{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:58:28Z","timestamp":1793048308911,"version":"4.5.0"},"reference-count":185,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T00:00:00Z","timestamp":1698019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>In patients with heart failure (HF), the neuroendocrine systems of the sympathetic nervous system (SNS), the renin\u2013angiotensin\u2013aldosterone system (RAAS) and the arginine vasopressin (AVP) system, are activated to various degrees producing often-observed tachycardia and concomitant increased systemic vascular resistance. Furthermore, sustained neurohormonal activation plays a key role in the progression of HF and may be responsible for the pathogenetic mechanisms leading to the perpetuation of the pathophysiology and worsening of the HF signs and symptoms. There are biomarkers of activation of these neurohormonal pathways, such as the natriuretic peptides, catecholamine levels and neprilysin and various newer ones, which may be employed to better understand the mechanisms of HF drugs and also aid in defining the subgroups of patients who might benefit from specific therapies, irrespective of the degree of left ventricular dysfunction. These therapies are directed against these neurohumoral systems (neurohumoral antagonists) and classically comprise beta blockers, angiotensin-converting enzyme (ACE) inhibitors\/angiotensin receptor blockers and vaptans. Recently, the RAAS blockade has been refined by the introduction of the angiotensin receptor\u2013neprilysin inhibitor (ARNI) sacubitril\/valsartan, which combines the RAAS inhibition and neprilysin blocking, enhancing the actions of natriuretic peptides. All these issues relating to the neurohumoral activation in HF are herein reviewed, and the underlying mechanisms are pictorially illustrated.<\/jats:p>","DOI":"10.3390\/ijms242015472","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T05:54:35Z","timestamp":1698040475000},"page":"15472","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":127,"title":["Neurohumoral Activation in Heart Failure"],"prefix":"10.3390","volume":"24","author":[{"given":"Antonis A.","family":"Manolis","sequence":"first","affiliation":[{"name":"First Department of Cardiology, Evagelismos Hospital, 106 76 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodora A.","family":"Manolis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Aiginiteio University Hospital, 115 28 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonis S.","family":"Manolis","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Ippokrateio University Hospital, 115 27 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1007\/s10741-019-09860-8","article-title":"Neurohormones, inflammatory mediators, and cardiovascular injury in the setting of heart failure","volume":"25","author":"Billia","year":"2020","journal-title":"Heart Fail. 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