在心力衰竭中神经幽默活性
Antonis A Manolis1, Theodora A Manolis2, Antonis S Manolis3
1First Department of Cardiology, Evagelismos Hospital, 106 76 Athens, Greece.
International journal of molecular sciences
|October 28, 2023
概括
在心力衰竭 (HF) 中的神经激素激活驱动疾病的进展. 针对交感神经系统 (SNS),氨酸- ангиотензин- 阿尔多斯特系统 (RAAS) 和氨酸血管压素 (AVP) 途径的疗法,包括ARNI等新型药物,可以改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 神经内分泌学神经内分泌学
背景情况:
- 心力衰竭 (HF) 的特点是神经内分泌系统的激活:交感神经系统 (SNS),氨酸-氨酸-氨系统 (RAAS) 和氨酸血管压素 (AVP) 系统.
- 这种持续的激活有助于HF的进展,病理生理学和恶化的症状,如高心率和增加的系统性血管抵抗.
- 生物标志物,如尿和甲基醇胺,表明神经激素通路的激活,有助于了解高风药物机制和患者分层.
研究的目的:
- 审查神经道激活在心力衰竭病变发生过程中的作用.
- 讨论评估HF中神经激素激活的生物标志物.
- 检查针对这些神经幽默系统的当前和新型治疗策略.
主要方法:
- 关于高频率中神经激素系统的文献综述.
- 讨论已建立和新兴的生物标志物.
- 对神经和抗剂疗法的分析,包括β抑制剂,ACE抑制剂/ARBs,vaptans和ARNIs.
主要成果:
- 持续激活SNS,RAAS和AVP系统是HF进展的核心.
- 生物标志物可以阐明HF机制,并指导个性化治疗选择.
- ангиотензин受体-neprilysin抑制剂 (RNAI) 是一种精细的RAAS阻断策略,增强尿素活性.
结论:
- 神经道激活是心力衰竭的关键驱动因素.
- 针对这些系统的向治疗对于管理高频是必不可少的.
- 像RNAI这样的新药通过结合RAAS抑制和 neprilysin阻断,提供了更好的治疗潜力.
更多相关视频
06:40Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System
Published on: May 22, 2018
10.7K
06:30Quantifying Acute Changes in Renal Sympathetic Nerve Activity in Response to Central Nervous System Manipulations in Anesthetized Rats
Published on: September 11, 2018
7.9K
相关概念视频
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
438
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...
438
01:29Heart Failure II: Pathophysiology
14
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...
14
01:17Pathophysiology of Heart Failure
1.6K
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...
1.6K
01:22Heart Failure Drugs: β-Blockers
346
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,...
346
01:22Heart Failure Drugs: Diuretics
400
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
400
01:30Heart Failure V: Medical Management
9
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
9