Vagal heart rate responses to chronic beta-blockade in human heart failure relate to cardiac norepinephrine spillover

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• 作者：Toshihiko Kubo ; John D. Parker ; Eduardo R. Azevedo ; Deborah J. Atchison ; Gary E. Newton ; Peter Picton and John S. Floras
• 关键词：Adrenergic receptor blockers ; Autonomic nervous system ; Baroreflex ; Heart rate variability ; Receptors ; adrenergic ; beta ; Sympathetic nervous system
• 刊名：European Journal of Heart Failure
• 出版年：2005
• 出版时间：2005
• 年：2005
• 卷：7
• 期：5
• 页码：878-881
• 全文大小：120 K

文摘

We have documented a pre-junctional β-2 adrenoceptor mediated reduction in cardiac norepinephrine spillover (CNES) in heart failure patients receiving chronic β-blockade. Our present objective was to ascertain the consequence of this decrease for vagal heart rate (HR) regulation by determining CNES, arterial baroreflex sensitivity for HR (BRS) and arterial baroreflex modulation of muscle sympathetic nerve activity (MSNA) before and upon 4 months of β-blockade with either carvedilol or metoprolol. In 19 heart failure patients in sinus rhythm (age: 55±2 [mean±S.E.]; ejection fraction: 20±2 % ), β-blockade increased BRS from 4.8±0.9 to 7.9±1.3 ms/mm Hg (P<0.005) but had no effect on arterial baroreflex modulation of MSNA. Changes in CNES and BRS were inversely related (r