Circulation, Vol 73, 913-919, Copyright © 1986 by American Heart Association
WN Leimbach Jr, BG Wallin, RG Victor, PE Aylward, G Sundlof and AL Mark
Patients with heart failure have increased vascular resistance and evidence
for increased neurohumoral drive. High levels of circulating norepinephrine
are found in patients with heart failure, but it is not known whether they
reflect increased sympathetic neural activity or result from altered
synthesis, release, or metabolism of norepinephrine. We used
microneurography (peroneal nerve) to directly record sympathetic nerve
activity to muscle (mSNA) and also measured plasma norepinephrine levels in
patients with heart failure and in normal control subjects. Our goal was to
determine whether sympathetic nerve activity is increased in patients with
heart failure and whether plasma norepinephrine levels correlate with
levels of mSNA in heart failure. Resting muscle sympathetic nerve activity
in 16 patients with moderate to severe heart failure (54 +/- 5 bursts/min,
mean +/- SE) was significantly higher (p less than .01) than the levels of
activity in either nine age-matched normal control subjects (25 +/- 4
bursts/min) or 19 "young" normal control subjects (24 +/- 2 bursts/min). We
found a significant correlation between plasma norepinephrine levels and
mSNA (r = .73, p less than .05). Neither mSNA nor plasma norepinephrine
levels correlated with total systemic vascular resistance, cardiac index,
left ventricular ejection fraction, or heart rate. However, both mSNA and
plasma norepinephrine levels showed significant positive correlations (p
less than .05) with left ventricular filling pressures (r = .80, mSNA vs
filling pressures; r = .82, norepinephrine levels vs filling pressures) and
mean right atrial pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Direct evidence from intraneural recordings for increased central sympathetic outflow in patients with heart failure
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 R. Corti, C. Binggeli, I. Sudano, L. E. Spieker, R. R. Wenzel, T. F. Luscher, and G. Noll The Beauty and the Beast: Aspects of the Autonomic Nervous System Physiology, June 1, 2000; 15(3): 125 - 129. [Abstract] [Full Text] [PDF]
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L. E. Spieker, V. Mitrovic, G. Noll, R. Pacher, M. R. Schulze, J.o. Muntwyler, C. Schalcher, W. Kiowski, T. F. Luscher, and on behalf of the ET 003 Investigators Acute hemodynamic and neurohumoral effects of selective ETA receptor blockade in patients with congestive heart failure J. Am. Coll. Cardiol., June 1, 2000; 35(7): 1745 - 1752. [Abstract] [Full Text] [PDF]
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E. R. Azevedo, G. E. Newton, J. S. Floras, and J. D. Parker Reducing Cardiac Filling Pressure Lowers Norepinephrine Spillover in Patients With Chronic Heart Failure Circulation, May 2, 2000; 101(17): 2053 - 2059. [Abstract] [Full Text] [PDF]
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D. M. Kaye, G. Vaddadi, S. L. Gruskin, X.-J. Du, and M. D. Esler Reduced Myocardial Nerve Growth Factor Expression in Human and Experimental Heart Failure Circ. Res., April 14, 2000; 86 (7): e80 - e84. [Abstract] [Full Text] [PDF]
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C Berry and A.L Clark Catabolism in chronic heart failure Eur. Heart J., April 1, 2000; 21(7): 521 - 532. [PDF]
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K. J. Osterziel, W. F. Blum, O. Strohm, and R. Dietz The Severity of Chronic Heart Failure due to Coronary Artery Disease Predicts the Endocrine Effects of Short- Term Growth Hormone Administration J. Clin. Endocrinol. Metab., April 1, 2000; 85(4): 1533 - 1539. [Abstract] [Full Text]
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K. P. Patel, K. Zhang, and P. K. Carmines Norepinephrine turnover in peripheral tissues of rats with heart failure Am J Physiol Regulatory Integrative Comp Physiol, March 1, 2000; 278(3): R556 - R562. [Abstract] [Full Text] [PDF]
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J. Cinca and A. Rodriguez-Sinovas Cardiovascular reflex responses induced by epicardial chemoreceptor stimulation Cardiovasc Res, January 1, 2000; 45(1): 163 - 171. [Abstract] [Full Text] [PDF]
