Heart failure as a metabolic problem

被引:21
作者
Anker, SD
Rauchhaus, M
机构
[1] Natl Heart & Lung Inst, Dept Cardiac Med, London SW3 6LY, England
[2] Max Delbruck Ctr, Franz Volhard Klin, Berlin, Germany
[3] Univ Halle Wittenberg, Klin Innere Med Kardiol 3, Halle, Germany
关键词
chronic heart failure; metabolism; hormones; neuroendocrine activation; cytokines;
D O I
10.1016/S1388-9842(99)00006-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Chronic heart failure (CHF) remains an important and increasing public health care problem. Not until recently it has been recognised that CHF is a chronic progressive disorder affecting different physiological and metabolic pathways. Nowadays CHF is reviewed as the consequence of an inter-play of haemodynamic, neurohormonal, immunological, and endocrine mechanisms, initially thought to have beneficial adaptive effects for the organism to compensate the heart's inability to pump properly. However, these secondary changes eventually contribute to further deterioration of CHF. This review focuses on metabolic features observed in patients with CHF and discusses immunological and neuroendocrine aspects and their potential contribution to the pathogenesis of CHF. The overall evidence suggests that advanced CHF is a multifactorial metabolic syndrome that can lead to cardiac cachexia and then carries a very poor prognosis. Joint efforts of cardiologists, endocrinologists, and immunologists are required to develop therapeutic strategies able to improve the metabolic status of CHF patients. (C) 1999 European Society of Cardiology. All rights reserved.
引用
收藏
页码:127 / 131
页数:5
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