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Borovac JA, D'Amario D, Bozic J, et al. Sympathetic nervous system activation and heart failure: Current state of evidence and the pathophysiology in the light of novel biomarkers. World J Cardiol. 2020;12(8):373-408doi: 10.4330/wjc.v12.i8.373.
Borovac, J. A., D'Amario, D., Bozic, J., & Glavas, D. (2020). Sympathetic nervous system activation and heart failure: Current state of evidence and the pathophysiology in the light of novel biomarkers. World journal of cardiology, 12(8), 373-408. https://doi.org/10.4330/wjc.v12.i8.373
Borovac, Josip Anđelo, et al. "Sympathetic nervous system activation and heart failure: Current state of evidence and the pathophysiology in the light of novel biomarkers." World journal of cardiology vol. 12,8 (2020): 373-408. doi: https://doi.org/10.4330/wjc.v12.i8.373
Borovac JA, D'Amario D, Bozic J, Glavas D. Sympathetic nervous system activation and heart failure: Current state of evidence and the pathophysiology in the light of novel biomarkers. World J Cardiol. 2020 Aug 26;12(8):373-408. doi: 10.4330/wjc.v12.i8.373. PMID: 32879702; PMCID: PMC7439452.
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World J Cardiol. 2020 Aug 26;12(8):373-408. doi: 10.4330/wjc.v12.i8.373.

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

World journal of cardiology

Josip Anđelo Borovac, Domenico D'Amario, Josko Bozic, Duska Glavas

Affiliations

  1. Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia.
  2. Department of Cardiovascular and Thoracic Sciences, IRCCS Fondazione Policlinico A. Gemelli, Universita Cattolica Sacro Cuore, Rome 00168, Italy.
  3. Working Group on Heart Failure of Croatian Cardiac Society, Zagreb 10000, Croatia.

PMID: 32879702 PMCID: PMC7439452 DOI: 10.4330/wjc.v12.i8.373

Abstract

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 tissues. The 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 muscles. When 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 HF. These detrimental effects of SNS activity on outcomes in HF warrant adequate diagnostic and treatment modalities. Therefore, this review summarizes basic physiological concepts about the interaction of SNS with the cardiovascular system and highlights key pathophysiological mechanisms of SNS derangement in HF. Finally, 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.

©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.

Keywords: Autonomic nervous system; Biomarkers; Catecholamines; Catestatin; Chromaffin system; Epinephrine; Heart failure; Myocardial failure; Norepinephrine; Sympathetic nervous system

Conflict of interest statement

Conflict-of-interest statement: Authors declare no conflict of interests for this article.

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