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Published on: December 2, 2014
Neurohormonal modulation in heart failure of ischemic etiology: correlates with left ventricular remodeling
Roberto Latini1, Serge Masson, Lidia Staszewsky
1Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche Mario Negri, via Eritrea 62, 20157 Milan, Italy. latini@marionegri.it
Insights
Heart failure (HF) progression involves neurohormonal activation and left ventricle changes. Tracking natriuretic peptides over time improves heart failure prognosis and may guide treatment.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Pathophysiology
Background:
- Heart failure (HF) involves neurohormonal system activation and left ventricular (LV) remodeling.
- These processes are interconnected, influencing LV structure and function.
Purpose of the Study:
- To explore the relationship between biomarkers, particularly natriuretic peptides, and LV remodeling in chronic heart failure.
- To assess the prognostic value of temporal changes in natriuretic peptide concentrations.
Main Methods:
- Observational study analyzing biomarker concentrations (natriuretic peptides) and LV parameters.
- Longitudinal assessment of biomarker levels to evaluate prognostic significance.
Main Results:
- Strong associations exist between natriuretic peptide levels and LV size/function.
- Dynamic changes in natriuretic peptides provide additional prognostic information beyond single measurements.
Conclusions:
- Temporal monitoring of natriuretic peptides offers incremental prognostic value in chronic HF.
- The utility of biomarker-guided therapy to improve clinical outcomes in HF requires further investigation.
Abstract:
The natural progression of heart failure (HF) is accompanied by the compensatory activation of cardiac and extracardiac neurohormonal systems and changes in the anatomy and function of the left ventricle. The processes of ventricular remodeling and neurohormonal activation are mutually influenced so that strong associations may be observed between circulating concentrations of biomarkers (especially the natriuretic peptides originating from the heart) and parameters of left ventricle size and function. Temporal changes in the concentration of natriuretic peptides convey incremental prognostic value compared with a single determination and are usually related to concomitant changes in markers of left ventricle remodeling in patients with chronic HF. Whether knowledge of biomarkers' concentration can improve the clinical outcome of patients with HF by helping in guiding and monitoring their therapy treatment is a stimulating working hypothesis still to be verified.
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