Wynik wyszukiwania w bazie Polska Bibliografia Lekarska GBL

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Tytuł oryginału: Odpowiedź neurohormonalna w niewydolności serca - implikacje terapeutyczne.
Tytuł angielski: Neurohormonal response in congestive heart failure - therapeutic implications.
Autorzy: Krzysztofiak Hubert, Mamcarz Artur
Źródło: Terapia 2002: 10 (9 z. 1) s.5-10, tab., bibliogr. 46 poz., sum.
Sygnatura GBL: 313,048

Hasła klasyfikacyjne GBL:
  • endokrynologia
  • kardiologia

    Wskaźnik treści:
  • ludzie

    Streszczenie angielskie: A number of neurohormonal systems are activated in congestive heart failure (CHF) to restore circulatory homeostasis. These initially beneficial responses, clearly adaptive over the short term, if excessive and persistent become maladaptive and deleterious. The most prominent components of the neuroendocrina response in CHF are the sympathetic nervous system (SNS), the renin-angiotensin-aldosterone system (RAA), arginine vasopressin (AVP) and endothelin (ET), which have a vasoconstrictor and partly cardiotoxic effects. On the other hand, there are vasodilatators with some cardioprotective functions, like atrial and brain natriuretic peptides (ANP and BNP respectively) and nitric oxide (NO). Myocardial SNS activity occurs early in the natural history of left ventricular dysfunction, even before hemodynamic changes and the onset of the symptoms. Levels of ANP and BNP are also elevated early, along with SNS activity, preceding ativation of RAA nad other neurohormones. Thus, endocrine activation has the key role in the development of CHF. Because the treatment of myocyte dysfunction is limited, the pharmacological treatment of CHF is based on modification of neuroendocrine activation. Beside classic drugs, with efficacy proven in large clinical trials (-blockers and angiotensin-converting enzyme inhibitors - otehr interventional possibilities of blockade of angiotesin receptor, blockade of endothelial receptors and inhibition of neutral endopeptidase - engageged on ANP and BNP degradation - are developing. The review discusses the role of all the above neurohormones with special emphasis on therapeutic perspectives.

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