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 Indolfi, C. Articles by Chiariello, M. Search for Related Content PubMed PubMed Citation Articles by Indolfi, C. Articles by Chiariello, M.

Circulation, Vol 90, 17-22, Copyright © 1994 by American Heart Association

ARTICLES

Forearm vascular responsiveness to alpha 1- and alpha 2-adrenoceptor stimulation in patients with congestive heart failure

C Indolfi, A Maione, M Volpe, A Rapacciuolo, G Esposito, R Ceravolo, V Rendina, M Condorelli and M Chiariello
Department of Medicine, University Federico II, Naples, Italy.

BACKGROUND: The alpha-adrenergic component of the sympathetic nervous system plays a major role in the pathophysiology, clinical manifestations, and natural history of human congestive heart failure (CHF). However, the functional integrity of vascular alpha 1- and alpha 2-adrenoceptors in CHF remains to be elucidated. The present study was designed to assess the vascular responsiveness of alpha 1- and alpha 2- adrenoceptors in patients with CHF. METHODS AND RESULTS: To evaluate alpha 1- and alpha 2-adrenoceptor responsiveness, we studied the effects of the regional infusion into the brachial artery of increasing doses of phenylephrine (a selective alpha 1-adrenoceptor agonist) and BHT 933 (a selective alpha 2-adrenoceptor agonist) on vascular responses in 12 healthy subjects and in 24 patients with CHF secondary to primary dilated cardiomyopathy or ischemic heart disease. Left ventricular ejection fraction was measured by radionuclide angiography, and forearm blood flow was determined by venous occlusion plethysmography. Phenylephrine reduced forearm blood flow in normal subjects from 5.2 +/- 0.9 to 2.5 +/- 0.6 mL per 100 mL of tissue/min (P < .05) at the highest dose (-50.8 +/- 4.8% versus baseline). A similar vasoconstriction was obtained in patients with CHF (from 3.5 +/- 0.5 to 1.5 +/- 0.2 mL per 100 mL of tissue/min (P < .05) (-58.7 +/- 5.0% versus baseline). The dose-response curves produced by phenylephrine in the two groups were comparable. The highest dose of BHT 933 reduced forearm blood flow in normal subjects from 5.3 +/- 0.9 to 2.3 +/- 0.6 mL per 100 mL of tissue/min (P < .05) (-59.0 +/- 4.9% versus baseline). In patients with CHF, a similar vasoconstriction was obtained (from 4.2 +/- 0.8 to 1.5 +/- 0.3 mL per 100 mL of tissue/min, P < .05, -62.1 +/- 6.5% versus baseline). The dose-response curves produced by BHT 933 also were comparable in the two groups. In patients with CHF, plasma concentrations of norepinephrine were significantly higher than in normal subjects. CONCLUSIONS: The results of the present study demonstrate that alpha 1- and alpha 2-adrenoceptor stimulations produced an equivalent vasoconstriction in patients with CHF and in normal subjects. This indicates that the vascular responsiveness to alpha-adrenoceptor agonists may be preserved in the limb vessels of patients with CHF.

This article has been cited by other articles:

				G. Heusch, D. Baumgart, P. Camici, W. Chilian, L. Gregorini, O. Hess, C. Indolfi, and O. Rimoldi {alpha}-Adrenergic Coronary Vasoconstriction and Myocardial Ischemia in Humans Circulation, February 15, 2000; 101(6): 689 - 694. [Abstract] [Full Text] [PDF]

				S. Makita, M. Nakamura, A. Ohira, S. Ito, K. Yoshioka, A. Hirose, T. Nakajima, K. Komoda, K. Kawazoe, and K. Hiramori Impaired Peripheral Vasodilation in Ischemic and Nonischemic Limbs of Patients with Unilateral Arteriosclerosis Obliterans: Effect of Revascularization on Leg Hemodynamics Vascular and Endovascular Surgery, September 1, 1998; 32(5): 491 - 502. [Abstract] [PDF]

				F. Perticone, R. Ceravolo, R. Maio, G. Ventura, A. Zingone, N. Perrotti, and P. L. Mattioli Angiotensin-Converting Enzyme Gene Polymorphism Is Associated With Endothelium-Dependent Vasodilation in Never Treated Hypertensive Patients Hypertension, April 1, 1998; 31(4): 900 - 905. [Abstract] [Full Text] [PDF]

				C. Indolfi, F. Piscione, R. Ceravolo, A. Maione, A. Focaccio, M. A. Rao, G. Esposito, M. Condorelli, and M. Chiariello Limb Vasoconstriction After Successful Angioplasty of the Left Anterior Descending Coronary Artery Circulation, October 15, 1995; 92(8): 2109 - 2112. [Abstract] [Full Text]