Neurohormonal Activation in Populations Susceptible to Heart Failure

This article discusses the adverse effects of neurohormonal activation in populations susceptible to chronic heart failure (CHF). The authors define neurohormonal activation, trace the contributions of relevant pathways to the development of subclinical left ventricular dysfunction and CHF, and summarize data on the evolution of neurohormonal antagonism as a therapeutic tool to prevent CHF, focusing on clinical studies that have evaluated circulating levels of neurohormones. The roles of the RAAS, catecholamines, endothelins, and the natriuretic peptides are described.