied this question.