Document Detail


Responses of plasma norepinephrine and renin-angiotensin-aldosterone system to dynamic exercise in patients with congestive heart failure.
MedLine Citation:
PMID:  8798111     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Neurohormonal activation is present and neurohormonal responses to dynamic exercise are altered in congestive heart failure (CHF). Responses of plasma norepinephrine in various degrees of heart failure have been investigated, but the responses of the renin-angiotensin-aldosterone system have not been studied in relation to the severity of CHF. The aim of this study was to determine if the responses of the renin-angiotensin-aldosterone system to exercise are augmented according to the severity of CHF. METHODS AND RESULTS: Ventilatory and neurohormonal responses were assessed in 38 patients with CHF (New York Heart Association class: I, 13 patients; II, 14 patients; III, 11 patients) and 11 normal subjects during symptom-limited cardiopulmonary exercise testing. Plasma norepinephrine, renin activity, angiotensin II, and aldosterone were measured at rest and at peak exercise. The increments in neurohormones were divided by peak oxygen consumption, and these ratios (norepinephrine exercise ratio, plasma renin activity-exercise ratio, angiotensin II-exercise ratio, aldosterone-exercise ratio) were compared among groups. Peak oxygen consumption and anaerobic threshold decreased progressively with the severity of CHF. Neurohormonal profiles at rest showed that plasma norepinephrine levels were significantly higher, and the renin-angiotensin-aldosterone system was augmented only in patients with class III CHF. Neurohormones increased during exercise both in patients with CHF and in normal subjects, but patients with class III CHF had significantly higher plasma renin activity (10.11 +/- 2.32 ng/mL/h), angiotensin II (73.9 +/- 14.2 pg/mL), and aldosterone (265.2 +/- 61.1 pg/mL) than did normal subjects. Plasma renin activity-exercise ratio, angiotensin II-exercise ratio, and aldosterone-exercise ratio in patients with class III CHF were significantly higher compared to normal subjects. This augmentation of the renin-angiotensin-aldosterone system was not observed in class I or II patients. Peak plasma norepinephrine levels were not different among normal subjects and subgroups of CHF patients, but the norepinephrine-exercise ratio was significantly higher in classes II and III CHF compared to normal subjects. CONCLUSIONS: These data suggest that neurohormonal excitation during exercise increases along with the severity of CHF when normalized for peak exercise level.
Authors:
M Kato; T Kinugawa; H Omodani; S Osaki; G U Ahmmed; K Ogino; I Hisatome; H Miyakoda; M D Thames
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  2     ISSN:  1071-9164     ISO Abbreviation:  J. Card. Fail.     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1996-10-31     Completed Date:  1996-10-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  103-10     Citation Subset:  IM    
Affiliation:
First Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aldosterone / blood
Angiotensin II / blood
Exercise / physiology*
Female
Heart Failure / blood,  physiopathology*
Hemodynamics
Humans
Male
Middle Aged
Norepinephrine / blood*
Oxygen Consumption / physiology
Pulmonary Ventilation
Renin / blood
Renin-Angiotensin System / physiology*
Sympathetic Nervous System / metabolism*
Chemical
Reg. No./Substance:
11128-99-7/Angiotensin II; 51-41-2/Norepinephrine; 52-39-1/Aldosterone; EC 3.4.23.15/Renin

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


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