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Regional epinephrinekinetics in humanheart failure:evidence forextra-adrenal,nonneural release David M. KayeJeffrey LefkovitsHelen Cox1995 год

Regional epinephrine kinetics in human heart failure: evidence for extra-adrenal, nonneural release
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Аннотация: A number of neurohumoral processes are activated in heart failure, including an increase in the plasma concentration of epinephrine. Radiotracer methods were applied in 42 patients with severe heart failure and 31 healthy volunteers to ascertain the rate at which epinephrine is released to plasma and to evaluate the contribution of extra-adrenal sources. The increase in arterial plasma epinephrine observed in the heart failure patients was explained principally by a 34% (P < 0.001) reduction in the whole body clearance rate of epinephrine from plasma. Regional venous sampling from the heart, lungs, and hepatomesenteric beds was performed in a subgroup of the study population, revealing a significant increase in the release rate of epinephrine to plasma from these organs in heart failure which accounted for 26% of the whole body plasma epinephrine appearance rate. To establish whether the cardiac epinephrine release was of neuronal origin, a physical (cycling) or mental (difficult mental arithmetic) stressor was applied as a sympathoexcitatory stimulus, given that a proportional release of norepinephrine and epinephrine could be expected if sympathetic nerves were the source. These interventions caused significant increases in the regional spillover of norepinephrine to plasma but not that of epinephrine. These findings suggest that nonadrenal tissues contribute significantly to the whole body epinephrine release rate in heart failure and that this may arise from a site other than sympathetic neurons.
Год издания: 1995
Авторы: David M. Kaye, Jeffrey Lefkovits, Helen Cox, Gavin Lambert, Garry Jennings, Andrea Turner, Murray Esler
Издательство: American Physical Society
Источник: AJP Heart and Circulatory Physiology
Ключевые слова: Heart Rate Variability and Autonomic Control, Cardiovascular and exercise physiology, Muscle activation and electromyography studies
Другие ссылки: AJP Heart and Circulatory Physiology (HTML)
PubMed (HTML)