Neurohumoral aspects of heart failure.

Understanding the possible role of neurohumoral mechanisms in patients with heart failure has begun to alter the way in which clinicians are likely to approach the management of these patients. Abnormalities in patients with congestive heart failure can no longer be explained only on the basis of hemodynamic changes; they should also include an assessment of the neurohormonal activation. It is highly likely that, in patients with progressive deterioration in cardiac function, the critical interaction between neurohormonal mechanisms and hemodynamic changes leads to the progression of this clinical syndrome.