The effect of chronic mechanical circulatory support on neuroendocrine activation in patients with end-stage heart failure (original) (raw)
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Clinical science (London, England : 1979), 1998
1. Hormones involved in cardiovascular regulation are influenced by drug treatment. It is therefore difficult to study endocrine mechanisms in heart failure as most patients are already on treatment by the time they reach hospital. 2. We studied nine hospital in-patients before and after treatment of acute New York Heart Association class IV heart failure. 3. Before treatment, plasma brain and atrial natriuretic peptides were markedly elevated (BNP 121 +/- 26 pg/ml, ANP 163 +/- 33 pg/ml; normal range: BNP 3.9 +/- 0.3 pg/ml, ANP 8.6 +/- 0.8 pg/ml) and correlated positively with serum creatinine and left ventricular end-diastolic diameter and negatively with ejection fraction. Eight patients improved and one died. 4. With improvement plasma ANP and BNP fell. Initial renin activity was within the normal range but increased on treatment. Plasma neuropeptide Y and adrenaline remained normal before and after treatment in the eight patients who improved. Initial plasma noradrenaline was in...
Neurohormone levels remain elevated in continuous flow left ventricular assist device recipients
Journal of cardiac surgery, 2018
The levels of neurohormones were assessed in continuous-flow left ventricular assist device (CF-LVAD) recipients and compared to patients with heart failure (HF) and to healthy controls (HCs), and CF-LVAD recipients with closed or open aortic valves (AVs). Aldosterone, norepinephrine, and renin levels were assessed in a total of 46 participants, including CF-LVAD recipients (n = 18), HF patients (n = 14), and HC individuals (n = 14). Echocardiographic assessments were performed to evaluate cardiac functions and aortic valve status and neurohormone levels were compared between CF-LVAD recipients with closed or open AVs. Aldosterone, norepinephrine, and renin levels were elevated to a similar extent in CF-LVAD recipients and HF patients, compared to HC individuals. In the CF-LVAD group, no differences were found between the levels of norepinephrine and aldosterone between recipients with AV opened or closed. With an open AVs, CF-LVAD recipients had higher levels of renin compared to r...
American Journal of Veterinary Research, 2002
Objective—To describe neuroendocrine responses that develop in dogs subjected to prolonged periods of ventricular pacing. Animals—14 adult male hound-type dogs. Procedure—Samples were obtained and neuroendocrine responses measured before (baseline) and after 3 periods of ventricular pacing. A pacemaker was used to induce heart rates of 180, 200, and 220 beats/min (BPM). Each heart rate was maintained for 3 weeks before increasing to the next rate. Atrial natriuretic peptide, antidiuretic hormone, aldosterone, norepinephrine, epinephrine, and dopamine concentrations and plasma renin activity were measured. Severity of left ventricular compromise was estimated. Results—Shortening fraction decreased significantly with increasing heart rates (mean ± SE, 35.5 ± 1.4, 25.0 ± 1.4, 19.5 ± 1.9, and 12.2 ± 2.3 for baseline, 180 BPM, 200 BPM, and 220 BPM, respectively). Atrial natriuretic peptide concentrations increased significantly at 180 BPM (44.1 ± 3.0 pg/mL) and 200 BPM (54.8 ± 5.5 pg/mL)...