Neurohormonal Determinants of Peak Oxygen Uptake in Patients with Chronic Heart Failure
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概要
- 論文の詳細を見る
Chronic heart failure (CHF) is characterized by the activation of neurohormones and cytokines. This study determined whether peak oxygen uptake (VO2) can be predicted by the degree of neurohormonal and cytokine activations in CHF. Plasma norepinephrine, epinephrine, renin-angiotensin system activity, ANP, BNP, and serum interleukin-6 (IL-6) and tumor necrosis factor (TNF)-α were measured in 84 CHF patients (age, 59 ± 1 years, LVEF, 36 ± 1%) and 34 controls. Maximal cardiopulmonary exercise testing was performed. Peak VO2 (Controls vs CHF: 27.8 ± 1.3 vs 18.2 ± 0.5 mL/min/kg, P < 0.0001) was lower in CHF. Patients with CHF had increased plasma norepinephrine (211 ± 11 vs 315 ± 24 pg/mL), renin activity (1.2 ± 0.2 vs 6.2 ± 1.1 ng/mL/hr), ANP (22 ± 3 vs 72 ± 7 pg/mL), and BNP levels (18 ± 3 vs 200 ± 25 pg/mL) (all P < 0.01). Serum IL-6 (1.1 ± 0.1 vs 2.4 ± 0.3 pg/mL) and TNF-α (2.7 ± 0.2 vs 4.0 ± 0.3 pg/mL) levels were higher in CHF (both P < 0.001). Univariate analysis revealed that age (P < 0.001), cardiothoracic ratio (P < 0.001), norepinephrine (P < 0.0001), ANP (P < 0.001), BNP (P < 0.01), and log IL-6 (P < 0.05) were significantly related with peak VO2. Stepwise regression analysis indicated that plasma norepinephrine and ANP emerged as significant determinants of peak VO2, independent of patient age (overall R = 0.61, P < 0.0001). In summary, patients with CHF exhibited activation of neurohormones and proinflammatory cytokines. Among the elevated hormonal and cytokine markers, plasma norepinephrine and ANP levels were independent predictors of exercise capacity.
- Japanese Heart Journal Associationの論文
著者
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Hisatome Ichiro
Division of Regenerative Medicine and Therapeutics, Tottori University Faculty of Medicine
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Shigemasa Chiaki
Division Of Regenerative Medicine And Therapeutics Department Of Genetic Medicine And Regenerative M
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Igawa Osamu
Division of Molecular Medicine and Therapeutics, Tottori University
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Hisatome Ichiro
Division Of Molecular Medicine And Therapeutics Department Of Multidisciplinary Internal Medicine To
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Ogino Kazuhide
Division of Cardiology, Department of Medicine, Faculty of Medicine, Tottori University
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Hisatome Ichiro
鳥取大学 医学系研究科遺伝子医療学
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Kinugawa Toru
Division of Cardiovascular Medicine, Department of Internal Medicine, Tottori University Faculty of
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Kato Masahiko
Division of Cardiovascular Medicine, Department of Internal Medicine, Tottori University Faculty of
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Nohara Ryuji
Cardiovascular Medicine, Kitano Hospital, The Tazuke Kofukai Medical Reserch Institute
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Nohara Ryuji
Cardiovascular Center Kitano Hospital The Tazuke Kofukai Medical Research Institute
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Igawa Osamu
Division of Cardiovascular Medicine, Department of Internal Medicine, Tottori University Faculty of Medicine
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Shigemasa Chiaki
Division of Cardiovascular Medicine, Department of Internal Medicine, Tottori University Faculty of Medicine
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Ogino Kazuhide
Division of Cardiovascular Medicine, Department of Internal Medicine, Tottori University Faculty of Medicine
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Hisatome Ichiro
Division of Cardiovascular Medicine, Department of Internal Medicine, Tottori University Faculty of Medicine
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