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Published in:

01-03-2014

Angiotensin II, sympathetic nerve activity and chronic heart failure

Authors: Yutang Wang, Sai-Wang Seto, Jonathan Golledge

Published in: Heart Failure Reviews | Issue 2/2014

Abstract

Sympathetic nerve activity has been reported to be increased in both humans and animals with chronic heart failure. One of the mechanisms believed to be responsible for this phenomenon is increased systemic and cerebral angiotensin II signaling. Plasma angiotensin II is increased in humans and animals with chronic heart failure. The increase in angiotensin II signaling enhances sympathetic nerve activity through actions on both central and peripheral sites during chronic heart failure. Angiotensin II signaling is enhanced in different brain sites such as the paraventricular nucleus, the rostral ventrolateral medulla and the area postrema. Blocking angiotensin II type 1 receptors decreases sympathetic nerve activity and cardiac sympathetic afferent reflex when therapy is administered to the paraventricular nucleus. Injection of an angiotensin receptor blocker into the area postrema activates the sympathoinhibitory baroreflex. In peripheral regions, angiotensin II elevates both norepinephrine release and synthesis and inhibits norepinephrine uptake at nerve endings, which may contribute to the increase in sympathetic nerve activity seen in chronic heart failure. Increased circulating angiotensin II during chronic heart failure may enhance the sympathoexcitatory chemoreflex and inhibit the sympathoinhibitory baroreflex. In addition, increased circulating angiotensin II can directly act on the central nervous system via the subfornical organ and the area postrema to increase sympathetic outflow. Inhibition of angiotensin II formation and its type 1 receptor has been shown to have beneficial effects in chronic heart failure patients.

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Title: Angiotensin II, sympathetic nerve activity and chronic heart failure
Authors: Yutang Wang
Sai-Wang Seto
Jonathan Golledge
Publication date: 01-03-2014
Publisher: Springer US
Published in: Heart Failure Reviews / Issue 2/2014
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI: https://doi.org/10.1007/s10741-012-9368-1

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Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

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Other articles of this Issue 2/2014

List of reviewers in 2013

Could interferon-gamma be a therapeutic target for treating heart failure?

Fibrosis and heart failure

Reversible cardiac dysfunction associated with hypocalcemia: a systematic review and meta-analysis of individual patient data

Co-morbidities in heart failure

Calcium handling proteins: structure, function, and modulation by exercise

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page