Pharmacologic modulation of parasympathetic activity in heart failure

Monali Y. Desai, Mari A. Watanabe, Abhay A. Laddu, Paul Hauptman

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

In the congestive heart failure state, autonomic dysregulation involves an increase in sympathetic tone and decrease in parasympathetic tone and is associated with increased mortality. It is possible that augmentation of the parasympathetic nervous system (PNS) with pharmacologic therapy may lead to improved symptoms and/or clinical outcomes. There are several new and established pharmacologic interventions that have been studied for their effect on the PNS, including antagonists of the renin-angiotensin system, beta-adrenergic antagonists, digoxin, and vasodilators. In this review, we discuss the current status of the published literature on pharmacologic influences on the PNS by both conventional and experimental drugs targeting heart failure as well as drugs that more directly influence vagal tone. While these analyses have been largely limited to putative surrogates for clinical outcomes like heart rate variability, and it is often difficult to differentiate between indirect and direct pharmacologic effects on the PNS, significant insight into potential mechanisms of action can be derived. The future evaluation of drugs in development for heart failure treatment should include a careful, scientifically sound exploration of the potential impact of the intervention on PNS activity.

Original languageEnglish (US)
Pages (from-to)179-193
Number of pages15
JournalHeart Failure Reviews
Volume16
Issue number2
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

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Parasympathetic Nervous System
Heart Failure
Drug Evaluation
Adrenergic beta-Antagonists
Digoxin
Drug Delivery Systems
Renin-Angiotensin System
Vasodilator Agents
Action Potentials
Heart Rate
Mortality
Therapeutics
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Pharmacologic modulation of parasympathetic activity in heart failure. / Desai, Monali Y.; Watanabe, Mari A.; Laddu, Abhay A.; Hauptman, Paul.

In: Heart Failure Reviews, Vol. 16, No. 2, 01.03.2011, p. 179-193.

Research output: Contribution to journalArticle

Desai, Monali Y. ; Watanabe, Mari A. ; Laddu, Abhay A. ; Hauptman, Paul. / Pharmacologic modulation of parasympathetic activity in heart failure. In: Heart Failure Reviews. 2011 ; Vol. 16, No. 2. pp. 179-193.
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