This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hasking, G. J. Articles by Lambert, G. Search for Related Content PubMed PubMed Citation Articles by Hasking, G. J. Articles by Lambert, G.

Circulation, Vol 78, 516-521, Copyright © 1988 by American Heart Association

ARTICLES

Norepinephrine spillover to plasma during steady-state supine bicycle exercise. Comparison of patients with congestive heart failure and normal subjects

GJ Hasking, MD Esler, GL Jennings, E Dewar and G Lambert
Clinical Research Unit, Alfred Hospital, Prahran, Victoria, Australia.

This study was performed to determine the relative contributions of plasma norepinephrine clearance and norepinephrine release to the increase in plasma norepinephrine concentration that occurs during exercise and to determine whether the high rates of cardiac norepinephrine release from the heart and kidney in patients with heart failure are associated with diminished reserve for regional sympathetic nervous stimulation. During supine steady-state bicycle exercise at 50% of maximum voluntary exercise capacity, the plasma norepinephrine concentration of six patients with congestive heart failure rose from 385 +/- 88 to 2,200 +/- 497 pg/ml, whereas that of nine normal subjects rose from 208 +/- 21 to 882 +/- 257 pg/ml. The change in plasma concentration in both groups was due to an increase in norepinephrine spillover to plasma without a change in plasma norepinephrine clearance. In patients with heart failure, cardiac spillover increased from 80 +/- 26 to 528 +/- 265 ng/min during exercise, and renal spillover rose from 146 +/- 71 to 418 +/- 69 ng/min. In the normal subjects, cardiac spillover rose from 5 +/- 2 to 73 +/- 23 ng/min, and renal spillover increased from 76 +/- 27 to 275 +/- 106 ng/min. There is no evidence of a reduced reserve for overall or regional sympathetic stimulation in patients with heart failure. Reduced reflex responses in these patients are more likely due to end-organ refractoriness than to inadequate stimulation.

This article has been cited by other articles:

				G.-X. Zhang, S. Kimura, A. Nishiyama, T. Shokoji, M. Rahman, L. Yao, Y. Nagai, Y. Fujisawa, A. Miyatake, and Y. Abe Cardiac oxidative stress in acute and chronic isoproterenol-infused rats Cardiovasc Res, January 1, 2005; 65(1): 230 - 238. [Abstract] [Full Text] [PDF]

				A. Al-Hesayen and J. D. Parker Impaired Baroreceptor Control of Renal Sympathetic Activity in Human Chronic Heart Failure Circulation, June 15, 2004; 109(23): 2862 - 2865. [Abstract] [Full Text] [PDF]

				A. Kjaer, J. Appel, P. Hildebrandt, and C. L. Petersen Basal and exercise-induced neuroendocrine activation in patients with heart failure and in normal subjects Eur J Heart Fail, January 1, 2004; 6(1): 29 - 39. [Abstract] [Full Text] [PDF]

				M. Sato, K. Maehara, H. Yaoita, H. Otani, A. Hirosaka, T. Saito, N. Onuki, N. Komatsu, T. Ishihata, and Y. Maruyama Correlation Between Cardiac Norepinephrine Overflow During Exercise and Cardiac 123I-MIBG Uptake in Patients with Chronic Heart Failure J. Nucl. Med., October 1, 2003; 44(10): 1618 - 1624. [Abstract] [Full Text] [PDF]

				H. Tsuchimochi, K. Matsukawa, H. Komine, and J. Murata Direct measurement of cardiac sympathetic efferent nerve activity during dynamic exercise Am J Physiol Heart Circ Physiol, November 1, 2002; 283(5): H1896 - H1906. [Abstract] [Full Text] [PDF]

				C.F. Notarius, E.R. Azevedo, J.D. Parker, and J.S. Floras Peak oxygen uptake is not determined by cardiac noradrenaline spillover in heart failure Eur. Heart J., May 2, 2002; 23(10): 800 - 805. [Abstract] [Full Text] [PDF]

				K. Singh, C. Communal, D. B. Sawyer, and W. S. Colucci Adrenergic regulation of myocardial apoptosis Cardiovasc Res, February 1, 2000; 45(3): 713 - 719. [Abstract] [Full Text] [PDF]

				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]

				J. S. Greiwe, R. C. Hickner, S. D. Shah, P. E. Cryer, and J. O. Holloszy Norepinephrine response to exercise at the same relative intensity before and after endurance exercise training J Appl Physiol, February 1, 1999; 86(2): 531 - 535. [Abstract] [Full Text] [PDF]

				T. Neumann and G. Heusch Myocardial, skeletal muscle, and renal blood flow during exercise in conscious dogs with heart failure Am J Physiol Heart Circ Physiol, November 1, 1997; 273(5): H2452 - H2457. [Abstract] [Full Text] [PDF]

				B. Rundqvist, G. Eisenhofer, M. Elam, and P. Friberg Attenuated Cardiac Sympathetic Responsiveness During Dynamic Exercise in Patients With Heart Failure Circulation, February 18, 1997; 95(4): 940 - 945. [Abstract] [Full Text]

				G. E. Newton and J. D. Parker Cardiac Sympathetic Responses to Acute Vasodilation: Normal Ventricular Function Versus Congestive Heart Failure Circulation, December 15, 1996; 94(12): 3161 - 3167. [Abstract] [Full Text]

				G. G. Neri Serneri, M. Boddi, P. A. Modesti, I. Cecioni, M. Coppo, L. Padeletti, A. Michelucci, A. Colella, and G. Galanti Increased Cardiac Sympathetic Activity and Insulin-Like Growth Factor-I Formation Are Associated With Physiological Hypertrophy in Athletes Circ. Res., November 23, 2001; 89(11): 977 - 982. [Abstract] [Full Text] [PDF]