The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.
Neurohormonal Activation and the Chronic Heart Failure Syndrome in Adults With Congenital Heart Disease
Abstract
Background — Neurohormonal activation characterizes chronic heart failure, relates to outcome, and is a therapeutic target. It is not known whether a similar pattern of neurohormonal activation exists in adults with congenital heart disease and, if so, whether it relates to common measures of disease severity or whether cardiac anatomy is a better discriminant. Methods and Results — Concentrations of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), endothelin-1 (ET-1), renin, aldosterone, norepinephrine, and epinephrine were determined in 53 adults with congenital heart disease, comprising 4 distinct anatomic subgroups (29 female; 33.5±1.5 years of age; New York Heart Association class 2.0±0.1, mean±SEM) and 15 healthy control subjects (8 female; 32.3±1.3 years of age). Systemic ventricular function was graded by a blinded echocardiographer as normal or mildly, moderately, or severely impaired. Adults with congenital heart disease had elevated levels of ANP (56.6 versus 3.1 pmol/L), BNP (35.8 versus 5.7 pmol/L), ET-1 (2.5 versus 0.7 pmol/L, all P <0.0001), renin (147 versus 16.3 pmol/L), norepinephrine (2.2 versus 1.6 pmol/L, both P <0.01) and aldosterone (546 versus 337 pmol/L, P <0.05). There was a highly significant stepwise increase in ANP, BNP, ET-1, and norepinephrine according to New York Heart Association class and systemic ventricular function, with even asymptomatic patients having evidence of significant neurohormonal activation. In contrast, there was no direct relationship between the 4 anatomic subgroups and any of the neurohormones studied. Conclusions — Neurohormonal activation in adult congenital heart disease bears the hallmarks of chronic heart failure, relating to symptom severity and ventricular dysfunction and not necessarily to anatomic substrate. Neurohormonal antagonism across this large and anatomically diverse population should be considered.
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Cites
Plasma Norepinephrine as a Guide to Prognosis in Patients with Chronic Congestive Heart Failure
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Self-citationGuidelines for the diagnosis and treatment of chronic heart failure
Remme, W. (2001) · European Heart Journal · doi:10.1053/euhj.2001.2783 · Cited by 1,592
Hormones and Hemodynamics in Heart Failure
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Plasma norepinephrine in congestive heart failure
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Self-citationCongenital Heart Disease in Adults
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Cited by
Warnes, C. A., Williams, R. G., Bashore, T. M., Child, J. S., Connolly, H. M., Dearani, J. A., del Nido, P., Fasules, J. W., Graham, T. P., Hijazi, Z. M., et al. (2008) · Circulation · doi:10.1161/circulationaha.108.190811 · Cited by 2,066
ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease
Warnes, C. A., Williams, R. G., Bashore, T. M., Child, J. S., Connolly, H. M., Dearani, J. A., del Nido, P., Fasules, J. W., Graham, T. P., Hijazi, Z. M., et al. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.10.001 · Cited by 1,533
Haddad, F., Hunt, S. A., Rosenthal, D. N., & Murphy, D. J. (2008) · Circulation · doi:10.1161/circulationaha.107.653576 · Cited by 1,523
Haddad, F., Doyle, R., Murphy, D. J., & Hunt, S. A. (2008) · Circulation · doi:10.1161/circulationaha.107.653584 · Cited by 1,304
Diller, G.-P., Dimopoulos, K., Okonko, D., Li, W., Babu-Narayan, S. V., Broberg, C. S., Johansson, B., Bouzas, B., Mullen, M. J., Poole-Wilson, P. A., et al. (2005) · Circulation · doi:10.1161/circulationaha.104.529800 · Cited by 878
Self-citation
Metadata
- Authors
- Bolger, A. P., Sharma, R., Li, W., Leenarts, M., Kalra, P. R., Kemp, M., Coats, A. J. S., Anker, S. D., & Gatzoulis, M. A.
- Venue
- Circulation
- Published
- 2002-07-02
- Volume
- 106
- Issue
- 1
- Pages
- 92-99
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2148813221
- Cited by
- 419
- References
- 28
- FWCI
- 13.31
- Type
- journal article
- Language
- en
- Open access
- closed
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- Bolger, A. P., Sharma, R., Li, W., Leenarts, M., Kalra, P. R., Kemp, M., Coats, A. J. S., Anker, S. D., & Gatzoulis, M. A. (2002). Neurohormonal Activation and the Chronic Heart Failure Syndrome in Adults With Congenital Heart Disease. Circulation. https://doi.org/10.1161/01.cir.0000020009.30736.3f
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