Peripheral Circulation in Congestive Heart Failure
The clinical state of congestive heart failure is accompanied by a large number of cardiovascular adjustments. Depending on the precise etiology of the heart failure, there are a number of changes which occur in the myocardium itself . In longstanding heart failure there is a decrease in myocardial contractile state, often accompanied by hypertrophy and some fibrosis. There is also myocardial depletion of norepinephrine and a decrease in actomyosin ATPase activity, which is concordant with a decrease in the maximum velocity of muscle shortening. In addition, there is decreased turnover of norepinephrine accompanied by a decrease in tyrosine hydroxylase activity, a key enzyme in the synthesis of norepinephrine. In general, therefore, the myocardium has a reduced ability to develop force and shorten, and this leads to a reduction in cardiac output in most patients with congestive heart failure.
KeywordsHeart Failure Cardiac Output Congestive Heart Failure Systemic Vascular Resistance Severe Congestive Heart Failure
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