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(Circulation. 1999;100:999-1008.)
© 1999 American Heart Association, Inc.
Current Perspective |
Mechanisms and Models in Heart Failure
A Combinatorial Approach
From the Winters Center for Heart Failure Research, Department of Medicine, Baylor College of Medicine, and Houston Veterans Administration Medical Center, Houston, Tex.
Correspondence to Douglas L. Mann, MD, Cardiology Research (151C), VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030. E-mail dmann@bcm.tmc.edu
Key Words: heart failure • neurohormone • mechanism remodeling • cytokine
 |
The people who bind themselves to systems are those who are unable to encompass the whole truth and try to catch it by the tail; a system is like the tail of truth, but the truth is like a lizard; it leaves its tail in your fingers and runs away knowing full well that it will grow a new one in a twinkling.
–Ivan Turgenev to Leo Tolstoy
Despite repeated attempts to develop a unifying
hypothesis that explains the clinical syndrome of heart failure, no
single conceptual paradigm for heart failure has withstood the test of
time. One logical explanation for our inability to define the syndrome
of heart failure in precise mechanistic and/or clinical terms is that
the clinical syndrome of heart failure almost certainly
represents the summation of multiple anatomic, functional, and
biological alterations that interact together in an exceedingly complex
manner and in different genetic and environmental backgrounds over a
sustained (but variable) period of time. Thus, it is not surprising
that clinicians and investigators have used a variety of increasingly
complex model systems in an attempt to describe the syndrome of heart
failure. Whereas clinicians initially viewed heart failure as a problem
of excessive salt and water retention that was caused by abnormalities
of renal blood flow (the "cardiorenal model"1 ), as
physicians began to perform careful hemodynamic
measurements, it also became apparent that heart failure was associated
with a reduced cardiac output and excessive peripheral
vasoconstriction. This latter realization led to the development of the
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D. Badenhorst, D. Veliotes, M. Maseko, O. J. Tsotetsi, R. Brooksbank, A. Naidoo, A. J. Woodiwiss, and G. R. Norton {beta}-Adrenergic Activation Initiates Chamber Dilatation in Concentric Hypertrophy Hypertension, March 1, 2003; 41(3): 499 - 504. [Abstract] [Full Text] [PDF]
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P. W. M. Fedak, S. M. Altamentova, R. D. Weisel, N. Nili, N. Ohno, S. Verma, T.-Y. J. Lee, C. Kiani, D. A. G. Mickle, B. H. Strauss, et al. Matrix remodeling in experimental and human heart failure: a possible regulatory role for TIMP-3 Am J Physiol Heart Circ Physiol, February 1, 2003; 284(2): H626 - H634. [Abstract] [Full Text] [PDF]
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 I. Sjaastad, J A. Wasserstrom, and O. M Sejersted Heart failure - a challenge to our current concepts of excitation-contraction coupling J. Physiol., January 1, 2003; 546(1): 33 - 47. [Abstract] [Full Text] [PDF]
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D. L. Mann Inflammatory Mediators and the Failing Heart: Past, Present, and the Foreseeable Future Circ. Res., November 29, 2002; 91(11): 988 - 998. [Abstract] [Full Text] [PDF]
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M. T. Kearney, K. A. A. Fox, A. J. Lee, R. J. Prescott, A. M. Shah, P. D. Batin, W. Baig, S. Lindsay, T. S. Callahan, W. E. Shell, et al. Predicting death due to progressive heart failure in patients with mild-to-moderate chronic heart failure J. Am. Coll. Cardiol., November 20, 2002; 40(10): 1801 - 1808. [Abstract] [Full Text] [PDF]
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M. V. Pitzalis, M. Iacoviello, R. Romito, F. Massari, B. Rizzon, G. Luzzi, P. Guida, A. Andriani, F. Mastropasqua, and P. Rizzon Cardiac resynchronization therapy tailored by echocardiographic evaluation of ventricular asynchrony J. Am. Coll. Cardiol., November 6, 2002; 40(9): 1615 - 1622. [Abstract] [Full Text] [PDF]
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I. Sjaastad, J. Bokenes, F. Swift, J. A. Wasserstrom, and O. M. Sejersted Normal contractions triggered by ICa,L in ventricular myocytes from rats with postinfarction CHF Am J Physiol Heart Circ Physiol, September 1, 2002; 283(3): H1225 - H1236. [Abstract] [Full Text] [PDF]
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B. Fiedler, S. M. Lohmann, A. Smolenski, S. Linnemuller, B. Pieske, F. Schroder, J. D. Molkentin, H. Drexler, and K. C. Wollert Inhibition of calcineurin-NFAT hypertrophy signaling by cGMP-dependent protein kinase type I in cardiac myocytes PNAS, August 20, 2002; 99(17): 11363 - 11368. [Abstract] [Full Text] [PDF]
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F.-L. Tan, C. S. Moravec, J. Li, C. Apperson-Hansen, P. M. McCarthy, J. B. Young, and M. Bond The gene expression fingerprint of human heart failure PNAS, August 20, 2002; 99(17): 11387 - 11392. [Abstract] [Full Text] [PDF]
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J. G.F Bronzwaer, C. Zeitz, C. A Visser, and W. J Paulus Endomyocardial nitric oxide synthase and the hemodynamic phenotypes of human dilated cardiomyopathy and of athlete's heart Cardiovasc Res, August 1, 2002; 55(2): 270 - 278. [Abstract] [Full Text] [PDF]
