Juraj Hrnčiar, Ivan Riečanský
Understanding numerous neurohormonal factors activated during chronic heart failure (CHF), mostly specific ones like natriuremic peptides and elements of sympathico - renin angiotensin aldosterone system (noradrenaline, PKA - plasmatic katecholamines, angiotensin II, aldosterone) in keeping homeostasis of effective vascular volume, helps to understand the pathogenesis of CHF and to use them like markers of presence and stage (NYHA) and prognosis of CHF. Pharmacologic influence by specific inhibitors can improve the state, prognosis of CHF and number of hospitalizations. Further less specific markers, metabolic hormonal markers of CHF reflect only intensity and length of any serious stress, like reduction of triiodothyronine - T3 and thyroxine - T4 (low T3/T4 syndrome), reduction of Ca2+ with regulation increase of parathormone, reduction of growth hormone and IGF-1. These markers are good indicators of the prognosis and severity of CHF, but their supplement does not influence positively neither state nor prognosis of CHF.