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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Aug 26, 2020; 12(8): 373-408
Published online Aug 26, 2020. doi: 10.4330/wjc.v12.i8.373
Published online Aug 26, 2020. doi: 10.4330/wjc.v12.i8.373
Sympathetic nervous system activation and heart failure: Current state of evidence and the pathophysiology in the light of novel biomarkers
Josip Anđelo Borovac, Josko Bozic, Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
Josip Anđelo Borovac, Duska Glavas, Working Group on Heart Failure of Croatian Cardiac Society, Zagreb 10000, Croatia
Domenico D'Amario, Department of Cardiovascular and Thoracic Sciences, IRCCS Fondazione Policlinico A. Gemelli, Universita Cattolica Sacro Cuore, Rome 00168, Italy
Duska Glavas, Clinic for Cardiovascular Diseases, University Hospital of Split, Split 21000, Croatia
Author contributions: Borovac JA was responsible for the conception and design of the manuscript and wrote the first original draft in its entirety; D'Amario D, Bozic J, and Glavas D contributed in making critical revisions related to important intellectual content of the manuscript; All authors provided the approval of the final version of the article to be published.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Josip Anđelo Borovac, MD, PhD, Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, Split 21000, Croatia. josip.borovac@me.com
Received: March 21, 2020
Peer-review started: March 21, 2020
First decision: May 5, 2020
Revised: May 19, 2020
Accepted: July 19, 2020
Article in press: July 19, 2020
Published online: August 26, 2020
Processing time: 149 Days and 3.3 Hours
Peer-review started: March 21, 2020
First decision: May 5, 2020
Revised: May 19, 2020
Accepted: July 19, 2020
Article in press: July 19, 2020
Published online: August 26, 2020
Processing time: 149 Days and 3.3 Hours
Core Tip
Core tip: Sympathetic nervous system activation is one of the key neurohumoral mechanisms that are operative in heart failure and is robustly associated with adverse myocardial remodeling, arrhythmias, sudden cardiac death, and overall poor prognosis in this population. Therefore, adequate diagnosis and quantification of the degree of upregulated sympathetic nervous system activity must be assessed by the clinician in every heart failure patient. A special emphasis must be put on adequate treatment by neurohumoral antagonists such as beta-blockers that will mitigate these adverse effects and improve outcomes. The adjunct use of advanced imaging methods and novel biomarkers might aid in clinical decision-making.