Abstract
This chapter focuses on the molecular and cellular changes that underlie heart failure with a reduced ejection fraction (HFrEF), with an emphasis on the role of neurohormonal activation and left ventricular (LV) remodeling as the primary determinants for disease progression in HF. The section on neurohormonal activation reviews the importance of the activation of the sympathetic nervous system, the renin angiotensin aldosterone system, as well as the role of inflammatory mediators. The section of LV remodeling discusses the cellular and molecular changes that occur in cardiac myocytes, the extracellular matrix and LV chamber geometry. The final part of the chapter highlights recent insights into the changes that occur in reverse LV remodeling and recovery of heart failure.
| Original language | English |
|---|---|
| Title of host publication | Braunwald's Heart Disease |
| Subtitle of host publication | a Textbook of Cardiovascular Medicine: 2 Vol Set, 12th Edition |
| Publisher | Elsevier |
| Pages | 913-932 |
| Number of pages | 20 |
| Volume | 1-2 |
| ISBN (Electronic) | 9780323722193 |
| ISBN (Print) | 9780443109201 |
| DOIs | |
| State | Published - Jan 1 2021 |
Keywords
- Angiotensin-converting enzyme
- extracellular matrix
- heart failure
- heart failure with a reduced ejection fraction
- matrix metalloproteinase
- neutral endopeptidase (neprilysin)
- norepinephrine
- renin-angiotensin-aldosterone system
- sympathetic nervous system
- tissue inhibitor of matrix metalloproteinase.