Neuroendocrine excitation in heart failure

Chronic congestive heart failure (CHF) is a syndrome in which cardiac dysfunction is associated with high morbidity and mortality. Severe symptomatic heart failure is the end point of a lengthy sequence of events, in which the functional state of the left ventricle is an important determinant of the prognosis. As well as the severity of the symptoms of heart failure and the depression of left ventricular ejection fraction, which are independent predictors of survival in heart failure, the neuroendocrine activation found in these patients is directly related to the outcome. It has been shown in controlled trials that one of the most important therapeutic aims to improve survival in patients with chronic CHF must be the inhibition of vasoconstrictor and sodium and water retaining neurohumoral factors. 2