Circulation, Vol 82, 1724-1729, Copyright © 1990 by American Heart Association
GS Francis, C Benedict, DE Johnstone, PC Kirlin, J Nicklas, CS Liang, SH Kubo, E Rudin-Toretsky and S Yusuf
Neuroendocrine activation is known to occur in patients with congestive
heart failure, but there is uncertainty as to whether this occurs before or
after the presence of overt symptoms. In the Studies of Left Ventricular
Dysfunction (SOLVD), a multicenter study of patients with ejection
fractions of 35% or less, we compared baseline plasma norepinephrine,
plasma renin activity, plasma atrial natriuretic factor, and plasma
arginine vasopressin in 56 control subjects, 151 patients with left
ventricular dysfunction (no overt heart failure), and 81 patients with
overt heart failure before randomization. Median values for plasma
norepinephrine (p = 0.0001), plasma atrial natriuretic factor (p less than
0.0001), plasma arginine vasopressin (p = 0.006), and plasma renin activity
(p = 0.03) were significantly higher in patients with left ventricular
dysfunction than in normal control subjects. Neuroendocrine values were
highest in patients with overt heart failure. Plasma renin activity was
normal in patients with left ventricular dysfunction without heart failure
who were not receiving diuretics and was significantly increased (p less
than 0.05) in patients on diuretic therapy. We conclude that neuroendocrine
activation occurs in patients with left ventricular dysfunction and no
heart failure. Neuroendocrine activation is further increased as overt
heart failure ensues and diuretics are added to therapy.
ARTICLES
Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure. A substudy of the Studies of Left Ventricular Dysfunction (SOLVD)
Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892.
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M. Gheorghiade, W. A. Gattis, C. M. O'Connor, K. F. Adams Jr, U. Elkayam, A. Barbagelata, J. K. Ghali, R. L. Benza, F. A. McGrew, M. Klapholz, et al. Effects of Tolvaptan, a Vasopressin Antagonist, in Patients Hospitalized With Worsening Heart Failure: A Randomized Controlled Trial JAMA, April 28, 2004; 291(16): 1963 - 1971. [Abstract] [Full Text] [PDF]
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J. Fletcher, A. N. Buch, H. C. Routledge, S. Chowdhary, J. H. Coote, and J. N. Townend Acute aldosterone antagonism improves cardiac vagal control in humans J. Am. Coll. Cardiol., April 7, 2004; 43(7): 1270 - 1275. [Abstract] [Full Text] [PDF]
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Y. Seino, A. Ogawa, T. Yamashita, M. Fukushima, K.-i. Ogata, H. Fukumoto, and T. Takano Application of NT-proBNP and BNP measurements in cardiac care: a more discerning marker for the detection and evaluation of heart failure Eur J Heart Fail, March 15, 2004; 6(3): 295 - 300. [Abstract] [Full Text] [PDF]
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F. Hartmann, M. Packer, A. J.S. Coats, M. B. Fowler, H. Krum, P. Mohacsi, J. L. Rouleau, M. Tendera, A. Castaigne, J. Trawinski, et al. NT-proBNP in severe chronic heart failure: rationale, design and preliminary results of the COPERNICUS NT-proBNP substudy Eur J Heart Fail, March 15, 2004; 6(3): 343 - 350. [Abstract] [Full Text] [PDF]
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T. J. Wang, M. G. Larson, D. Levy, E. J. Benjamin, E. P. Leip, T. Omland, P. A. Wolf, and R. S. Vasan Plasma Natriuretic Peptide Levels and the Risk of Cardiovascular Events and Death N. Engl. J. Med., February 12, 2004; 350(7): 655 - 663. [Abstract] [Full Text] [PDF]
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M. A. Konstam and D. DeNofrio Endothelin Expression and the Progression of Heart Failure: Exemplifying the Vagaries of Therapeutic Development Circulation, January 20, 2004; 109(2): 143 - 145. [Full Text] [PDF]
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P A Modesti, G Polidori, I Bertolozzi, S Vanni, and I Cecioni Impairment of cardiopulmonary receptor sensitivity in the early phase of heart failure Heart, January 1, 2004; 90(1): 30 - 36. [Abstract] [Full Text] [PDF]
