Heart Failure as a Multiple Hormonal Deficiency Syndrome

T he classic neurohormonal model of heart failure (HF) is rooted in the overexpression of neurohormonal molecules. To complement this paradigm, increasing evidence indicates that a variety of hormones and metabolic signals may be downregulated in HF patients. 2] This review examines the evidence in support of the concept that HF is a multiple hormonal and metabolic deficiency syndrome (MHD). Particular attention is focused on the relevance of MHD in terms of cardiac performance and physical capacity and its impact on HF progression. Translation of new concepts into potential therapeutic options is also discussed.