Effect of sympathoinhibition on exercise performance in patients with heart failure.

Abstract:

BACKGROUND:In patients with heart failure, excessive sympathetic activation during exercise could interfere with exercise performance by impairing arteriolar dilation in working muscle and by adversely altering skeletal muscle metabolic behavior. To test this hypothesis, we examined the effect of sympathoinhibition with clonidine, a central sympatholytic agent, on skeletal muscle blood flow and metabolism in patients with heart failure. METHODS AND RESULTS:Swan-Ganz and femoral venous catheters were inserted in 20 patients with chronic heart failure and exercise intolerance (peak exercise VO2 = 9.3 +/- 1.4 [SEM] mL.min-1.kg-1). Central hemodynamic measurements, leg blood flow determined by thermodilution, and systemic and leg metabolic parameters were measured during maximal treadmill exercise before and 2 hours after clonidine 2 micrograms/kg IV (n = 15) or 0.9% normal saline (n = 5). During-control exercise before the administration of clonidine, leg blood flow increased from 0.3 +/- 0.1 to 1.8 +/- 0.2 L/min and plasma norepinephrine increased from 485 +/- 61 to 2155 +/- 186 pg/mL (both P < .01). Treatment with clonidine markedly suppressed norepinephrine levels during exercise (matched peak exercise workload: control, 2137 +/- 187 versus clonidine, 1430 +/- 161 pg/mL), increased leg blood flow (control, 1.8 +/- 0.2 versus clonidine, 2.3 +/- 0.4 L/min), reduced systemic oxygen consumption (control, 1002 +/- 70 versus clonidine, 966 +/- 68 mL/min), reduced pulmonary artery lactate concentration (control, 3.2 +/- 0.3 versus clonidine, 2.6 +/- 0.2 mEq/L), and decreased minute ventilation (control, 39.7 +/- 2.1 versus clonidine, 34.9 +/- 2.4 L/min) (all P < .05). CONCLUSIONS:These findings suggest that sympathetic activation during exercise reduces leg blood flow, increases muscle glycolysis, and decreases muscle efficiency in patients with heart failure.

journal_name

Circulation

journal_title

Circulation

authors

Lang CC,Rayos GH,Chomsky DB,Wood AJ,Wilson JR

doi

10.1161/01.cir.96.1.238

subject

Has Abstract

pub_date

1997-07-01 00:00:00

pages

238-45

issue

1

eissn

0009-7322

issn

1524-4539

journal_volume

96

pub_type

临床试验,杂志文章
  • Effects of cycle length on atrial vulnerability.

    abstract::The effect of cycle length on atrial vulnerability was studied in 14 patients manifesting reproducible repetitive atrial firing during atrial extra-stimulus (A2) testing. Repetitive atrial firing was defined as the occurrence of two or more premature atrial responses with return cycle (A2-A3) of 250 msec or less and s...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.55.2.260

    authors: Wyndham CR,Amat-y-Leon F,Wu D,Denes P,Dhingra R,Simpson R,Rosen KM

    更新日期:1977-02-01 00:00:00

  • Origin of the third heart sound. II. Studies in human subjects.

    abstract::We report noninvasive and invasive studies designed to clarify the mechanism of the third heart sound (S3) in humans. The noninvasive observations were made using a miniature accelerometer attached to the skin surface at the cardiac apex. In subjects with no S3, the tracings were either flat or showed very low undulat...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.67.2.399

    authors: Ozawa Y,Smith D,Craige E

    更新日期:1983-02-01 00:00:00

  • Endocardial catheter mapping: wire skeleton technique for representation of computed arrhythmogenic sites compared with intraoperative mapping.

    abstract::Guiding surgical therapy of ventricular tachycardia by preoperative endocardial catheter mapping necessitates improvement of the accuracy of localization of the arrhythmogenic site. We therefore used a new mathematical cineradiographic method during catheter mapping to compute the position of left ventricular arrhythm...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.74.6.1346

    authors: Hauer RN,de Zwart MT,de Bakker JM,Hitchcock JF,Penn OC,Nijsen-Karelse M,Robles de Medina EO

    更新日期:1986-12-01 00:00:00

  • Effect of digoxin and diuretics on high altitude left ventricular dysfunction.

    abstract::Systolic time intervals, stroke volume, cardiac output and (dZ/dt)/RZ index were serially estimated in 51 normal healthy volunteers at sea level, for ten days after air induction to 3658 m altitude and on return to sea level. The subjects were divided into three groups and were administered a diuretic, beta methyldigo...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.57.6.1180

    authors: Balasubramanian V,Behl A,Das GS,Wadhwa AK,Mathew OP,Hoon RS

    更新日期:1978-06-01 00:00:00

  • Alterations in left ventricular geometry, wall stress, and ejection performance after correction of congenital aortic stenosis.

