Nonadrenergic Hormonal Alterations in Congestive Heart Failure

  • Milton Packer


When cardiac output falls after an insult to the myocardium, several neurohormonal mechanisms are activated in an attempt to preserve circulatory homeostasis. These mechanisms include both endogenous vasoconstrictor systems (sympathetic nervous system, reninangiotensin system, and vasopressin) that act to increase systemic blood pressure and expand intravasular volume, and endogenous vasodilator systems (atrial natriuretic peptide and prostaglandins) that limit the pressor, antinatriuretic, and antidiuretic effects of the vasoconstrictor systems.1 The hemodynamic and metabolic abnormalities in heart failure result in large part from the complex interplay of these neurohormonal forces, which regulate systemic and regional blood flow as well as salt and water balance.


Heart Failure Chronic Heart Failure Atrial Natriuretic Peptide Plasma Renin Activity Renal Blood Flow 
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  • Milton Packer

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