id:"swepub:oai:lup.lub.lu.se:6c19801a-8ca0-4be5-bc92-5ec288382978"
Search: id:"swepub:oai:lup.lub.lu.se:6c19801a-8ca0-4be5-bc92-5ec288382978" > Neurohormonal activ...
- 1 of 1
- Previous record
- Next record
- To hitlist
Neurohormonal activation in heart failure after acute myocardial infarction treated with beta-receptor antagonists
-
- Persson, H (author)
- Karolinska Institutet
- Andreasson, K (author)
-
- Kahan, T (author)
- Karolinska Institutet
- show more...
- Tidgren, B (author)
- Hjemdahl, P (author)
- Hall, C (author)
- show less...
- (creator_code:org_t)
- 2002
- 2002
- English.
- In: European Journal of Heart Failure. - 1879-0844 .- 1388-9842. ; 4:1, s. 73-82
- Journal article (peer-reviewed)
Abstract
Subject headings
Close
- Background: Few studies have described how neurohormonal activation is influenced by treatment with beta-receptor antagonists in patients with heart failure after acute myocardial infarction. The aims were to describe neurohormonal activity in relation to other variables and to investigate treatment effects of a beta, receptor-antagonist compared to a partial beta, receptor-agonist. Methods: Double-blind, randomized comparison of metoprolol 50-100 mg b.i.d. (n = 74), and xamoterol 100-200 mg b.i.d (n = 67). Catecholamines, neuropeptide Y-like immunoreactivity (NPY-LI), renin activity, and N-terminal pro-atrial natriuretic factor (N-ANF) were measured in venous plasma before discharge and after 3 months. Clinical and echocardiographic variables were assessed. Results: N-ANF showed the closest correlations to clinical and echo cardiographic measures of heart failure severity, e.g. NYHA functional class, furosemide dose, exercise tolerance, systolic and diastolic function. Plasma norepinephrine, dopamine and renin activity decreased after 3 months on both treatments, in contrast to a small increase in NPY-LI which was greater (by 3.9 pmol/l, 95% CI 1.2-6.6) in the metoprolol group. N-ANF increased on metoprolol, and decreased on xamoterol (difference: 408 pmol/l, 95% CI 209-607). Increase above median of NPY-LI (> 25.2 pmol/l, odds ratio 2.8, P = 0.0050) and N-ANF (> 1043 pmol/l, odds ratio 2.8, P = 0.0055) were related to long term (mean follow-up 6.8 years) cardiovascular mortality. Conclusions: Decreased neurohormonal activity, reflecting both the sympathetic nervous system and the renin-angiotensin system, was found 3 months after an acute myocardial infarction with heart failure treated with beta-receptor antagonists. The small increase in NPY-LI may suggest increased sympathetic activity or reduced clearance from plasma. The observed changes of N-ANF may be explained by changes in cardiac preload, renal function, and differences in beta-receptor mediated inhibition of atrial release of N-ANF. NPY-LI, and N-ANF at discharge were related to long term cardiovascular mortality. (C) 2002 European Society of Cardiology. All rights reserved.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- congestive heart failure
- myocardial infarction
- neurohormonal
- activation
- atrial natriuretic
- beta-adrenergic blocking agents
- peptide
- cardiac function
Publication and Content Type
- art (subject category)
- ref (subject category)
Find in a library
- European Journal of Heart Failure (Search for host publication in LIBRIS)
To the university's database
- 1 of 1
- Previous record
- Next record
- To hitlist
Find more in SwePub
- By the author/editor
- Persson, H
- Andreasson, K
- Kahan, T
- Eriksson, SV
- Tidgren, B
- Hjemdahl, P
- show more...
- Hall, C
- Erhardt, Leif RW
- show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
- MEDICAL AND HEAL ...
- and Clinical Medicin ...
- and Cardiac and Card ...
- Articles in the publication
- European Journal ...
- By the university
- Lund University
- Karolinska Institutet
Search outside SwePub
- Extend your search to:
- Google Book Search
- Google Scholar
Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.
- Copyright © LIBRIS - National Library Systems
- LIBRIS.kb.se
