Document Detail


Effects of hypertension and obesity on the sympathetic activation of heart failure patients.
MedLine Citation:
PMID:  14568999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies have shown that congestive heart failure is characterized by sympathetic and reflex dysfunctions. Whether these alterations are potentiated in the presence of obesity and hypertension, two conditions that also display neuroadrenergic abnormalities and markedly increase the risk of heart failure, is unknown. In 14 healthy control subjects (C; age, 55.1+/-3.0 years; mean+/-SEM), 13 lean hypertensive subjects (H), 15 obese normotensive subjects (O), 14 lean normotensive subjects with congestive heart failure (CHF, New York Heart Association class II), 14 lean hypertensive subjects with CHF (CHFH), 14 obese normotensive subjects with CHF (CHFO), and 13 obese hypertensive subjects with CHF (CHFOH), all age-matched with C, we measured mean blood pressure (Finapres), heart rate (ECG), and muscle sympathetic nerve traffic (MSNA, microneurography) at rest and during baroreflex testing. Compared with C, body mass index was similarly increased in O, CHFO, and CHFOH, whereas mean blood pressure was similarly increased in HF, CHFH, and CHFOH, and left ventricular ejection fraction (echocardiography) was similarly reduced in CHF, CHFH, CHFO and CHFOH. Compared with C, MSNA was significantly increased in O, H, and CHF (43.0+/-2.2 versus 54.1+/-2.8, 53.1+/-2.5, and 57.4+/-2.8 bursts/100 heart beats, P<0.01). When O or H was combined with CHF, the MSNA increase was significantly more pronounced and maximal when O and H were concomitantly associated with CHF. Baroreflex sensitivity was reduced in O and H, with a further reduction in CHF and a minimal value in CHFOH. These data show that the sympathetic activation characterizing CHF is markedly potentiated when O and H alone or combined together are associated with a low cardiac output state and that this may depend on an arterial baroreflex impairment.
Authors:
Guido Grassi; Gino Seravalle; Fosca Quarti-Trevano; Raffaella Dell'Oro; Gianbattista Bolla; Giuseppe Mancia
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Publication Detail:
Type:  Journal Article     Date:  2003-10-20
Journal Detail:
Title:  Hypertension     Volume:  42     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-07     Completed Date:  2003-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  873-7     Citation Subset:  IM    
Affiliation:
Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Centro Interuniversitario di Fisiologia Clinica e Ipertensione and Istituto Auxologico Italiano, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure
Heart Failure / diagnosis,  etiology*,  physiopathology
Heart Rate
Humans
Hypertension / complications*,  physiopathology
Male
Middle Aged
Muscles / innervation
Norepinephrine / blood
Obesity / complications*
Pressoreceptors / physiopathology
Sympathetic Nervous System / physiopathology*
Chemical
Reg. No./Substance:
51-41-2/Norepinephrine
Comments/Corrections
Comment In:
Hypertension. 2003 Nov;42(5):870-2   [PMID:  14569000 ]

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