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V. G. Macefield, B. Rundqvist, Y. B. Sverrisdottir, B. G. Wallin, and M. Elam Firing Properties of Single Muscle Vasoconstrictor Neurons in the Sympathoexcitation Associated With Congestive Heart Failure Circulation, October 19, 1999; 100(16): 1708 - 1713. [Abstract] [Full Text] [PDF]
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R. W. Braith, M. A. Welsch, M. S. Feigenbaum, H. A. Kluess, and C. J. Pepine Neuroendocrine activation in heart failure is modified by endurance exercise training J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1170 - 1175. [Abstract] [Full Text] [PDF]
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H. Kawai, T.-H. M. Fan, E. Dong, R. A. Siddiqui, A. Yatani, S. Y. Stevens, and C.-S. Liang ACE inhibition improves cardiac NE uptake and attenuates sympathetic nerve terminal abnormalities in heart failure Am J Physiol Heart Circ Physiol, October 1, 1999; 277(4): H1609 - H1617. [Abstract] [Full Text] [PDF]
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S. A. Akhter, A. D. Eckhart, H. A. Rockman, K. Shotwell, R. J. Lefkowitz, and W. J. Koch In Vivo Inhibition of Elevated Myocardial {beta}-Adrenergic Receptor Kinase Activity in Hybrid Transgenic Mice Restores Normal {beta}-Adrenergic Signaling and Function Circulation, August 10, 1999; 100(6): 648 - 653. [Abstract] [Full Text] [PDF]
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 C. Rostagno, M. Felici, S. Caciolli, G. Olivo, M. Comeglio, G. Galanti, and G. G. N. Serneri Decreased Baroreflex Sensitivity Assessed from Phase IV of Valsalva Maneuver in Mild Congestive Heart Failure Angiology, August 1, 1999; 50(8): 655 - 664. [Abstract] [PDF]
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K. Narkiewicz, C. A. Pesek, P. J. H. van de Borne, M. Kato, and V. K. Somers Enhanced Sympathetic and Ventilatory Responses to Central Chemoreflex Activation in Heart Failure Circulation, July 20, 1999; 100(3): 262 - 267. [Abstract] [Full Text] [PDF]
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G Grassi and G Mancia Sympathetic overactivity and exercise intolerance in heart failure: a cause-effect relationship Eur. Heart J., June 2, 1999; 20(12): 854 - 855. [PDF]
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C.F. Notarius, S. Ando, G.A. Rongen, and J.S. Floras Resting muscle sympathetic nerve activity and peak oxygen uptake in heart failure and normal subjects Eur. Heart J., June 2, 1999; 20(12): 880 - 887. [Abstract] [PDF]
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B. L. Abramson, S.-i. Ando, C. F. Notarius, G. A. Rongen, and J. S. Floras Effect of Atrial Natriuretic Peptide on Muscle Sympathetic Activity and Its Reflex Control in Human Heart Failure Circulation, April 13, 1999; 99(14): 1810 - 1815. [Abstract] [Full Text] [PDF]
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S.-Y. Sun, W. Wang, I. H. Zucker, and H. D. Schultz Enhanced peripheral chemoreflex function in conscious rabbits with pacing-induced heart failure J Appl Physiol, April 1, 1999; 86(4): 1264 - 1272. [Abstract] [Full Text] [PDF]
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A. Cohen-Solal, Y. Esanu, D. Logeart, F. Pessione, C. Dubois, G. Dreyfus, R. Gourgon, and P. Merlet Cardiac metaiodobenzylguanidine uptake in patients with moderate chronic heart failure: relationship with peak oxygen uptake and prognosis J. Am. Coll. Cardiol., March 1, 1999; 33(3): 759 - 766. [Abstract] [Full Text] [PDF]
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F Hartmann, S Ziegler, S Nekolla, M Hadamitzky, M Seyfarth, G Richardt, and M Schwaiger Regional patterns of myocardial sympathetic denervation in dilated cardiomyopathy: an analysis using carbon-11 hydroxyephedrine and positron emission tomography Heart, March 1, 1999; 81(3): 262 - 270. [Abstract] [Full Text]
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G. S. Pepper and R. W. Lee Sympathetic Activation in Heart Failure and Its Treatment With {beta}-Blockade Arch Intern Med, February 8, 1999; 159(3): 225 - 234. [Abstract] [Full Text] [PDF]
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