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      Relevance of the Carotid Body Chemoreflex in the Progression of Heart Failure

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          Abstract

          Chronic heart failure (CHF) is a global health problem affecting millions of people. Autonomic dysfunction and disordered breathing patterns are commonly observed in patients with CHF, and both are strongly related to poor prognosis and high mortality risk. Tonic activation of carotid body (CB) chemoreceptors contributes to sympathoexcitation and disordered breathing patterns in experimental models of CHF. Recent studies show that ablation of the CB chemoreceptors improves autonomic function and breathing control in CHF and improves survival. These exciting findings indicate that alterations in CB function are critical to the progression of CHF. Therefore, better understanding of the physiology of the CB chemoreflex in CHF could lead to improvements in current treatments and clinical management of patients with CHF characterized by high chemosensitivity. Accordingly, the main focus of this brief review is to summarize current knowledge of CB chemoreflex function in different experimental models of CHF and to comment on their potential translation to treatment of human CHF.

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          Most cited references55

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          Lifetime risk for developing congestive heart failure: the Framingham Heart Study.

          Congestive heart failure (CHF) is an increasing public health problem. Among Framingham Heart Study subjects who were free of CHF at baseline, we determined the lifetime risk for developing overt CHF at selected index ages. We followed 3757 men and 4472 women from 1971 to 1996 for 124 262 person-years; 583 subjects developed CHF and 2002 died without prior CHF. At age 40 years, the lifetime risk for CHF was 21.0% (95% CI 18.7% to 23.2%) for men and 20.3% (95% CI 18.2% to 22.5%) for women. Remaining lifetime risk did not change with advancing index age because of rapidly increasing CHF incidence rates. At age 80 years, the lifetime risk was 20.2% (95% CI 16.1% to 24.2%) for men and 19.3% (95% CI 16.5% to 22.2%) for women. Lifetime risk for CHF doubled for subjects with blood pressure >/=160/100 versus <140/90 mm Hg. In a secondary analysis, we only considered those who developed CHF without an antecedent myocardial infarction; at age 40 years, the lifetime risk for CHF was 11.4% (95% CI 9.6% to 13.2%) for men and 15.4% (95% CI 13.5% to 17.3%) for women. When established clinical criteria are used to define overt CHF, the lifetime risk for CHF is 1 in 5 for both men and women. For CHF occurring in the absence of myocardial infarction, the lifetime risk is 1 in 9 for men and 1 in 6 for women, which highlights the risk of CHF that is largely attributable to hypertension. These results should assist in predicting the population burden of CHF and placing greater emphasis on prevention of CHF through hypertension control and prevention of myocardial infarction.
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            Guidelines for the diagnosis and treatment of chronic heart failure.

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              Carotid body chemoreceptors: from natural stimuli to sensory discharges.

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                Author and article information

                Journal
                Biomed Res Int
                Biomed Res Int
                BMRI
                BioMed Research International
                Hindawi Publishing Corporation
                2314-6133
                2314-6141
                2015
                8 December 2015
                : 2015
                : 467597
                Affiliations
                1Laboratory of Cardiorespiratory Control, Center of Biomedical Research, Universidad Autónoma de Chile, 8900000 Santiago, Chile
                2Centro de Fisiología Celular e Integrativa, Clínica Alemana-Universidad del Desarrollo, 7500000 Santiago, Chile
                3Department of Physiology and Pharmacology, Des Moines University, Des Moines, IA 50312, USA
                4Department of Cellular & Integrative Physiology, University of Nebraska Medical Center, Omaha, NE 68198, USA
                5Dirección de Investigación, Universidad Científica del Sur, Lima 15067, Peru
                Author notes

                Academic Editor: Peter M. Becher

                Article
                10.1155/2015/467597
                4686619
                26779536
                f0070f0b-02b1-4ba4-ba75-a2e199dc035e
                Copyright © 2015 David C. Andrade et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 July 2015
                : 8 October 2015
                Categories
                Review Article

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