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Review

Endothelial, Vascular and Sympathetic Alterations as Therapeutic Targets in Chronic Heart Failure

by
Fosca Quarti-Trevano
1,†,
Raffaella Dell’Oro
1,†,
Cesare Cuspidi
1,
Pasquale Ambrosino
2 and
Guido Grassi
1,*
1
Clinica Medica, School of Medicine and Surgery, University Milano-Bicocca, 20052 Monza, Italy
2
Istituti Clinici Scientifici Maugeri IRCCS, Directorate of Telese Terme Institute, 82037 Telese Terme, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Biomedicines 2023, 11(3), 803; https://doi.org/10.3390/biomedicines11030803
Submission received: 13 February 2023 / Revised: 21 February 2023 / Accepted: 3 March 2023 / Published: 6 March 2023
(This article belongs to the Special Issue Endothelial Dysfunction: From a Pathophysiological Mechanism to a Potential Therapeutic Target (Volume II))
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Abstract

Vascular and sympathetic abnormalities characterize chronic heart failure (CHF). Alterations include (1) a reduction in arterial distensibility, (2) endothelial dysfunction, (3) a decrease in arterial compliance and a parallel increase in arterial stiffness, and (4) sympathetic cardiovascular activation. Altogether, these alterations represent important targets in therapeutic interventions, because they display an independent negative impact on the disease prognosis, favouring disease progression and the development of cardiovascular complications with direct and indirect mechanisms. The present review will examine the effects of the different therapeutic interventions targeting the vascular/sympathetic alterations detected in CHF. Non-pharmacological, pharmacological and device-based treatments will be discussed in detail, highlighting the possible mechanisms responsible for the vascular/sympathetic effects of each intervention. Finally, the unmet goals in treatment in relation to endothelial and adrenergic targets will be also discussed.
Keywords: chronic heart failure; endothelial function; sympathetic activity; cardiovascular drugs; physical training; rehabilitation; renal denervation; carotid baroreceptor stimulation chronic heart failure; endothelial function; sympathetic activity; cardiovascular drugs; physical training; rehabilitation; renal denervation; carotid baroreceptor stimulation

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MDPI and ACS Style

Quarti-Trevano, F.; Dell’Oro, R.; Cuspidi, C.; Ambrosino, P.; Grassi, G. Endothelial, Vascular and Sympathetic Alterations as Therapeutic Targets in Chronic Heart Failure. Biomedicines 2023, 11, 803. https://doi.org/10.3390/biomedicines11030803

AMA Style

Quarti-Trevano F, Dell’Oro R, Cuspidi C, Ambrosino P, Grassi G. Endothelial, Vascular and Sympathetic Alterations as Therapeutic Targets in Chronic Heart Failure. Biomedicines. 2023; 11(3):803. https://doi.org/10.3390/biomedicines11030803

Chicago/Turabian Style

Quarti-Trevano, Fosca, Raffaella Dell’Oro, Cesare Cuspidi, Pasquale Ambrosino, and Guido Grassi. 2023. "Endothelial, Vascular and Sympathetic Alterations as Therapeutic Targets in Chronic Heart Failure" Biomedicines 11, no. 3: 803. https://doi.org/10.3390/biomedicines11030803

APA Style

Quarti-Trevano, F., Dell’Oro, R., Cuspidi, C., Ambrosino, P., & Grassi, G. (2023). Endothelial, Vascular and Sympathetic Alterations as Therapeutic Targets in Chronic Heart Failure. Biomedicines, 11(3), 803. https://doi.org/10.3390/biomedicines11030803

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