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Titolo:
Nonselective versus selective beta-adrenergic receptor blockade in congestive heart failure - Differential effects on sympathetic activity
Autore:
Azevedo, ER; Kubo, T; Mak, S; Al-Hesayen, A; Schofield, A; Allan, R; Kelly, S; Newton, GE; Floras, JS; Parker, JD;
Indirizzi:
Univ Toronto, Mt Sinai Hosp, Div Cardiol, Dept Med, Toronto, ON M5G 1X5, Canada Univ Toronto Toronto ON Canada M5G 1X5 t Med, Toronto, ON M5G 1X5, Canada Univ Manitoba, St Boniface Hosp, Dept Med, Cardiol Sect, Winnipeg, MB, Canada Univ Manitoba Winnipeg MB Canada Med, Cardiol Sect, Winnipeg, MB, Canada
Titolo Testata:
CIRCULATION
fascicolo: 18, volume: 104, anno: 2001,
pagine: 2194 - 2199
SICI:
0009-7322(20011030)104:18<2194:NVSBRB>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
IDIOPATHIC DILATED CARDIOMYOPATHY; NOREPINEPHRINE RELEASE; DOUBLE-BLIND; NERVE ACTIVITY; METOPROLOL; CARVEDILOL; PLASMA; NORADRENALINE; BUCINDOLOL; EXERCISE;
Keywords:
heart failure; receptors, adrenergic, beta; nervous system, autonomic; norepinephrine;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Parker, JD Univ Toronto, Mt Sinai Hosp, Div Cardiol, Dept Med, 600 Univ Ave,Suite 1609, Toronto, ON M5G 1X5, Canada Univ Toronto 600 Univ Ave,Suite 1609 Toronto ON Canada M5G 1X5
Citazione:
E.R. Azevedo et al., "Nonselective versus selective beta-adrenergic receptor blockade in congestive heart failure - Differential effects on sympathetic activity", CIRCULATION, 104(18), 2001, pp. 2194-2199

Abstract

Background-Activation of the sympathetic nervous system has important prognostic implications in chronic heart failure. Nonselective versus selectivebeta -adrenergic receptor antagonists may have differential effects oil norepinephrine release from nerve terminals mediated by prejunctional beta (2)-adrenergic receptors. Methods and Results-Thirty-six patients with chronic heart failure were randomized to the nonselective beta -blocker carvedilol or the selective beta-blocker metoprolol (double-blind). Measurements of hemodynamics and cardiac and systemic norepinephrine spillover as well as microneurographic recordings of muscle sympathetic nerve traffic were made before and after 4 months of therapy. In the carvedilol group (n = 17), there were significant reductions in both total body (-1.7 +/-0.5 nmol/min, P <0.01) and cardiac norepinephrine spillover (-87 +/- 29 pmol/min, P <0.01). By contrast, in the metoprolol group (n = 14), there were no significant changes in total body orcardiac norepinephrine spillover. Responses in the carvedilol group were significantly different from those observed in the metoprolol group (P <0.05). Both agents caused a reduction in heart rate and increases in pulse pressure, although mean arterial pressure did not change. Importantly, microneurographic measures of sympathetic nerve traffic to skeletal muscle did not change in either group. Conclusions-Therapy with carvedilol caused significant decreases in systemic and cardiac norepinephrine spillover, an indirect measure of norepinephrine release. Such changes were not observed in patients treated with metoprolol. There was no effect of either agent on sympathetic efferent neuronal discharge to skeletal muscle. These findings suggest that carvedilol, a nonselective beta -blocker, caused its sympathoinhibitory effect by blocking peripheral, prejunctional beta -adrenergic receptors.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/04/20 alle ore 10:19:22