The sympathetic/parasympathetic imbalance in heart failure with reduced ejection fraction
- PMID: 25975657
- PMCID: PMC4528097
- DOI: 10.1093/eurheartj/ehv087
The sympathetic/parasympathetic imbalance in heart failure with reduced ejection fraction
Abstract
Cardiovascular autonomic imbalance, a cardinal phenotype of human heart failure, has adverse implications for symptoms during wakefulness and sleep; for cardiac, renal, and immune function; for exercise capacity; and for lifespan and mode of death. The objectives of this Clinical Review are to summarize current knowledge concerning mechanisms for disturbed parasympathetic and sympathetic circulatory control in heart failure with reduced ejection fraction and its clinical and prognostic implications; to demonstrate the patient-specific nature of abnormalities underlying this common phenotype; and to illustrate how such variation provides opportunities to improve or restore normal sympathetic/parasympathetic balance through personalized drug or device therapy.
Keywords: Baroreceptor reflex; Chemoreceptor reflex; Exercise; Heart failure; Human; Parasympathetic nervous system; Sleep apnoea; Sympathetic nervous system.
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
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References
-
- Amorim DS, Dargie HJ, Heer K, Brown M, Jenner D, Olsen EG, Richardson P, Goodwin JF. Is there autonomic impairment in congestive (dilated) cardiomyopathy? Lancet 1981;1:525–527. - PubMed
-
- Floras JS. Sympathetic nervous system activation in human heart failure: clinical implications of an updated model. J Am Coll Card 2009;54:375–385. - PubMed
-
- Benedict CR, Shelton B, Johnstone DE, Francis G, Greenberg B, Konstam M, Probsfield JL, Yusuf S. Prognostic significance of plasma norepinephrine in patients with asymptomatic left ventriculardysfunction. SOLVD Investigators. Circ 1996;94:690–697. - PubMed
-
- Grassi G, Seravalle G, Cattaneo BM, Lanfranchi A, Vailati S, Giannattasio C, Del Bo A, Sala C, Bolla GB, Pozzi M. Sympathetic activation and loss of reflex sympathetic control in mild congestive heart failure. Circ 1995;92:3206–3211. - PubMed
-
- Task force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability. Standards of measurement, physiological interpretation and clinical use. Circ 1996;93:1043–1065. - PubMed
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