Document Detail


Neurohumoral and hemodynamic effects of lower body negative pressure in patients with congestive heart failure.
MedLine Citation:
PMID:  2662730     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Baroreflex modulation of forearm vascular resistance (FVR) has been reported to be abnormal in patients with congestive heart failure (CHF). However, the neurohumoral mechanisms for this impairment are not defined. We assessed the responses of arterial pressure, FVR, plasma norepinephrine, and plasma renin activity to lower body negative pressure in 29 patients with compensated CHF (New York Heart Association class III and IV) and in 11 normal age-matched control subjects. Baseline mean arterial pressure (83 +/- 2 vs 84 +/- 2 mm Hg) and mean arterial pressure during LBNP (-10, -20, and -40 mm Hg) were not significantly different in the two groups. Basal FVR (43.7 +/- 4 vs 27 +/- 2 units), plasma norepinephrine (605 +/- 81 vs 155 +/- 8 pg/ml), and plasma renin activity (8.3 +/- 1.7 vs 1.2 +/- 0.2 ng/ml/hr) were significantly (p less than 0.01) higher in patients with CHF. The relative increases in FVR responses during LBNP of -10, -20, and -40 mm Hg (10 +/- 4% vs 70 +/- 12%, 17 +/- 6% vs 106 +/- 21%, and 24 +/- 9% vs 152 +/- 28%) were markedly attenuated in patients with CHF compared to control subjects. Plasma norepinephrine and plasma renin activity responses during LBNP were also attenuated in patients with heart failure. Our results suggest that baroreflex control of FVR and plasma norepinephrine and plasma renin activity is impaired in CHF because of the inability of the cardiopulmonary baroreceptors to alter sympathetic outflow.
Authors:
P K Mohanty; J A Arrowood; K A Ellenbogen; M D Thames
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  118     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1989 Jul 
Date Detail:
Created Date:  1989-08-01     Completed Date:  1989-08-01     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  78-85     Citation Subset:  AIM; IM; S    
Affiliation:
Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, VA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure
Cold Temperature / diagnostic use
Decompression*
Echocardiography
Forearm / blood supply
Heart Failure / blood,  physiopathology*
Heart Rate
Hemodynamics*
Humans
Lower Body Negative Pressure*
Male
Middle Aged
Norepinephrine / blood*
Renin / blood*
Vascular Resistance
Grant Support
ID/Acronym/Agency:
HL-30506/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
51-41-2/Norepinephrine; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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