{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:03:50Z","timestamp":1791201830497,"version":"4.2.0"},"reference-count":114,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T00:00:00Z","timestamp":1697068800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The neurohormonal model of heart failure (HF) pathogenesis states that a reduction in cardiac output caused by cardiac injury results in sympathetic nervous system (SNS) activation, that is adaptive in the short-term and maladaptive in the long-term. This model has proved extremely valid and has been applied in HF with a reduced left ventricular (LV) ejection fraction (LVEF). In contrast, it has been undermined in HF with preserved LVEF (HFpEF), which is due to hypertension (HTN) in the vast majority of the cases. Erroneously, HTN, which is the leading cause of cardiovascular disease and premature death worldwide and is present in more than 90% of HF patients, is tightly linked with SNS overactivity. In this paper we provide a contemporary overview of the contribution of SNS overactivity to the development and progression of hypertensive HF (HHF) as well as the clinical implications resulting from therapeutic interventions modifying SNS activity. Throughout the manuscript the terms HHF with preserved LVEF and HfpEF will be used interchangeably, considering that the findings in most HFpEF studies are driven by HTN.<\/jats:p>","DOI":"10.3390\/jcm12206486","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T12:46:13Z","timestamp":1697114773000},"page":"6486","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Sympathetic Nervous System in Hypertensive Heart Failure with Preserved LVEF"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6433-4016","authenticated-orcid":false,"given":"Filippos","family":"Triposkiadis","sequence":"first","affiliation":[{"name":"School of Medicine, European University Cyprus, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-9670","authenticated-orcid":false,"given":"Alexandros","family":"Briasoulis","sequence":"additional","affiliation":[{"name":"Department of Therapeutics, Heart Failure and Cardio-Oncology Clinic, National and Kapodistrian University of Athens, 115 27 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9174-4018","authenticated-orcid":false,"given":"Pantelis","family":"Sarafidis","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Magouliotis","sequence":"additional","affiliation":[{"name":"Unit of Quality Improvement, Department of Cardiothoracic Surgery, University of Thessaly, 411 10 Biopolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanos","family":"Athanasiou","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, St Mary\u2019s Hospital, London W2 1NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7764-6411","authenticated-orcid":false,"given":"Ioannis","family":"Paraskevaidis","sequence":"additional","affiliation":[{"name":"6th Department of Cardiology, Hygeia Hospital, 151 23 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7159-2478","authenticated-orcid":false,"given":"John","family":"Skoularigis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of Larissa, 411 10 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9439-3946","authenticated-orcid":false,"given":"Andrew","family":"Xanthopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of Larissa, 411 10 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1016\/j.jacc.2009.05.015","article-title":"The sympathetic nervous system in heart failure physiology, pathophysiology, and clinical implications","volume":"54","author":"Triposkiadis","year":"2009","journal-title":"J. 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