Heart Failure

Question 1

Neurohormonal Responses Step 2

Perfusion to the kidneys decreases

Answer 1

2. Activates the renin-angiotensin-aldosterone system (RAAS)

• Increase levels of angiotensin II & aldosterone
  
  • Angiotensin II causes arteriole vasoconstriction
    (increases afterload)
  • Aldosterone causes Na & water retention (increases
    preload)
• Increase release of ADH from posterior pituitary
  
  • Further Na & water retention
• Release of endothelin = a vasoconstrictor

Question 2

Neurohormonal Responses Step 3

Perfusion to the kidneys decreases

Answer 2

3. Ventricular Remodeling

• Change in ventricular size, geometry, & function as a result of years of toxic neurohormonal stimulation
  
  • Hypertrophy of myocytes
  • Large abnormal cells that don’t contract efficiently
  • Dilation & hypertrophy of ventricles
  • Reshaping of the LV from football to basketball
    shape