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University of Cincinnati Academic Health Center
Publish Date: 08/19/99
Media Contact: AHC Public Relations, (513) 558-4553
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UC Professor Coauthors NEJM Article on Congestive Heart Failure

Cincinnati—An article entitled "Hormones and Hemodynamics in Heart Failure," coauthored by William T. Abraham, MD, associate professor and director of the heart failure and transplant program at the University of Cincinnati Medical Center, and Robert W. Schrier, MD, University of Colorado School of Medicine, takes a closer look at the biochemical changes that lead to the progression of congestive heart failure. The review article was published in the August 19 issue of the New England Journal of Medicine and offers an examination of recent research on the series of molecular events that cause congestive heart failure. Abraham and Schrier conclude that it is the damaged heart itself that initiates the sequence of events leading to congestive heart failure.

Abraham explains: "The pumping chamber of the heart, which is damaged by a previous heart attack, infection, or other processes, loses its ability to pump effectively and causes the arteries to become underfilled. The blood pressure becomes low because of the sluggish pumping. In an attempt to increase blood pressure, the body releases several hormones which signal the kidneys to conserve sodium and water. The increased fluid raises the blood pressure, but makes the heart work harder. Eventually the weakened heart muscle is exhausted from pumping the greater volume of blood and fluid, and congestive heart failure occurs."

Without appropriate medical intervention, the cycle becomes lethal. According to Abraham and Schrier, "The understanding of the long-term consequences of arterial underfilling in heart failure has led to beneficial therapies in addition to diuretics." Abraham adds, "When a person receives a new heart, usually their water and sodium retention problems improve.&148;



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