Compared with control subjects, the systemic sympathetic nervous system is activated in patients with mitral regurgitation
Compared with control subjects, the systemic sympathetic nervous system is activated in patients with mitral regurgitation
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DOI：
10.1016/s0002-8703(03)00111-x
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发表时间：
2003-06-01
影响因子：
4.8
通讯作者：
Starling, MR
中科院分区：
文献类型：
--
作者：
Mehta, RH;Supiano, MA;Starling, MR
背景人类的全身交感神经系统是否被激活作为对二尖瓣返流（MR）的代偿机制尚不清楚：我们检验了这样的假设，即与对照组相比，MR患者的全身交感神经系统将被激活，并且这种激活将在疾病过程的早期发生，作为慢性左心室（LV）的代偿机制。方法我们研究了37例MR患者，他们接受了右心导管和双平面电影心室造影术，以获得LV舒张末期和收缩末期容积、射血分数和收缩容积。在这37例MR患者和3例对照受试者中，[H-3]-去甲肾上腺素（[H-3]-NE）输注和多个动脉血样品提供了用于二室模型分析的数据，以计算血管外NE释放速率（NE 2）。二尖瓣返流患者（2.05 +/- 0.76 mug/min/m2）高于对照组（1.48 +/- 0.75 mug/min/m2，P = 0.007）。此外，平均NE 2值在临床I级MR患者中也更大（P = 0.05），肺毛细血管楔压
Background Whether the systemic sympathetic nervous system is activated as a compensatory mechanism in response to mitral regurgitation (MR) in humans is unknown: We tested the hypotheses that the systemic sympathetic nervous system would be activated in patients with MR in comparison with control subjects and that this activation would occur early in the disease process as a compensatory mechanism for chronic left ventricular (LV) volume overload.Methods We studied 37 patients with MR who underwent right heart catheterization and biplane cineventriculography to obtain LV end-diastolic and end-systolic volumes, ejection fractions, and regurgitant volumes. In these 37 patients with MR and in 3 control subjects, an [H-3]-norepinephrine ([H-3]-NE) infusion and multiple arterial blood samples provided data for a 2-compartment modeling analysis to calculate extravascular NE release rates (NE2).Results The mean NE2 (2.05 +/- 0.76 mug/min/m(2)) in the patients with MR was greater than that in the control sub/m(2), projects (1.48 +/- 0.75 mug/min/m(2), P = .007). Furthermore, the mean NE2 values were also greater in the patients with MR who were in clinical class I (P = .05), with a pulmonary capillary wedge pressure