    abstract::Children with congenital aortic stenosis have "excessive" left ventricular hypertrophy with reduced resting systolic wall stress that allows for supernormal ejection performance. If aortic stenosis is uncorrected, this pattern persists until adulthood. The effect of removing the aortic pressure gradient on left ventri...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.78.6.1358

    authors: Dorn GW 2nd,Donner R,Assey ME,Spann JF Jr,Wiles HB,Carabello BA

    更新日期:1988-12-01 00:00:00

  • Endoventricular remodeling of left ventricular aneurysm. Functional, clinical, and electrophysiological results.

    abstract:BACKGROUND:Recent advances in surgical techniques for the repair of left ventricular aneurysms (LVAs) include the use of an endoventricular patch to exclude the aneurysm cavity. This technique has replaced conventional linear plication of the aneurysm. The endoventricular patch technique remodels the left ventricular c...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.92.9.98

    authors: Grossi EA,Chinitz LA,Galloway AC,Delianides J,Schwartz DS,McLoughlin DE,Keller N,Kronzon I,Spencer FC,Colvin SB

    更新日期:1995-11-01 00:00:00

  • Usefulness of fractional flow reserve to predict clinical outcome after balloon angioplasty.

    abstract:BACKGROUND:After regular coronary balloon angioplasty, it would be helpful to identify those patients who have a low cardiac event rate. Coronary angiography alone is not sensitive enough for that purpose, but it has been suggested that the combination of optimal angiographic and optimal functional results indicates a ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.99.7.883

    authors: Bech GJ,Pijls NH,De Bruyne B,Peels KH,Michels HR,Bonnier HJ,Koolen JJ

    更新日期:1999-02-23 00:00:00

  • Randomized trial of simple versus complex drug-eluting stenting for bifurcation lesions: the British Bifurcation Coronary Study: old, new, and evolving strategies.

    abstract:BACKGROUND:The optimal strategy for treating coronary bifurcation lesions remains a subject of debate. With bare-metal stents, single-stent approaches appear to be superior to systematic 2-stent strategies. Drug-eluting stents, however, have low rates of restenosis and might offer improved outcomes with complex stentin...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/CIRCULATIONAHA.109.888297

    authors: Hildick-Smith D,de Belder AJ,Cooter N,Curzen NP,Clayton TC,Oldroyd KG,Bennett L,Holmberg S,Cotton JM,Glennon PE,Thomas MR,Maccarthy PA,Baumbach A,Mulvihill NT,Henderson RA,Redwood SR,Starkey IR,Stables RH

    更新日期:2010-03-16 00:00:00

  • Trends in Mortality From Ischemic Heart Disease and Cerebrovascular Disease in Europe: 1980 to 2009.

    abstract:BACKGROUND:Trends in cardiovascular mortality across Europe demonstrate significant geographical variation, and an understanding of these trends has a central role in global public health. METHODS AND RESULTS:Ischemic heart disease and cerebrovascular disease age-standardized death rates (as per International Classifi...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.115.018931

    authors: Hartley A,Marshall DC,Salciccioli JD,Sikkel MB,Maruthappu M,Shalhoub J

    更新日期:2016-05-17 00:00:00

  • High-volume continuous hemofiltration during cardiopulmonary bypass attenuates pulmonary dysfunction in neonatal lambs after deep hypothermic circulatory arrest.

    abstract:BACKGROUND:Cardiopulmonary bypass (CPB) induces an inflammatory reaction that activates neutrophils and releases free radicals in tissue. Ischemia-reperfusion further aggravates inflammation. Hemofiltration (HF) could potentially remove inflammatory mediators and reduce injury. This study assessed the effect of continu...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:

    authors: Nagashima M,Shin'oka T,Nollert G,Shum-Tim D,Rader CM,Mayer JE Jr

    更新日期:1998-11-10 00:00:00

  • Radionuclide assessment of nitroglycerin influence on abnormal left ventricular segmental contraction in patients with coronary heart disease.

    abstract::Noninvasive gated cardiac blood pool imaging with technetium-99m autologous erythrocytes was employed to differentiate reversible verus irreversible abnormal ventricular segmental contraction by regional wall and pump responses to sublingual nitroglycerin in 25 patients with chronic coronary heart disease. In 12 patie...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.53.6.975

    authors: Salel AF,Berman DS,DeNardo GL,Mason DT

    更新日期:1976-06-01 00:00:00

  • Carotid plaque echolucency increases the risk of stroke in carotid stenting: the Imaging in Carotid Angioplasty and Risk of Stroke (ICAROS) study.

