Chromogranin A: friend or foe of the failing myocardium?

Chronic heart failure is defined as the inability of the heartto meet the circulatory demands of the organism. While cardiacinjury, e.g. of ischaemic, toxic, metabolic, or genetic cause,is the initial abnormality, secondary changes occur over thecourse of the disease affecting most organ systems. This leadsto a variety of pathologic changes including endothelial, pulmonary,hepatic, renal, endocrine and skeletal muscle abnormalities,and the state of multi-organ impairment in chronic heart failureis now considered the syndrome of chronic heart failure.¹ A neuroendocrine activation has been described early in