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Titolo:
Neurohormonal activation, the renal dopaminergic system and sodium handling in patients with severe heart failure under vasodilator therapy
Autore:
Ferreira, A; Bettencourt, P; Dias, P; Pestana, M; Serrao, P; Soares-da-Silva, P; Cerqueira-Gomes, M;
Indirizzi:
Hosp de S Joao, Serv Med 3, P-4200 Porto, Portugal Hosp de S Joao Porto Portugal P-4200 Serv Med 3, P-4200 Porto, Portugal Unidade Invest & Desenvolvimento Cardiovasc Porto, Porto, Portugal UnidadeInvest & Desenvolvimento Cardiovasc Porto Porto Portugal rtugal Hosp S Joao, Serv Cardiol, Porto, Portugal Hosp S Joao Porto PortugalHosp S Joao, Serv Cardiol, Porto, Portugal Hosp S Joao, Serv Nefrol, Porto, Portugal Hosp S Joao Porto PortugalHosp S Joao, Serv Nefrol, Porto, Portugal Fac Med, Inst Farmacol & Terapeut, Porto, Portugal Fac Med Porto Portugal c Med, Inst Farmacol & Terapeut, Porto, Portugal
Titolo Testata:
CLINICAL SCIENCE
fascicolo: 5, volume: 100, anno: 2001,
pagine: 557 - 566
SICI:
0143-5221(200105)100:5<557:NATRDS>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
NA+-K+-ATPASE; INTRARENAL DOPAMINE; NATRIURETIC PEPTIDE; URINARY-EXCRETION; PROXIMAL TUBULE; COLLECTING DUCT; SALT INTAKE; RAT; MECHANISMS; STIMULATION;
Keywords:
heart failure; neurohormonal activation; renal dopamine; sodium;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
52
Recensione:
Indirizzi per estratti:
Indirizzo: Ferreira, A Hosp de S Joao, Serv Med 3, Piso 8,Alameda Hernani Monteiro, P-4200 Porto,Portugal Hosp de S Joao Piso 8,Alameda Hernani Monteiro Porto Portugal P-4200
Citazione:
A. Ferreira et al., "Neurohormonal activation, the renal dopaminergic system and sodium handling in patients with severe heart failure under vasodilator therapy", CLIN SCI, 100(5), 2001, pp. 557-566

Abstract

The benefits of tailoring therapy with vasodilators in patients with severe heart failure are well documented, but this may lead to neurohormonal activation and sodium retention. Renal dopamine has local natriuretic actions and interacts with other hormones involved in renal sodium handling. The aim of the present work was to determine the effects of arterial underfillinginduced by vasodilator therapy on renal sodium hand ling, neurohormonal activation and the activity of the renal dopaminergic system in patients withsevere heart failure. For this purpose we monitored haemodynamic parameters, plasma levels of type B natriuretic peptide (BNP), catecholamines, aldosterone, renin activity (PRA), sodium and creatinine, and urinary excretion of sodium, creatinine, L-DOPA, dopamine and its metabolites, before initiation of sodium nitroprusside therapy and every 6 h thereafter (for 42 h), and again after 5 days of angiotensin-converting enzyme (ACE) inhibition, in IO male patients with severe heart failure. The results of nitroprusside therapy were a marked increase in cardiac index and a substantial decrease insystemic vascular resistance index. Plasma levels of BNP decreased significantly, while PRA, noradrenaline and aldosterone showed marked increases, resulting in a substantial reduction in urinary sodium excretion. Creatinineclearance was not affected. Urinary dopamine and dopamine metabolites increased in response to nitroprusside therapy. After 5 days of ACE inhibition,urinary sodium returned to baseline values, while urinary dopamine was markedly reduced. These results suggest that the renal dopaminergic system is activated in patients with severe heart failure by stimuli leading to sodium renal reabsorption.

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Documento generato il 12/07/20 alle ore 13:09:33