    abstract:BACKGROUND:Carotid artery stenting (CAS) has recently emerged as a potential alternative to carotid endarterectomy. Cerebral embolization is the most devastating complication of CAS, and the echogenicity of carotid plaque has been indicated as one of the risk factors involved. This is the first study to analyze the rol...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000138103.91187.E3

    authors: Biasi GM,Froio A,Diethrich EB,Deleo G,Galimberti S,Mingazzini P,Nicolaides AN,Griffin M,Raithel D,Reid DB,Valsecchi MG

    更新日期:2004-08-10 00:00:00

  • L-4F, an apolipoprotein A-1 mimetic, restores nitric oxide and superoxide anion balance in low-density lipoprotein-treated endothelial cells.

    abstract:BACKGROUND:Low-density lipoprotein (LDL) impairs endothelial cell function by uncoupling endothelial nitric oxide synthase (eNOS) activity, which allows superoxide anion (O2*-)) to be generated rather than nitric oxide (*NO). Recent reports indicate that apolipoprotein (apo) A-1 mimetics inhibit the development of athe...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000061949.17174.b6

    authors: Ou Z,Ou J,Ackerman AW,Oldham KT,Pritchard KA Jr

    更新日期:2003-03-25 00:00:00

  • Late hemodynamic effects of the preserved papillary muscles during mitral valve replacement.

    abstract:BACKGROUND:The late hemodynamic effects of preserving the papillary muscles during mitral valve replacement have not been evaluated. METHODS AND RESULTS:Sixteen patients who had chronic mitral regurgitation due to myxomatous degeneration were randomized to preservation (Pres group, n = 8) or no preservation (No Pres g...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Komeda M,David TE,Rao V,Sun Z,Weisel RD,Burns RJ

    更新日期:1994-11-01 00:00:00

  • Direct evidence for cytokine involvement in neointimal hyperplasia.

    abstract:BACKGROUND:Tumor necrosis factor-alpha (TNF-alpha) and interleukin 1 (IL-1) are proximal inflammatory cytokines that stimulate expression of adhesion molecules and induce synthesis of other proinflammatory cytokines. In addition, TNF-alpha and IL-1 influence vascular smooth muscle cell migration and proliferation in vi...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.102.14.1697

    authors: Rectenwald JE,Moldawer LL,Huber TS,Seeger JM,Ozaki CK

    更新日期:2000-10-03 00:00:00

  • Elevated levels of shed membrane microparticles with procoagulant potential in the peripheral circulating blood of patients with acute coronary syndromes.

    abstract:BACKGROUND:Apoptotic microparticles are responsible for almost all tissue factor activity of the plaque lipid core. We hypothesized that elevated levels of procoagulant microparticles could also circulate in the peripheral blood of patients with recent clinical signs of plaque disruption and thrombosis. METHODS AND RE...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.101.8.841

    authors: Mallat Z,Benamer H,Hugel B,Benessiano J,Steg PG,Freyssinet JM,Tedgui A

    更新日期:2000-02-29 00:00:00

  • Fractional Flow Reserve and Cardiac Events in Coronary Artery Disease: Data From a Prospective IRIS-FFR Registry (Interventional Cardiology Research Incooperation Society Fractional Flow Reserve).

    abstract:BACKGROUND:We evaluated the prognosis of deferred and revascularized coronary stenoses after fractional flow reserve (FFR) measurement to assess its revascularization threshold in clinical practice. METHODS:The IRIS-FFR registry (Interventional Cardiology Research In-cooperation Society Fractional Flow Reserve) prospe...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究

    doi:10.1161/CIRCULATIONAHA.116.024433

    authors: Ahn JM,Park DW,Shin ES,Koo BK,Nam CW,Doh JH,Kim JH,Chae IH,Yoon JH,Her SH,Seung KB,Chung WY,Yoo SY,Lee JB,Choi SW,Park K,Hong TJ,Lee SY,Han M,Lee PH,Kang SJ,Lee SW,Kim YH,Lee CW,Park SW,Park SJ,IRIS-FF

    更新日期:2017-06-06 00:00:00

  • Coronary sinus morphology in patients with atrioventricular junctional reentry tachycardia and other supraventricular tachyarrhythmias.

    abstract:BACKGROUND:Coronary sinus access by electrode catheters is easier in patients with atrioventricular junctional reentry tachycardia (AVJRT) than in patients with other supraventricular tachyarrhythmias. The reason for this has not been addressed. METHODS AND RESULTS:The size and shape of the proximal coronary sinus wer...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.92.3.436

    authors: Doig JC,Saito J,Harris L,Downar E

    更新日期:1995-08-01 00:00:00

  • Operator-independent isotropic three-dimensional magnetic resonance imaging for morphology in congenital heart disease: a validation study.

