This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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 Creager, M. A. Articles by Colucci, W. S. Search for Related Content PubMed PubMed Citation Articles by Creager, M. A. Articles by Colucci, W. S.

Circulation, Vol 83, 1873-1879, Copyright © 1991 by American Heart Association

ARTICLES

Limb vascular responsiveness to beta-adrenergic receptor stimulation in patients with congestive heart failure

MA Creager, RJ Quigg, CJ Ren, MA Roddy and WS Colucci
Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 02115.

BACKGROUND. In patients with congestive heart failure, the chronotropic and inotropic responses to beta-adrenergic agonists are reduced. It is not known whether desensitization of peripheral beta-adrenoceptors accounts for impaired limb vasodilation in these patients. Accordingly, we studied 14 normal subjects and 13 age-matched patients with congestive heart failure. METHODS AND RESULTS. To distinguish vasodilation mediated by beta-adrenoceptors and adenylate cyclase from that mediated by stimulation of guanylate cyclase, each subject received intrabrachial artery infusions of isoproterenol (1-100 ng/min) and sodium nitroprusside (0.3-10 micrograms/min), respectively. Forearm blood flow was determined by venous occlusion plethysmography. Maximal vasodilative potential, determined during reactive hyperemia, was reduced in the patients with congestive heart failure. The maximal forearm blood flow response to isoproterenol was comparable in patients with heart failure and in normal subjects (8.0 +/- 1.1 versus 9.2 +/- 1.2 ml/100 ml of tissue/min, respectively, p = NS). Furthermore, the dose-response relation to isoproterenol was similar in both groups. Likewise, the forearm vasodilative response to sodium nitroprusside was preserved in the heart failure group. Plasma concentration of norepinephrine was higher in the patients with heart failure (436 +/- 34 versus 201 +/- 74 pg/ml, p less than 0.01). When both groups were considered, there was no correlation between norepinephrine levels and the maximal forearm blood flow response to isoproterenol (r = 0.10, p = NS). CONCLUSIONS. We conclude that beta-adrenoceptor desensitization does not occur in the limb vessels of patients with congestive heart failure.

This article has been cited by other articles:

				J. Cui, A. Arbab-Zadeh, A. Prasad, S. Durand, B. D. Levine, and C. G. Crandall Effects of Heat Stress on Thermoregulatory Responses in Congestive Heart Failure Patients Circulation, October 11, 2005; 112(15): 2286 - 2292. [Abstract] [Full Text] [PDF]

				M. Nakamura, H. Yoshida, Y. Naganuma, H. Kon, S. Sugawara, and K. Hiramori Peripheral Vasodilatory Dysfunction in Adult Patients with Congenital Heart Disease and Severely Elevated Pulmonary Vascular Resistance Angiology, November 1, 2002; 53(6): 715 - 720. [Abstract] [PDF]

				S. D. Katz, K. Balidemaj, S. Homma, H. Wu, J. Wang, and S. Maybaum Acute type 5 phosphodiesterase inhibition with sildenafil enhances flow-mediated vasodilation in patients with chronic heart failure J. Am. Coll. Cardiol., September 1, 2000; 36(3): 845 - 851. [Abstract] [Full Text] [PDF]

				C. M. Stein, R. Nelson, R. Deegan, H. He, T. Inagami, M. Frazer, K. F. Badr, M. Wood, and A. J. J. Wood Tachyphylaxis of Human Forearm Vascular Responses Does Not Occur Rapidly After Exposure to Isoproterenol Hypertension, June 1, 1995; 25(6): 1294 - 1300. [Abstract] [Full Text]