Neurohormonal modulation in heart failure of ischemic etiology: correlates with left ventricular remodeling.

The natural progression of heart failure (HF) is accompanied by the compensatory activation of cardiac and extracardiac neurohormonal systems and changes in the anatomy and function of the left ventricle. The processes of ventricular remodeling and neurohormonal activation are mutually influenced so that strong associations may be observed between circulating concentrations of biomarkers (especially the natriuretic peptides originating from the heart) and parameters of left ventricle size and function. Temporal changes in the concentration of natriuretic peptides convey incremental prognostic value compared with a single determination and are usually related to concomitant changes in markers of left ventricle remodeling in patients with chronic HF. Whether knowledge of biomarkers' concentration can improve the clinical outcome of patients with HF by helping in guiding and monitoring their therapy treatment is a stimulating working hypothesis still to be verified.