2013


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2013/№5

Epinephrine and norepinephrine in patients with moderate chronic heart failure

Kuznetsov V. A., Shebeko P. V., Enina T. N., Soldatova A. M., Melnikov N. N., Rychkov A. Yu.

Keywords: epinephrine, noradrenaline, CHF

DOI: 10.18087/rhfj.2013.5.1824

Background. Activation of the sympathetico-adrenal system has been demonstrated in CHF development and progression and documented by increased levels of catecholamines (CA) epinephrine (E) and norepinephrine (NE). However, contribution of individual CA to the CHF pathogenesis in patients with moderate CHF has not been studied sufficiently. Searching for new biochemical markers characterizing the CHF severity also remains an urgent issue. Aim. Studying the interrelation of 24hour urinary CA levels and the E / NE ratio with heart structure and function parameters and with biochemical markers for CHF severity in patients with CHF. Materials and methods. The study included 40 patients with CHF of primarily II–III FC (95 %). A correlation analysis was performed for correlations between 24h urinary E and NE levels, plasma levels of pro-brain natriuretic peptide (NT-proBNP), endothelin-1, tumor necrosis factor α (TNF-α) and major echoCG parameters. Results. NE had higher number of significant correlations with study parameters than E. Thus, multiple significant negative correlations of NE levels with heart chamber dimensions, CHF FC and biochemical markers for unfavorable prognosis in CHF patients suggested a beneficial effect of NE on heart inotropy, which is adaptive in patients with moderate CHF. The observed alternate correlations of E and NE levels with plasma levels of endothelin-1 (r=0.383, p=0.053 and r= –0.413, p=0.035, respectively) evidence unequal roles of these CA in HF development in patients with moderate CHF. Significant correlations of E / NE ratio values with levels of major biomarkers for CHF progression, endothelin-1 and NTproBNP (r=0.614, p=0.001 and r=0.485, p=0.014, respectively) as well as with CHF severity (r=0.376; p=0.017) highlight the significance of this coefficient for evaluation of CHF severity not accounting patients with terminal CHF. Conclusion. This cross-sectional study was performed only for the study parameters and it did not evaluate their changes with the disease duration. This issue requires additional and deeper studies.
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Kuznetsov V.A., Shebeko P.V., Enina T.N. et al. Epinephrine and norepinephrine in patients with moderate chronic heart failure. Russian Heart Failure Journal. 2013;14 (5):252-255

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