The origin of sympathetic outflow in heart failure: The roles of angiotensin II and nitric oxide

Irving H. Zucker, Harold D. Schultz, Yi Fan Li, Yu Wang, Wei Wang, Kaushik P. Patel

Research output: Contribution to journalReview article

111 Scopus citations


The regulation of sympathetic nerve activity in chronic heart failure (CHF) has been an area of renewed investigation. Understanding the central mechanisms that are responsible for sympatho-excitation in this disease state may help in reducing the deleterious effects of chronic sympatho-excitation. This review will summarize our understanding of abnormal reflex control of the circulation in CHF. The roles of the arterial baroreflex, the chemoreflex, the cardiac sympathetic afferent reflex and the cardiopulmonary reflex are discussed. New experimental techniques that allow genetic manipulation of substances such as nitric oxide synthase in discrete areas of the brain aid in clarifying the role of NO in the modulation of sympathetic tone in the CHF state. Lastly, clinical implications of this work are discussed.

Original languageEnglish (US)
Pages (from-to)217-232
Number of pages16
JournalProgress in Biophysics and Molecular Biology
Issue number2-3
StatePublished - Jan 1 2004



  • Baroreflex
  • Chronic heart failure
  • Medulla
  • Neurohumoral regulation
  • Renal nerve activity

ASJC Scopus subject areas

  • Biophysics
  • Molecular Biology

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