Left ventricular mass is linked to cardiac noradrenaline in normotensive and hypertensive patients
Abstract
BACKGROUND: Left ventricular hypertrophy constitutes a powerful independent risk factor for heart failure, sudden death and ventricular dysrhythmia. Experimental data suggest that, apart from increased cardiac work load, noradrenaline may be one of the factors triggering myocardial hypertrophy. OBJECTIVE: To test the hypothesis that the extent of left ventricular hypertrophy is coupled to cardiac noradrenaline independently from the magnitude of arterial blood pressure. PATIENTS AND METHODS: Following exclusion of coronary artery disease by cardiac catheterization, cardiac noradrenaline release was measured in relation to left ventricular mass in 25 patients with arterial hypertension (HT), of whom five had left ventricular hypertrophy (HT + LVH) and 20 had normal left ventricular mass (HT - LVH), seven normotensive patients with hypertrophic cardiomyopathy (HCM) and a normotensive control group (n = 7). Noradrenaline was measured in arterial and coronary venous plasma using high-performance liquid chromatography. Coronary blood flow was quantified using the gas chromatographic argon method. Indices of left ventricular mass were calculated from the end-diastolic thicknesses of the interventricular septum and the posterior wall determined by echocardiography. RESULTS: The coronary venous plasma concentration of noradrenaline was significantly higher in HT - LVH, HT + LVH and HCM than it was in normotensives. Whereas in normotensives there was a net uptake of noradrenaline (17 +/- 10 pmol/min) across the coronary circulation, a net release of noradrenaline was observed in HT - LVH (69 +/- 26 pmol/min), in HT + LVH (121 +/- 55 pmol/min) and in HCM (341 +/- 96 pmol/min). In a multivariate linear regression analysis model, left ventricular mass correlated significantly with the net noradrenaline release rate (r = 0.64, P < 0.001), whereas arterial blood pressure as an additional independent variable did not correlate with left ventricular mass. CONCLUSION: The present data demonstrate that an increased left ventricular mass in normotensive and in hypertensive patients is closely coupled to an increased cardiac sympathetic activity, supporting the need for additional studies to determine whether adjunctive sympatholytic therapy is beneficial in patients with left ventricular hypertrophy and increased cardiac noradrenaline release.
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In human studies, indexes of left ventricular mass have tended to correlate with plasma norepinephrine values and cardiac noradrenaline spillover.
“Also, in human studies, indexes of LVM have tended to correlate with plasma norepinephrine values (37)and cardiac noradrenaline spillover (38).”
From Hypertensive left ventricular hypertrophy: relation to peripheral sympathetic drive (2001) · cites this paper as [38]
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“Das Myokard von Hypertoniker mit linksventrikulärer Hypertrophie setzt vermehrt Katecholamine in den Koronarkreislauf frei, entsprechend kann die chronische Gabe von Clonidin zu einer Regression der Myokardhypertrophie führen [35,45].”
BackgroundSelf-citationEffect of Clonidine on Cardiac Norepinephrine Spillover in Isolated Rat Heart
Akers, W. S., Shah, S. K., Flynn, J. D., et al. (2004) · Journal of Cardiovascular Pharmacology · doi:10.1097/00005344-200406000-00013 · Cited by 3 · see citing works
“Left ventricular hypertrophy has been demonstrated to be an independent risk factor for cardiovascular morbidity and mortality in patients with hypertension and recent evidence suggests that its development is related to an increase in cardiac NE spillover.(2,5) Similar findings have been observed in patients with hea…”
BackgroundAbsence of circadian variation of acute coronary syndrome onset in chronic kidney disease patients
Itaya, H., Takagi, T., Sugi, K., & Nakamura, M. (2011) · Cardiovascular revascularization medicine · doi:10.1016/j.carrev.2011.03.002 · Cited by 2 · see citing works
The Function of the Autonomic Nervous System in Hypertension
Mancia, G., & Grassi, G. (2002) · CRC Press eBooks · doi:10.1201/9780203908891-16 · Cited by 2 · see citing works
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Obesity and hypertension in coronary heart disease
Kelm, M., & Strauer, B. E. (2003) · Journal of Hypertension · doi:10.1097/00004872-200303000-00006 · Cited by 1 · see citing works
Self-citationAngiotensin-converting enzyme in cardiovascular function and dysfunction
Ljungberg, L. U. (2011) · DiVA (Linkoping University) · Cited by 1 · see citing works
The Function of the Autonomic Nervous System in Hypertension
Mancia, G., & Grassi, G. M. (2002) · CRC Press eBooks · doi:10.1201/9780203908891.ch13 · Cited by 1 · see citing works
THE ROLE OF THE L-TYPE CALCIUM CHANNEL AND ITS CARBOXYL-TERMINUS
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The Cardiovascular Continuum — Pathophysiology and Targets for Therapy
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METFORMINA, FUNCION ARTERIAL Y GROSOR INTIMA-MEDIA EN SUJETOS CON SINDROME METABOLICO
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Magubane, M. M., Woodiwiss, A. J., Norton, G. R., & Michel, F. S. (2014) · Journal of the American Society of Hypertension · doi:10.1016/j.jash.2014.03.304
“In addition, in pressure overload induced ventricular hypertrophy an increased myocardial norepinephrine (NE) concentration has been measured in the coronary sinus (Agabiti-Rosei et al. 1987, Kelm et al. 1996, & Brunner-La Rocca et al. 2001).”
BackgroundLeft ventricular hypertrophy and the insulin resistance syndrome
Sundström, J. (2001) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Correia, R. J. (2011) · University of the Witwatersrand, Johannesburg Institutional Repository on DSpace (University of the Witwatersrand, Johannesburg)
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Sympathetic hyperactivity in patients with chronic kidney disease
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- Authors
- Kelm, M., Sch??fer, S., Mingers, S., Heydthausen, M., Vogt, M., Motz, W., & Strauer, B. E.
- Affiliations
- Heinrich Heine University Düsseldorf (DE)
- Corresponding author
- Heydthausen, Manfred
- ORCID
- Kelm, Malte
- Venue
- Journal of Hypertension
- Published
- 1996-11
- Volume
- 14
- Issue
- 11
- Pages
- 1357-1364
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W2003972147
- Cited by
- 97
- References
- 0
- Citations by year
- 2022: 2 · 2020: 1 · 2019: 2 · 2017: 1 · 2016: 2 · 2015: 3 · 2014: 4 · 2013: 1 · 2012: 4
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Keywords
- left ventricular mass, left ventricular hypertrophy, sympathetic activity, hypertension, hypertrophic cardiomyopathy, coronary blood flow, cardiac hypertrophy, sympatholytic therapy
- MeSH terms
- Epinephrine, Female, Cardiac Catheterization, Humans, Hypertension, Male, Middle Aged, Myocardium, Norepinephrine, Hypertrophy, Left Ventricular
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