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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]
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J. G.F. Cleland, N. Freemantle, G. Kaye, M. Nasir, P. Velavan, K. Lalukota, T. Mudawi, R. Shelton, A. L. Clark, and A. P. Coletta Clinical trials update from the American Heart Association meeting: {Omega}-3 fatty acids and arrhythmia risk in patients with an implantable defibrillator, ACTIV in CHF, VALIANT, the Hanover autologous bone marrow transplantation study, SPORTIF V, ORBIT and PAD and DEFINITE Eur J Heart Fail, January 1, 2004; 6(1): 109 - 115. [Abstract] [Full Text] [PDF]
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A. El-Armouche, O. Zolk, T. Rau, and T. Eschenhagen Inhibitory G-proteins and their role in desensitization of the adenylyl cyclase pathway in heart failure Cardiovasc Res, December 1, 2003; 60(3): 478 - 487. [Abstract] [Full Text] [PDF]
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H. Ohuchi, H. Takasugi, H. Ohashi, Y. Okada, O. Yamada, Y. Ono, T. Yagihara, and S. Echigo Stratification of Pediatric Heart Failure on the Basis of Neurohormonal and Cardiac Autonomic Nervous Activities in Patients With Congenital Heart Disease Circulation, November 11, 2003; 108(19): 2368 - 2376. [Abstract] [Full Text] [PDF]
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S. Velez-Roa, M. Renard, J.-P. Degaute, and P. van de Borne Peripheral sympathetic control during dobutamine infusion: effects of aging and heart failure J. Am. Coll. Cardiol., November 5, 2003; 42(9): 1605 - 1610. [Abstract] [Full Text] [PDF]
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G. Grassi, G. Seravalle, F. Quarti-Trevano, R. Dell'Oro, G. Bolla, and G. Mancia Effects of Hypertension and Obesity on the Sympathetic Activation of Heart Failure Patients Hypertension, November 1, 2003; 42(5): 873 - 877. [Abstract] [Full Text] [PDF]
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R. S. McKelvie, J.-L. Rouleau, M. White, R. Afzal, J. B. Young, A. P. Maggioni, P. Held, and S. Yusuf Comparative impact of enalapril, candesartan or metoprolol alone or in combination on ventricular remodelling in patients with congestive heart failure Eur. Heart J., October 1, 2003; 24(19): 1727 - 1734. [Abstract] [Full Text] [PDF]
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J. N. Cohn, M. A. Pfeffer, J. Rouleau, N. Sharpe, K. Swedberg, M. Straub, C. Wiltse, T. J. Wright, and for the MOXCON Investigators Adverse mortality effect of central sympathetic inhibition with sustained-release moxonidine in patients with heart failure (MOXCON) Eur J Heart Fail, October 1, 2003; 5(5): 659 - 667. [Abstract] [Full Text] [PDF]
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F. Roveda, H. R. Middlekauff, M. U. P. B. Rondon, S. F. Reis, M. Souza, L. Nastari, A. C. P. Barretto, E. M. Krieger, and C. E. Negrao The effects of exercise training on sympathetic neural activation in advanced heart failure: A randomized controlled trial J. Am. Coll. Cardiol., September 3, 2003; 42(5): 854 - 860. [Abstract] [Full Text] [PDF]
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K. H Chee, K. Amudha, N. A Hussain, H. K Haizal, A.-M. J Choy, and C. C Lang Combination of drugs acting on the natriuretic system and the renin-angiotensin system in heart failure Journal of Renin-Angiotensin-Aldosterone System, September 1, 2003; 4(3): 140 - 148. [Abstract] [PDF]
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A. M. Richards, M. G. Nicholls, E. A. Espiner, J. G. Lainchbury, R. W. Troughton, J. Elliott, C. Frampton, J. Turner, I. G. Crozier, and T. G. Yandle B-Type Natriuretic Peptides and Ejection Fraction for Prognosis After Myocardial Infarction Circulation, June 10, 2003; 107(22): 2786 - 2792. [Abstract] [Full Text] [PDF]
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