Document Detail

Sympathetic nervous response relative to the adenosine triphosphate supply-demand imbalance during exercise is augmented in patients with heart failure.
MedLine Citation:
PMID:  9824004     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Increase in plasma hypoxanthine (HX) (purine nucleotide degradation product from working muscle) reflects insufficiency of adenosine triphosphate (ATP) supply during exercise, and the exercise-induced increase in plasma norepinephrine (NE) can be an index of sympathetic nerve activity. The aim of this study was to investigate the relationship between plasma NE and plasma HX during exercise in patients with heart failure (HF) according to its severity. METHODS: Blood lactate, plasma HX, and plasma NE were measured at rest and after symptom-limited cardiopulmonary exercise test in 54 patients with HF (New York Heart Association [NYHA] classes I:18, II:20, III:16) and 19 normal subjects. RESULTS: Peak work rate and peak oxygen uptake decreased as the NYHA functional class increased. Blood lactate and plasma HX levels at rest were comparable, but peak blood lactate (normal, NYHA I, II, III: 6.4+/-0.3, 5.6+/-0.4, 5.3+/-0.3, 3.5+/-0.2 mmol/L) and peak plasma HX (3.6+/-0.4, 3.0+/-0.5, 2.4+/-0.3, 1.4+/-0.1 micromol/L) were progressively smaller as HF worsened. Resting plasma NE (137+/-15, 180+/-29, 201+/-21, 318+/-55 pg/mL) was significantly higher in NYHA class III HF, but peak plasma NE (2,235+/-356, 2,021+/-326, 2,188+/-292, 2,210+/-316 pg/mL) was not different among groups. The ratio of the exercise increments in plasma NE to the increments in plasma HX during exercise (deltaplasma NE/deltaplasma HX: 666+/-96, 1,083+/-229, 1,252+/-222, 2,260+/-351) increased according to the severity of HF. CONCLUSION: These data suggest that plasma levels of HX after maximal exercise are smaller as HF worsened, and sympathetic responsiveness to the imbalance of ATP supply-demand during exercise is augmented according to the severity of HF.
T Kinugawa; K Ogino; N Noguchi; M Mori; H Miyakoda; I Hisatome; C Shigemasa
Related Documents :
23651344 - Serial measurements of high-sensitivity cardiac troponin t after exercise stress test i...
6468924 - Adrenocortical and adrenomedullary responses of fowl to treadmill exercise.
7583804 - Hormonal responses in elders experiencing pre-syncopal symptoms during head-up tilt bef...
24775544 - Usefulness of clinical profiling and exercise testing in the prognostic assessment of p...
11113404 - Usefulness of qt dispersion immediately after exercise as an indicator of coronary sten...
21519354 - Clinical utility of exercise training in chronic systolic heart failure.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  114     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-12-09     Completed Date:  1998-12-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1295-300     Citation Subset:  AIM; IM    
First Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Adenosine Diphosphate / metabolism*
Anaerobic Threshold
Exercise Test*
Heart Failure / metabolism,  physiopathology*
Hypoxanthine / blood
Lactic Acid / blood
Middle Aged
Norepinephrine / blood
Oxygen Consumption
Sympathetic Nervous System / physiopathology*
Reg. No./Substance:
50-21-5/Lactic Acid; 51-41-2/Norepinephrine; 58-64-0/Adenosine Diphosphate; 68-94-0/Hypoxanthine
Erratum In:
Chest 1999 May;115(5):1485

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

Previous Document:  Captopril reduces the VE/VCO2 ratio in myocardial infarction patients with low ejection fraction.
Next Document:  Invasion beyond interlobar pleura in non-small cell lung cancer.