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Chronic heart failure and heart transplantation: The relationship between autonomic function and cardiac performance
Lin-Zhi Wu1, Yi-Ning Huang1, Yue Chen1
1Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China.
Insights
Autonomic nervous system (ANS) dysfunction, marked by sympathetic overactivation and parasympathetic withdrawal, significantly worsens chronic heart failure (CHF) and impacts heart transplant outcomes. Modulating the ANS offers a promising therapeutic strategy for improving cardiac health.
Area of Science:
- Cardiology
- Neuroscience
Background:
- Chronic heart failure (CHF) is increasingly recognized as involving autonomic nervous system (ANS) dysfunction beyond traditional hemodynamic factors.
- The ANS, with its sympathetic and parasympathetic branches, critically regulates cardiac function.
Purpose of the Study:
- To review the role of autonomic dysfunction in the progression of CHF.
- To examine the impact of ANS dysregulation on outcomes following heart transplantation.
Main Methods:
- Literature review synthesizing current evidence on ANS function in CHF.
- Analysis of the contribution of sympathetic nervous system imbalance to CHF progression.
- Evaluation of autonomic dysregulation's effects on post-transplant results.
Main Results:
- Sympathetic overactivation and parasympathetic withdrawal in CHF contribute to adverse cardiac remodeling, arrhythmias, and reduced cardiac performance.
- Autonomic dysfunction significantly influences outcomes after heart transplantation.
Conclusions:
- ANS modulation is a crucial therapeutic target for enhancing cardiac function and prognosis in CHF patients.
- Understanding ANS roles is vital for improving outcomes in both CHF management and heart transplantation.
Abstract:
Chronic heart failure (CHF) is a complex clinical syndrome characterized by impaired cardiac function and neurohormonal dysregulation. While CHF has traditionally been regarded as a hemodynamic disorder, growing evidence highlights the pivotal role of autonomic nervous system (ANS) dysfunction in its progression and prognosis. The ANS, comprising sympathetic and parasympathetic branches, exerts significant control over cardiac function, including heart rate, contractility, and vascular tone. In CHF, sympathetic overactivation coupled with parasympathetic withdrawal contributes to adverse cardiac remodeling, arrhythmogenesis, and further deterioration of cardiac performance. This minireview summarizes current knowledge on the role of autonomic dysfunction in CHF and heart transplantation. It focuses on how sympathetic nervous system imbalance contributes to CHF progression and explores the impact of autonomic dysregulation on post-transplant outcomes. By synthesizing existing evidence, the review highlights ANS modulation as a key therapeutic target for improving cardiac function and patient prognosis in both clinical settings.
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