Related Experiment Video
Updated: Jun 10, 2026
07:49
A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models
Published on: July 21, 2023
Autonomic nervous system dysfunction in advanced systolic heart failure
Ignacio J Sánchez-Lázaro1, Oscar Cano-Pérez, Cristina Ruiz-Llorca
1Heart Failure and Transplantation Unit, Cardiology Department, Hospital Universitario La Fe, Valencia, Spain. ignaciosanchezlazaro@gmail.com
International Journal of Cardiology
|August 3, 2010
Summary
In advanced heart failure, both sympathetic and parasympathetic nervous systems show significant impairment. This parallel autonomic dysfunction may impact prognosis and heart transplant waiting list prioritization.
Area of Science:
- Cardiology
- Autonomic Neuroscience
Background:
- Heart failure (HF) is associated with autonomic nervous system (ANS) alterations.
- The sympathetic nervous system (SNS) and parasympathetic nervous system (PNS) are key components of the ANS.
Purpose of the Study:
- To assess, compare, and relate the impairment of both SNS and PNS in advanced heart failure patients.
- To investigate the relationship between autonomic dysfunction and heart transplantation candidacy.
Main Methods:
- Studied 23 advanced HF patients (NYHA III-IV/IV and IV/IV, EF<35%) awaiting heart transplantation.
- Assessed SNS via cardiac uptake of (123)I metaiodobenzylguanidine (HMR, WR).
- Assessed PNS via 24-hour Holter ECG (HRT, TO, TS).
Main Results:
- Higher creatinine correlated with lower myocardial washout rate (WR) in SNS assessment.
- Lower LVEF correlated with higher turbulence onset (TO) in PNS assessment.
- SNS (HMR) and PNS (TO) showed near-significant correlation; WR correlated with TS (PNS).
Conclusions:
- Advanced HF patients exhibit significant, parallel impairment in both SNS and PNS.
- This dual autonomic dysfunction may have prognostic implications.
- Findings could aid in prioritizing heart transplant candidates.
Related Concept Videos
01:29Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
01:17Pathophysiology of Heart Failure
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
01:18Disorders of the Autonomic Nervous System
The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's phenomenon, is a...
Raynaud's disease, also known as Raynaud's phenomenon, is a...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
01:30Heart Failure VII: Nursing Interventions
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
01:27Heart Failure I: Introduction
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...