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F. Kuwahara, H. Kai, K. Tokuda, M. Kai, A. Takeshita, K. Egashira, and T. Imaizumi Transforming Growth Factor-{beta} Function Blocking Prevents Myocardial Fibrosis and Diastolic Dysfunction in Pressure-Overloaded Rats Circulation, July 2, 2002; 106(1): 130 - 135. [Abstract] [Full Text] [PDF]
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 R.A de Boer and D.J van Veldhuisen Polypharmacy in chronic heart failure: practical issues regarding the use of angiotensin-converting enzyme inhibitors, beta-blockers and other drugs Eur. Heart J. Suppl., April 1, 2002; 4(suppl_D): D111 - D116. [Abstract] [PDF]
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N. de Jonge, D. F. van Wichen, M. E. I. Schipper, J. R. Lahpor, F. H. J. Gmelig-Meyling, E. O. Robles de Medina, and R. A. de Weger Left ventricular assist device in end-stage heart failure: persistence of structural myocyte damage after unloading: An immunohistochemical analysis of the contractile myofilaments J. Am. Coll. Cardiol., March 20, 2002; 39(6): 963 - 969. [Abstract] [Full Text] [PDF]
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S. Adamopoulos, J. Parissis, D. Karatzas, C. Kroupis, M. Georgiadis, G. Karavolias, J. Paraskevaidis, K. Koniavitou, A. J. S. Coats, and D. T. Kremastinos Physical training modulates proinflammatory cytokines and the soluble Fas/soluble Fasligand system in patients with chronic heart failure J. Am. Coll. Cardiol., February 20, 2002; 39(4): 653 - 663. [Abstract] [Full Text] [PDF]
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G. R. Norton, A. J. Woodiwiss, W. H. Gaasch, T. Mela, E. S. Chung, G. P. Aurigemma, and T. E. Meyer Heart failure in pressure overload hypertrophy: The relative roles of ventricularremodeling and myocardial dysfunction J. Am. Coll. Cardiol., February 20, 2002; 39(4): 664 - 671. [Abstract] [Full Text] [PDF]
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K. L. Peterson Pressure overload hypertrophy and congestive heart failure: Where is the "Achilles' heel"? J. Am. Coll. Cardiol., February 20, 2002; 39(4): 672 - 675. [Full Text] [PDF]
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 J. M. Foody, M. H. Farrell, and H. M. Krumholz {beta}-Blocker Therapy in Heart Failure: Scientific Review JAMA, February 20, 2002; 287(7): 883 - 889. [Abstract] [Full Text] [PDF]
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L. A Nikolaidis, T. Hentosz, A. Doverspike, R. Huerbin, C. Stolarski, Y.-T. Shen, and R. P Shannon Catecholamine stimulation is associated with impaired myocardial O2 utilization in heart failure Cardiovasc Res, February 1, 2002; 53(2): 392 - 404. [Abstract] [Full Text] [PDF]
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S. Adamopoulos, J. T. Parissis, and D. Th. Kremastinos A glossary of circulating cytokines in chronic heart failure Eur J Heart Fail, October 1, 2001; 3(5): 517 - 526. [Abstract] [Full Text] [PDF]
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A. L. Pauca, M. F. O'Rourke, and N. D. Kon Prospective Evaluation of a Method for Estimating Ascending Aortic Pressure From the Radial Artery Pressure Waveform Hypertension, October 1, 2001; 38(4): 932 - 937. [Abstract] [Full Text] [PDF]
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D. L. Mann and H. Taegtmeyer Dynamic Regulation of the Extracellular Matrix After Mechanical Unloading of the Failing Human Heart: Recovering the Missing Link in Left Ventricular Remodeling Circulation, September 4, 2001; 104(10): 1089 - 1091. [Full Text] [PDF]
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P. M. McCarthy, M. Takagaki, Y. Ochiai, J. B. Young, T. Tabata, T. Shiota, J. X. Qin, J. D. Thomas, T. J. Mortier, R. F. Schroeder, et al. Device-based change in left ventricular shape: A new concept for the treatment of dilated cardiomyopathy J. Thorac. Cardiovasc. Surg., September 1, 2001; 122(3): 482 - 490. [Abstract] [Full Text] [PDF]
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F. Forini, A. Paolicchi, T. Pizzorusso, G. M. Ratto, M. Saviozzi, V. Vanini, and G. Iervasi 3,5,3'-Triiodothyronine deprivation affects phenotype and intracellular [Ca2+]i of human cardiomyocytes in culture Cardiovasc Res, August 1, 2001; 51(2): 322 - 330. [Abstract] [Full Text] [PDF]
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J. S. Rao and M. Bond Microarrays : Managing the Data Deluge Circ. Res., June 22, 2001; 88(12): 1226 - 1227. [Full Text] [PDF]
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J. L. Abramson, S. A. Williams, H. M. Krumholz, and V. Vaccarino Moderate Alcohol Consumption and Risk of Heart Failure Among Older Persons JAMA, April 18, 2001; 285(15): 1971 - 1977. [Abstract] [Full Text] [PDF]
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J. Huang, J. M. Rogers, C. R. Killingsworth, G. P. Walcott, B. H. KenKnight, W. M. Smith, and R. E. Ideker Improvement of Defibrillation Efficacy and Quantification of Activation Patterns During Ventricular Fibrillation in a Canine Heart Failure Model Circulation, March 13, 2001; 103(10): 1473 - 1478. [Abstract] [Full Text] [PDF]
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B. K. Podesser, D. A. Siwik, F. R. Eberli, F. Sam, S. Ngoy, J. Lambert, K. Ngo, C. S. Apstein, and W. S. Colucci ETA-receptor blockade prevents matrix metalloproteinase activation late postmyocardial infarction in the rat Am J Physiol Heart Circ Physiol, March 1, 2001; 280(3): H984 - H991. [Abstract] [Full Text] [PDF]
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