Prognostic Significance of Exercise Plasma Noradrenaline Levels for Cardiac Death in Patients With Mild Heart Failure
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概要
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The present study was designed to determine whether exercise plasma noradrenaline (NA) levels could predict cardiac death in patients with mild heart failure in whom the plasma NA levels were only minimally elevated. Treadmill exercise testing with serial measurement of plasma NA and plasma adrenaline were performed in 142 patients with heart failure (New York Heart Association class I-II ; age, 58±12 years) and 26 age-matched normal subjects. During a median follow-up of 9.6 years, 27 cardiac deaths occurred among the patients. By univariate Cox proportional hazard analysis, left ventricular end-systolic dimension (p<0.001), age (p<0.01), peak exercise heart rate (p<0.01), exercise plasma NA level (p<0.01) and left ventricular ejection fraction (p<0.001) were identified as significant prognostic markers. In a multivariate analysis, exercise plasma NA level was identified as the most powerful prognostic marker (p<0.001), followed by left ventricular end-systolic dimension and peak exercise heart rate. In addition, from the Kaplan-Meter analysis, patients with a supramedian level of exercise plasma NA concentration (NA≥840pg/ml) had a significantly lower survival rate than those with an inframedian level (p<0.01). Exercise plasma NA levels can provide prognostic information in patients with mild heart failure, which suggests an important role of exercise-induced activation of sympathetic nervous system activity in the prognosis of patients with mild heart failure.
- 社団法人日本循環器学会の論文
- 2002-02-20
著者
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Kato Masahiko
Department Of Cardiovascular Medicine Faculty Of Medicine Tottori University
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Fujita Masatoshi
College of Medical Technology, Kyoto University
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Osaki Shuichi
Department Of Cardiology San-in Rosai Hospital
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Kinugawa Toru
Kitano Hospital
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Fujita Masatoshi
College Of Medical Technology Kyoto University
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HISATOME Ichiro
the Department of Cardiovascular Medicine, Tottori University Hospital
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IGAWA Osamu
the Department of Cardiovascular Medicine, Tottori University Hospital
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SHIGEMASA Chiaki
the Department of Cardiovascular Medicine, Tottori University Hospital
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Kinugawa Tooru
Kitano Hospital The Tazuke Kofukai Medical Research Institute
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Kinugawa Toru
Dept. Of Internal Medicine Tottori Univ.
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Kinugawa Toru
The Division of Cardiology, The 1st Department of Internal Medicine, Tottori University Faculty of M
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Ogino Kazuhide
The Division of Cardiology, The 1st Department of Internal Medicine, Tottori University Faculty of M
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Osaki Shuichi
The Division of Cardiology, The 1st Department of Internal Medicine, Tottori University Faculty of M
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Kato Masahiko
The Division of Cardiology, The 1st Department of Internal Medicine, Tottori University Faculty of M
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