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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...
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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Related Experiment Video

Updated: Dec 13, 2025

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
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Neurohormonal Blockade During Left Ventricular Assist Device Support.

Teruhiko Imamura1, Priya Mehta2, Ann Nguyen1

  • 1From the Section of Cardiology, University of Chicago Medical Center, Chicago, Illinois.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|August 3, 2020
PubMed
Summary

Neurohormonal blockade, including beta-blockers and ACE inhibitors/ARBs, shows promise in reducing heart failure readmissions for LVAD patients during the late post-discharge period.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Pharmacology

Background:

  • Neurohormonal blockade (NHB) is standard for systolic heart failure (HF).
  • The effectiveness of NHB in patients with left ventricular assist devices (LVADs) is not well-established.
  • LVADs are increasingly used for advanced heart failure.

Purpose of the Study:

  • To investigate the efficacy of NHB in LVAD patients.
  • To determine the association between NHB use and clinical outcomes in LVAD patients.
  • To evaluate the impact of NHB on heart failure readmissions and other adverse events.

Main Methods:

  • A cohort of 114 LVAD patients was followed for 12 months post-discharge.
  • Medication use (beta-blockers, ACE inhibitors/ARBs, aldosterone antagonists) was recorded at baseline and during follow-up.
  • Event rates for heart failure readmission and gastrointestinal bleeding were compared based on NHB use.

Main Results:

  • During the early post-discharge period (0-6 months), NHB use did not significantly affect event rates.
  • During the late post-discharge period (6-12 months), beta-blocker use was linked to reduced HF readmissions.
  • ACE inhibitor/ARB use in the late period was associated with decreased HF readmissions and gastrointestinal bleeding.

Conclusions:

  • Late-period use of beta-blockers and ACE inhibitors/ARBs may reduce heart failure recurrence in LVAD patients.
  • NHB therapy might play a beneficial role in the long-term management of LVAD recipients.
  • Further randomized controlled trials are needed to confirm the utility of NHB in LVAD patients.