Document Detail


Relation between major indices of prognosis in patients with chronic congestive heart failure: studies of maximal exercise oxygen consumption, neurohormones and ventricular function.
MedLine Citation:
PMID:  1289216     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Peak exercise capacity (Peak VO2), neurohormonal changes, ventricular enlargement and ejection fraction are among the most important determinants of prognosis in congestive heart failure. However, the inter-relation between these parameters is unknown. We, therefore, correlated these indices in patients with hemodynamically severe congestive heart failure (NYHA class II, pulmonary artery wedge pressure 25 +/- 2 mm Hg, cardiac index 2.5 +/- 0.2 l/min/m2, ejection fraction 43 +/- 2% and fractional shortening 19 +/- 1%). Peak VO2 measured directly during exercise by breath to breath expiratory gas analysis using a metabolic cart was 23 ml/min/kg. Plasma epinephrine (E) and norepinephrine (NE) were measured by high performance liquid chromatography (HPLC) and plasma renin activity (PRA), aldosterone (Aldo), cortisol, prolactin, growth hormone, anti-diuretic hormone (ADH) and antinatriuretic peptide (ANP) by radioimmunoassay. Ejection fraction was measured by echocardiography. There was no relation between peak VO2 and any of the neurohormones E: r = -0.43, NE: r = -0.43, ANP: r = -0.49, Cortisol: r = -0.37, ADH: r = -0.07, Aldo: r = -0.45, 2 tail critical value 0.55. PRA showed a modest correlation (r = -0.61). Similarly, there was no relation between ejection fraction or degree of ventricular enlargement and any of the other indices (r = -0.05). We conclude that although peak VO2, neurohormonal profile and ventricular function are important individual prognostic determinants, there seems to be no direct relation between them.
Authors:
Y Chandrashekhar; I S Anand
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian heart journal     Volume:  44     ISSN:  0019-4832     ISO Abbreviation:  Indian Heart J     Publication Date:    1992 Jul-Aug
Date Detail:
Created Date:  1993-03-25     Completed Date:  1993-03-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0374675     Medline TA:  Indian Heart J     Country:  INDIA    
Other Details:
Languages:  eng     Pagination:  213-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Postgraduate Institute of Medical Education & Research, Chandigarh.
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MeSH Terms
Descriptor/Qualifier:
Adult
Catecholamines / blood
Exercise Tolerance
Heart Failure / blood,  physiopathology*
Hemodynamics
Hormones / blood
Humans
Middle Aged
Oxygen Consumption
Prognosis
Chemical
Reg. No./Substance:
0/Catecholamines; 0/Hormones

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