The proinflammatory heart failure phenotype

A case of integrative physiology

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Congestive heart failure is a clinical syndrome that features more than signs and symptoms arising from Na+ and water retention. The attendant neurohormonal activation gives rise to a systemic illness that features an altered redox state in multiple cells, tissues, and blood; a proinflammatory phenotype with elevations in circulating chemokines, cytokines, and activated lymphocytes and monocytes; and a wasting of tissues that includes muscle and bone. CHF represents a neuroendocrine-immune interface that has gone awry and whose origins can best be understood using principles of integrative physiology. Based on experimental studies in rats and clinical findings in patients with primary and secondary aldosteronism, it is likely that HPT is an integral feature of CHF and which may be further aggravated by the use of a loop diuretic and by hypovitaminosis D. The attendant Ca2+ paradox of HPT with Ca2+ loading of diverse cells can lead to adverse cardiovascular events and to loss of bone mineral density and bone strength predisposing to fracture. Concerted clinical research is needed to document 1) the prevalence of HPT, hypovitaminosis D and B1, osteopenia, and osteoporosis in patients with untreated and treated CHF secondary to systolic or diastolic ventricular dysfunction; and 2) optimal medical management that includes the judicious and optimal use of diuretics and such dietary supplements as Ca2+, Mg2+, vitamin D, and thiamine.

Original languageEnglish (US)
Pages (from-to)219-226
Number of pages8
JournalAmerican Journal of the Medical Sciences
Volume330
Issue number5
DOIs
StatePublished - Jan 1 2005

Fingerprint

Heart Failure
Sodium Potassium Chloride Symporter Inhibitors
Phenotype
Ventricular Dysfunction
Bone and Bones
Hyperaldosteronism
Metabolic Bone Diseases
Thiamine
Dietary Supplements
Chemokines
Diuretics
Vitamin D
Bone Density
Osteoporosis
Signs and Symptoms
Oxidation-Reduction
Monocytes
Blood Cells
Lymphocytes
Cytokines

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

The proinflammatory heart failure phenotype : A case of integrative physiology. / Weber, Karl.

In: American Journal of the Medical Sciences, Vol. 330, No. 5, 01.01.2005, p. 219-226.

Research output: Contribution to journalArticle

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