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

Abstract:

:We have documented a pre-junctional beta-2 adrenoceptor mediated reduction in cardiac norepinephrine spillover (CNES) in heart failure patients receiving chronic beta-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 beta-blockade with either carvedilol or metoprolol. In 19 heart failure patients in sinus rhythm (age: 55+/-2 [mean+/-S.E.]; ejection fraction: 20+/-2%), beta-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=-0.52; n=16, P<0.05). Chronic beta-blockade in heart failure augments reflex vagal control of HR at an efferent site of interaction involving blockade of cardiac sympathetic pre-junctional beta-2 adrenoceptors that facilitate NE release.

journal_name

Eur J Heart Fail

authors

Kubo T,Parker JD,Azevedo ER,Atchison DJ,Newton GE,Picton P,Floras JS

doi

10.1016/j.ejheart.2004.10.012

keywords:

subject

Has Abstract

pub_date

2005-08-01 00:00:00

pages

878-81

issue

5

eissn

1388-9842

issn

1879-0844

pii

S1388-9842(04)00290-9

journal_volume

7

pub_type

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