[Heart failure. Neurohormonal treatment]. / Tratamiento neurohormonal de la insuficiencia cardíaca.

Two hypothesis on the cause of heart failure (HF) have been postulated, one of hemodynamic character and another one of neurohormonal nature. According to the second one, HF is consequence of the overactivity of endogenous endocrine systems such as the renin-angiotensin aldosterone or the autonomic system. Angiotensin-II blockage is actually the first option in the medical treatment of HF. Since it reduces cardiac and vascular remodelation, synthesis of collagen and improves the endothelial function. Preceding to this option one can find the use of beta adrenergic blochers. Recently it was discovered that atrial myocardium liberates, in response to stretching, several peptides with natriuretic properties, specially one denominated B. Such compound has utility in the treatment of decompensated heart failure exclusively in hospitalized patients.