Prognostic Significance of Exercise Plasma Noradrenaline Levels for Cardiac Death in Patients With Mild Heart Failure.

Kinugawa, Toru; Oginö, Kazuhíde; Osaki, Satoru; Kato, Masahiko; Igawa, Osamu; Hisatome, Ichiro; Fujita, Masatoshi; Shigemasa, Chiaki

doi:10.1253/circj.66.261

Cited by 17 publications

(10 citation statements)

References 31 publications

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“…The important difference between the two studies was severity of heart failure. Consistent with previous reports [32,33], our patients with mild CHF showed little or no increase in plasma norepinephrine concentrations. We speculate that the lack of sympathoexcitation at baseline is responsible for the no change in plasma norepinephrine after losartan therapy.…”

Section: Discussionsupporting

confidence: 93%

Effects of Angiotensin II Type 1 Receptor Antagonist, Losartan, on Ventilatory Response to Exercise and Neurohormonal Profiles in Patients with Chronic Heart Failure

Kinugawa

Kato

Oginö

et al. 2004

JJP

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Neurohormonal activation is a hallmark of chronic heart failure (CHF). The renin-angiotensin system, angiotensin II in particular, plays an important role in the pathophysiology and prognosis of patients with CHF. Angiotensin II type 1 receptor antagonists have been introduced as therapy for CHF [1,2], and several studies have demonstrated that this class of drugs exerts favorable effects on heart failure progression [3], exercise capacity [4,5], and neurohormonal profiles [6][7][8][9][10].Exercise hyperventilation is commonly seen in pa-

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Section: Discussionsupporting

confidence: 93%

Effects of Angiotensin II Type 1 Receptor Antagonist, Losartan, on Ventilatory Response to Exercise and Neurohormonal Profiles in Patients with Chronic Heart Failure

Kinugawa

Kato

Oginö

et al. 2004

JJP

Self Cite

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“…Brouwer et al [77] found that heart rate variability has prognostic value, not only for identification of patients at high risk for allcause cardiac mortality, but also for the prediction of sudden cardiac death. Kinugawa et al [78] observed that patients with supramedian level of exercise plasma norepinephrine concentration had a significantly lower survival rate than those with inframedian level. La Rovere and colleagues [79] showed that low-frequency variability during controlled breathing is a powerful predictor of sudden death in patients with chronic HF that is independent of other parameters.…”

Section: Clinical Implications Of the Excitatory And Inhibitory Autonmentioning

confidence: 99%

Adaptations in autonomic function during exercise training in heart failure

2007

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Although neurohumoral excitation is the hallmark of heart failure (HF), the mechanisms underlying this alteration are not entirely known. Abnormalities in several systems contribute to neurohumoral excitation in HF, including arterial and cardiopulmonary baroreceptors, central and peripheral chemoreceptors, cardiac chemoreceptors, and central nervous system abnormalities. Exercise intolerance is characteristic of chronic HF, and growing evidence strongly suggests that exercise limitation in patients with chronic HF is not due to elevated filling pressures or inadequate cardiac output during exercise, but instead due to skeletal myopathy. Several lines of evidence suggest that sympathetic excitation contributes to the skeletal myopathy of HF, since sympathetic activity mediates vasoconstriction at rest and during exercise likely restrains muscle blood flow, arteriolar dilatation, and capillary recruitment, leading to underperfused areas of working muscle, and areas of muscle ischemia, release of reactive oxygen species (ROS), and inflammation. Although controversial, either unmyelinated, metabolite-sensitive afferent fibers, and/or myelinated, mechanosensitive afferent fibers in skeletal muscle underlie the exaggerated sympathetic activity in HF. Exercise training has emerged as a unique non-pharmacological strategy for the treatment of HF. Regular exercise improves functional capacity and quality of life, and perhaps prognosis in chronic HF patients. Recent studies have provided convincing evidence that these benefits in chronic HF patients are mediated by significant reduction in central sympathetic outflow as a consequence of improvement in arterial and chemoreflex controls, and correction of central nervous system abnormalities, and increase in peripheral blood flow with reduction in cytokines and increase in mass muscle.

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“…Brouwer et al [9] found that heart rate variability has prognostic value not only for identification of patients at high risk for all-cause cardiac mortality, but also for sudden cardiac death. More recently, Kinugawa et al [10] observed that patients with supramedian level of exercise plasma norepinephrine concentration had a significantly lower survival rate than those with inframedian level. Although plasma norepinephrine levels and heart rate variability are important markers of prognosis in heart failure, they have some limitations.…”

Section: Introductionmentioning

confidence: 99%

Increased muscle sympathetic nerve activity predicts mortality in heart failure patients

Barretto

Santos

Munhoz

et al. 2009

International Journal of Cardiology

259

191

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Prognostic Significance of Exercise Plasma Noradrenaline Levels for Cardiac Death in Patients With Mild Heart Failure.

Cited by 17 publications

References 31 publications

Effects of Angiotensin II Type 1 Receptor Antagonist, Losartan, on Ventilatory Response to Exercise and Neurohormonal Profiles in Patients with Chronic Heart Failure

Effects of Angiotensin II Type 1 Receptor Antagonist, Losartan, on Ventilatory Response to Exercise and Neurohormonal Profiles in Patients with Chronic Heart Failure

Adaptations in autonomic function during exercise training in heart failure

Increased muscle sympathetic nerve activity predicts mortality in heart failure patients

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