Research ArticleHeart Failure

Central-acting therapeutics alleviate respiratory weakness caused by heart failure–induced ventilatory overdrive

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Science Translational Medicine  17 May 2017:
Vol. 9, Issue 390, eaag1303
DOI: 10.1126/scitranslmed.aag1303

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A brainy treatment for heart failure

Respiratory difficulty and diaphragm weakness are known symptoms of heart failure, but they are usually attributed to pulmonary edema damaging the diaphragm through physical stress. Now, Foster et al. have determined that this is not the only contributing factor, using mouse models to demonstrate that diaphragm weakness develops even in heart failure without pulmonary edema. The authors linked this observation to changes in angiotensin II and β-adrenergic signaling, which result in centrally controlled ventilatory overdrive. As a result, the researchers found that drugs targeting β-adrenergic signaling were effective in preventing ventilatory overdrive and subsequent diaphragmatic injury but only if they penetrated the blood-brain barrier.

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