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Published on: May 22, 2018
Evaluating presynaptic and postsynaptic innervation in heart failure
Grace P Chen1, James H Caldwell
1Departments of Medicine and Radiology, University of Washington, Seattle, WA 98195, USA.
Insights
Imaging the cardiac sympathetic nervous system can help predict outcomes in patients with congestive heart failure. This approach evaluates the nerve-muscle connection, offering insights into progressive disease and sudden death risk.
Area of Science:
- Cardiology
- Neuroscience
- Medical Imaging
Background:
- Congestive heart failure (CHF) is a growing cause of cardiovascular morbidity and mortality.
- Current therapies improve symptoms and survival, but patient response varies.
- Predicting CHF progression, sudden death, or transplantation needs is challenging, especially with left ventricular systolic dysfunction.
Purpose of the Study:
- To explore the role of the cardiac sympathetic nervous system in CHF.
- To investigate the myocyte-sympathetic nerve terminal interface in CHF.
- To assess the utility of cardiac sympathetic nervous system imaging for outcome prediction in CHF.
Main Methods:
- Focus on the sympathetic nervous system's role in CHF.
- Investigate the ventricular myocyte-sympathetic nerve terminal interface.
- Utilize cardiac sympathetic nervous system imaging techniques.
Main Results:
- The sympathetic nervous system significantly impacts CHF morbidity and mortality.
- Malfunction at the myocyte-sympathetic nerve terminal interface is a key factor in sudden death and CHF progression.
- Cardiac sympathetic nervous system imaging can evaluate this interface.
Conclusions:
- Cardiac sympathetic nervous system imaging is a valuable tool for assessing the myoneural interface in CHF.
- This imaging modality can aid in predicting patient outcomes, including risk of sudden death and disease progression.
Abstract:
Congestive heart failure increasingly contributes to the overall morbidity and mortality associated with cardiovascular disease. Although significant advances in therapies allow patients to feel better and have improved functional status and survival, not all patients respond equally to these therapies. Moreover, for any given level of left ventricular systolic dysfunction, it is difficult to predict who will have progressive heart failure leading to death or transplantation or who will die suddenly. It has long been recognized that the sympathetic nervous system plays a major role in the morbidity and mortality associated with congestive heart failure from systolic left ventricular dysfunction. Although some of the sympathetic effect occurs at the systemic level, malfunction at the ventricular myocyte-sympathetic nerve terminal interface is likely a major contributor to sudden death and progressive heart failure. Imaging the cardiac sympathetic nervous system can be used to evaluate this myoneural interface and to predict outcome.
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