Hormonal alterations in heart failure: Anabolic impairment in chronic heart failure - diagnostic, prognostic and therapeutic issues

Michele Arcopinto, Antonio Cittadini

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Chronic heart failure represents a leading cause of mortality and health care expenditure in developed countries. In the last 20 years, medical therapy of heart failure has dramatically changed thanks to the introduction of agents able to significantly reduce the neurohormonal hyperactivation that underpins the syndrome, and to the growing opportunities of electrical therapies. Although major advances in terms of improved survival and quality of life have been achieved, the reduction in the burden of heart failure is still the primary goal of cardiovascular societies. In the last decades, other research lines have also grown to complement the neurohormonal paradigm. It is increasingly evident that several hormonal systems are down-regulated or impaired in patients with heart failure, including growth and thyroid hormones, androgens and insulin. These abnormalities could be considered interrelated and linked, in turn, to the neurohormonal and cytokine hyperactivation. Since most of these alterations provide prognostic information, these new lines of evidence support the extension of the classical neurohormonal scheme to a more comprehensive pathophysiological model that includes multiple hormonal and metabolic deficiencies. This chapter examines the evidence in support of this concept. Preliminary experience concerning targeted hormonal supplementation or metabolic modulation is also briefly reviewed in this article.

Original languageEnglish
Title of host publicationCardiovascular Issues in Endocrinology
PublisherS. Karger AG
Pages57-69
Number of pages13
Volume43
ISBN (Print)9783318026740, 9783318026733
DOIs
Publication statusPublished - Jun 12 2014

Fingerprint

Heart Failure
Therapeutics
Health Expenditures
Thyroid Hormones
Developed Countries
Androgens
Growth Hormone
Quality of Life
Insulin
Cytokines
Delivery of Health Care
Survival
Mortality
Research

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Arcopinto, M., & Cittadini, A. (2014). Hormonal alterations in heart failure: Anabolic impairment in chronic heart failure - diagnostic, prognostic and therapeutic issues. In Cardiovascular Issues in Endocrinology (Vol. 43, pp. 57-69). S. Karger AG. https://doi.org/10.1159/000360559

Hormonal alterations in heart failure : Anabolic impairment in chronic heart failure - diagnostic, prognostic and therapeutic issues. / Arcopinto, Michele; Cittadini, Antonio.

Cardiovascular Issues in Endocrinology. Vol. 43 S. Karger AG, 2014. p. 57-69.

Research output: Chapter in Book/Report/Conference proceedingChapter

Arcopinto, M & Cittadini, A 2014, Hormonal alterations in heart failure: Anabolic impairment in chronic heart failure - diagnostic, prognostic and therapeutic issues. in Cardiovascular Issues in Endocrinology. vol. 43, S. Karger AG, pp. 57-69. https://doi.org/10.1159/000360559
Arcopinto, Michele ; Cittadini, Antonio. / Hormonal alterations in heart failure : Anabolic impairment in chronic heart failure - diagnostic, prognostic and therapeutic issues. Cardiovascular Issues in Endocrinology. Vol. 43 S. Karger AG, 2014. pp. 57-69
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