Nitric oxide, other hormones, cytokines, and chemokines in heart failure
- Wilson S Colucci, MD
Wilson S Colucci, MD
- Section Editor — Heart Failure
- Professor of Medicine
- Boston University School of Medicine
The signs and symptoms of heart failure (HF) are in part due to compensatory mechanisms utilized by the body in an attempt to repair the primary deficit in the cardiac output. Well-recognized neurohumoral adaptations, such as activation of the renin-angiotensin-aldosterone and sympathetic nervous systems and antidiuretic hormone (vasopressin) by the low output state, can contribute to maintenance of perfusion of vital organs in two ways:
●Maintenance of systemic pressure by vasoconstriction, resulting in redistribution of blood flow to vital organs.
●Restoration of cardiac output by increasing myocardial contractility and heart rate and by expansion of the extracellular fluid volume.
As discussed below, HF is also associated with alterations in a host of cellular, autocrine, and paracrine signaling systems that are involved in mediating inflammation and oxidative stress, and may manifest as alterations in the levels of nitric oxide, inflammatory cytokines, and other chemokines that can be measured as biomarkers. The physiologic and clinical significance of these changes is not well understood.
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