Document Detail

Prognostic significance of exercise plasma noradrenaline levels for cardiac death in patients with mild heart failure.
MedLine Citation:
PMID:  11922275     Owner:  NLM     Status:  MEDLINE    
The present study was designed to determine whether exercise plasma noradrenaline (NA) levels could predict cardiac death in patients with mild heart failure in whom the plasma NA levels were only minimally elevated. Treadmill exercise testing with serial measurement of plasma NA and plasma adrenaline were performed in 142 patients with heart failure (New York Heart Association class I-II; age, 58+/-12 years) and 26 age-matched normal subjects. During a median follow-up of 9.6 years, 27 cardiac deaths occurred among the patients. By univariate Cox proportional hazard analysis, left ventricular end-systolic dimension (p<0.001), age (p<0.01), peak exercise heart rate (p<0.01), exercise plasma NA level (p<0.01) and left ventricular ejection fraction (p<0.001) were identified as significant prognostic markers. In a multivariate analysis, exercise plasma NA level was identified as the most powerful prognostic marker (p<0.001), followed by left ventricular end-systolic dimension and peak exercise heart rate. In addition, from the Kaplan-Meier analysis, patients with a supramedian level of exercise plasma NA concentration (NA > or =840pg/ml) had a significantly lower survival rate than those with an inframedian level (p<0.01). Exercise plasma NA levels can provide prognostic information in patients with mild heart failure, which suggests an important role of exercise-induced activation of sympathetic nervous system activity in the prognosis of patients with mild heart failure.
Toru Kinugawa; Kazuhide Ogino; Shuichi Osaki; Masahiko Kato; Osamu Igawa; Ichiro Hisatome; Masatoshi Fujita; Chiaki Shigemasa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  66     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-29     Completed Date:  2003-06-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  261-6     Citation Subset:  IM    
The Division of Cardiology, The 1st Department of Internal Medicine, Tottori University Faculty of Medicine, Yonago, Japan.
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MeSH Terms
Analysis of Variance
Biological Markers / blood
Cardiac Output, Low / blood*,  mortality
Case-Control Studies
Epinephrine / blood
Follow-Up Studies
Middle Aged
Norepinephrine / blood*
Prospective Studies
Survival Analysis
Reg. No./Substance:
0/Biological Markers; 51-41-2/Norepinephrine; 51-43-4/Epinephrine

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