CARDIAC SYMPATHETIC NERVOUS ACTIVITY IN CONGESTIVE-HEART-FAILURE - EVIDENCE FOR INCREASED NEURONAL NOREPINEPHRINE RELEASE AND PRESERVED NEURONAL UPTAKE
CARDIAC SYMPATHETIC NERVOUS ACTIVITY IN CONGESTIVE-HEART-FAILURE - EVIDENCE FOR INCREASED NEURONAL NOREPINEPHRINE RELEASE AND PRESERVED NEURONAL UPTAKE
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DOI：
10.1161/01.cir.88.1.136
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发表时间：
1993-07-01
期刊：
影响因子：
37.8
通讯作者：
ESLER, MD
中科院分区：
文献类型：
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作者：
MEREDITH, IT;EISENHOFER, G;ESLER, MD
背景。充血性心力衰竭（CHF）中冠状窦血浆中去甲肾上腺素浓度升高可能是由于心脏交感神经放电和去甲肾上腺素释放增加或神经元摄取机制无法重新捕获释放的去甲肾上腺素所致。我们应用心力衰竭患者心脏交感神经功能的神经化学指标来描述潜在的神经病理生理学。方法和结果。心脏去甲肾上腺素合成，根据去甲肾上腺素前体二羟基苯丙氨酸（DOPA）的心脏溢出进行评估，根据神经元内代谢物二羟基苯乙二醇（DHPG）的溢出评估神经元内代谢，根据血浆氚化去甲肾上腺素的部分提取和心脏中氚化DHPG的产生评估神经元去甲肾上腺素再摄取，以及去甲肾上腺素溢出到血浆的八名患者进行了检查由冠状动脉疾病引起的 CHF（左心室射血分数为 26+/-5%，平均值+/-SEM）和 14 名年龄匹配的健康受试者。 CHF 受试者的心脏去甲肾上腺素溢出增加了八倍（健康受试者为 127 ng/min，而健康受试者为 14 ng/min；差异标准误差 [SED]，8 ng/min；P
Background. Increased concentrations of norepinephrine in coronary sinus plasma reported in congestive heart failure (CHF) could result from increased cardiac sympathetic nerve firing and norepinephrine release or from failure of neuronal uptake mechanisms to recapture released norepinephrine. We have applied neurochemical indexes of cardiac sympathetic nerve function in heart failure patients to delineate the underlying neural pathophysiology.Methods and Results. Cardiac norepinephrine synthesis, assessed from the cardiac overflow of the norepinephrine precursor dihydroxyphenylalanine (DOPA), intraneuronal metabolism estimated from the overflow of the intraneuronal metabolite dihydroxyphenylglycol (DHPG), neuronal norepinephrine reuptake assessed from the fractional extraction of plasma-tritiated norepinephrine and production of tritiated DHPG across the heart, and norepinephrine spillover to plasma were examined in eight patients with CHF caused by coronary artery disease (left ventricular ejection fraction of 26+/-5%, mean+/-SEM) and 14 age-matched healthy subjects. Cardiac norepinephrine spillover was increased eightfold in CHF subjects (127 ng/min versus 14 ng/min in healthy subjects; standard error of the difference [SED], 8 ng/min; P