Copyright
©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Dec 26, 2015; 7(12): 824-828
Published online Dec 26, 2015. doi: 10.4330/wjc.v7.i12.824
Published online Dec 26, 2015. doi: 10.4330/wjc.v7.i12.824
Peripheral reflex feedbacks in chronic heart failure: Is it time for a direct treatment?
Alberto Giannoni, Gianluca Mirizzi, Michele Emdin, Claudio Passino, Division of Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
Alberto Aimo, Michele Emdin, Claudio Passino, Institute of Life Sciences, Scuola Superiore Sant’Anna, 56126 Pisa, Italy
Author contributions: All authors contributed to this work.
Conflict-of-interest statement: All Authors declare no conflict of interest concerning this paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Claudio Passino, MD, Division of Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, via Giuseppe Moruzzi 1, 56124 Pisa, Italy. passino@ftgm.it
Telephone: +39-050-3152191 Fax: +39-050-3152109
Received: February 26, 2015
Peer-review started: February 27, 2015
First decision: April 10, 2015
Revised: September 21, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: December 26, 2015
Peer-review started: February 27, 2015
First decision: April 10, 2015
Revised: September 21, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: December 26, 2015
Core Tip
Core tip: At the borders of the neurohormonal model of heart failure (HF), a partially unexplored path trough the maze of HF pathophysiology is represented by the feedback systems. There are several evidences, from both animal studies and humans reports, that the deregulation of baro-, ergo- and chemo-reflexes in HF patients elicits autonomic imbalance associated with parasympathetic withdrawal and increased adrenergic drive to the heart, thus fundamentally contributing to the evolution of the disease. Hence, on top of guideline-recommended medical therapy mainly based on neurohormonal antagonisms, all visceral feedbacks have been recently considered in HF patients as additional potential therapeutic targets.