Mechanisms of neurohormonal activation in chronic congestive heart failure: pathophysiology and therapeutic implications

Int J Cardiol. 2005 Jun 8;101(3):343-6. doi: 10.1016/j.ijcard.2004.08.023.


Patients with chronic congestive heart failure have a sequential and incessant activation of those neurohormonal systems, which control body fluids, cardiac output and systemic blood pressure. Neurohormonal activation is initially selective and regional. Generalized activation is a late event in the natural history of congestive heart failure. Although the ultimate stimulus responsible for the activation of these neurohormonal systems is unknown, a decreased cardiac output and diminished effective blood volume have been proposed as the responsible mechanisms. However, extensive clinical and experimental research suggest that cardiac remodeling and loading of low-pressure cardiac receptors with sympathetic afferents could be the triggering events followed by unloading of high-pressure carotid receptors by decreased cardiac output and diminished effective blood volume.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Cardiotonic Agents / therapeutic use*
  • Heart Failure / drug therapy*
  • Heart Failure / metabolism
  • Heart Failure / physiopathology*
  • Heart Ventricles / innervation
  • Heart Ventricles / physiopathology
  • Hormones / physiology*
  • Humans
  • Neurotransmitter Agents / physiology*
  • Signal Transduction / drug effects
  • Signal Transduction / physiology
  • Sympathetic Nervous System / metabolism
  • Sympathetic Nervous System / physiopathology
  • Vasodilator Agents / therapeutic use*


  • Adrenergic beta-Antagonists
  • Cardiotonic Agents
  • Hormones
  • Neurotransmitter Agents
  • Vasodilator Agents