Document Detail


Regional sympathetic effects of low-dose clonidine in heart failure.
MedLine Citation:
PMID:  12623958     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study examined the effects of low doses of intravenous clonidine on regional and global sympathetic nervous system activity in heart failure. In heart failure, adrenoceptor-blocking treatments have a limited sphere of activity. Centrally acting sympatholytic therapies should be further investigated, with a specific emphasis on targeting cardiac and renal sympathetic overactivity. In 10 patients with moderate-severe congestive heart failure, we examined the effect of intravenous clonidine on systemic, cardiac, and renal sympathetic activity and on brain monoamine turnover using the norepinephrine spillover method. In addition, we assessed the effect of clonidine on cardiac release of the sympathetic cotransmitter neuropeptide Y. A dose of 1 microg/kg of clonidine resulted in a fall in cardiac (326+/-73 to 160+/-40 pmol/min, P<0.001), renal (2.5+/-0.6 to 1.5+/-0.3 nmol/min, P=0.01), and global norepinephrine spillover (4.0+/-0.6 to 3.1+/-0.5 nmol/min, P<0.01), with a significantly disproportionate reduction in cardiac versus total-body sympathetic activity (P<0.05). No significant changes in cardiac neuropeptide Y release or in central monoamine turnover were demonstrated. Clonidine, at modest doses, significantly attenuates cardiac and renal sympathetic tone in heart failure. In addition to the beneficial effects of antiadrenergic therapy in the heart, the renal sympatholytic effect may counter the salt and water retention that is a hallmark of the condition.
Authors:
Anuradha Aggarwal; Murray D Esler; Margaret J Morris; Gavin Lambert; David M Kaye
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2003-02-24
Journal Detail:
Title:  Hypertension     Volume:  41     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-07     Completed Date:  2003-04-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  553-7     Citation Subset:  IM    
Affiliation:
Baker Medical Research Institute, University of Melbourne, Melbourne, Victoria, Australia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain / drug effects,  metabolism
Clonidine / administration & dosage,  pharmacology*
Dose-Response Relationship, Drug
Heart / innervation
Heart Failure / metabolism,  physiopathology*
Hemodynamics / drug effects
Humans
Kidney / innervation,  metabolism
Male
Middle Aged
Myocardium / metabolism
Neuropeptide Y / metabolism
Norepinephrine / metabolism
Organ Specificity
Sympathetic Nervous System / drug effects*
Sympatholytics / administration & dosage,  pharmacology*
Chemical
Reg. No./Substance:
0/Neuropeptide Y; 0/Sympatholytics; 4205-90-7/Clonidine; 51-41-2/Norepinephrine

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


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