    abstract:BACKGROUND:Operator-independent isotropic 3D MRI may greatly simplify the assessment of complex morphology in congenital heart disease. We sought to evaluate the reliability of this new approach. METHODS AND RESULTS:In 31 adolescent and adult patients (age, 6 to 42 years; median, 16 years) with congenital heart diseas...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000134282.35183.AD

    authors: Sørensen TS,Körperich H,Greil GF,Eichhorn J,Barth P,Meyer H,Pedersen EM,Beerbaum P

    更新日期:2004-07-13 00:00:00

  • Selective upregulation of endothelin B receptor gene expression in severe pulmonary hypertension.

    abstract:BACKGROUND:The pulmonary circulation is an important site for the production and clearance of endothelin (ET)-1, a potent vasoactive and mitogenic peptide. Increased plasma ET-1 levels are observed in pulmonary arterial hypertension (PHT) and may contribute to the regulation of pulmonary vascular resistance, as well as...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/hc0902.105719

    authors: Bauer M,Wilkens H,Langer F,Schneider SO,Lausberg H,Schäfers HJ

    更新日期:2002-03-05 00:00:00

  • Congenital abnormalities of the conduction system in two patients with tachyarrhythmias.

    abstract::Serial sections of the conduction system (CS) were performed in two patients with recurrent tachyarrhythmias. Case 1, a 34-year-old female who had dual atrioventricular (AV) nodal pathways with recurrent paroxysmal supraventricular tachycardia, committed suicide. Autopsy revealed an abnormally formed atrial septum wit...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.59.3.593

    authors: Bharati S,Bauernfiend R,Scheinman M,Massie B,Cheitlin M,Denes P,Wu D,Lev M,Rosen KM

    更新日期:1979-03-01 00:00:00

  • Fibroblast growth factor receptor-1 signaling induces osteopontin expression and vascular smooth muscle cell-dependent adventitial fibroblast migration in vitro.

    abstract:BACKGROUND:Increased expression of osteopontin (OPN), fibroblast growth factors (FGFs), and their type-1 receptor (FGFR-1) is associated with neointima formation and atherosclerosis. This study tested the hypothesis that ligand activation of FGFR-1 stimulates OPN expression in rat aortic smooth muscle cells (RASMCs), e...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000024113.26985.cc

    authors: Li G,Oparil S,Kelpke SS,Chen YF,Thompson JA

    更新日期:2002-08-13 00:00:00

  • A new paradigm for plaque stabilization.

    abstract::The concept of plaque stabilization was developed to explain how lipid lowering could decrease adverse coronary events without a substantial reduction in the regression of atherosclerosis. Plaques were stabilized by reducing serum cholesterol leading to several favorable pathobiological changes in the vessel wall of l...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000012528.89469.8e

    authors: Ambrose JA,Martinez EE

    更新日期:2002-04-23 00:00:00

  • Outcome and assessment after the modified Fontan procedure for hypoplastic left heart syndrome.

    abstract:BACKGROUND:We reviewed the outcome of 76 consecutive patients (age range, 5 months to 6 years; median age, 19 months) who underwent a modified Fontan procedure after initial palliative surgery for hypoplastic left heart syndrome (HLHS) between January 1984 and December 1989. METHODS AND RESULTS:Modifications of the Fo...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.85.1.116

    authors: Farrell PE Jr,Chang AC,Murdison KA,Baffa JM,Norwood WI,Murphy JD

    更新日期:1992-01-01 00:00:00

  • The clinician as investigator: participating in clinical trials in the practice setting.

    abstract::The rapid development of new drugs, therapies, and devices has created a dramatic increase in the number of trials needed to properly evaluate them. The majority of patients treated today, many of whom could be eligible for participation in these studies, are seen in community hospitals and medical practices that are ...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:10.1161/01.CIR.0000128702.16441.75

    authors: Lader EW,Cannon CP,Ohman EM,Newby LK,Sulmasy DP,Barst RJ,Fair JM,Flather M,Freedman JE,Frye RL,Hand MM,Jesse RL,Van de Werf F,Costa F,American College of Cardiology Foundation.

    更新日期:2004-06-01 00:00:00

  • Glucose levels predict hospitalization for congestive heart failure in patients at high cardiovascular risk.

    abstract:BACKGROUND:Patients with diabetes mellitus (DM) are at high risk of developing congestive heart failure (CHF). However, the relationships between glucose levels and CHF in people with or without a history of DM have not been well characterized. METHODS AND RESULTS:We evaluated the associations between fasting plasma g...

    journal_title:Circulation

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/CIRCULATIONAHA.106.661405

    authors: Held C,Gerstein HC,Yusuf S,Zhao F,Hilbrich L,Anderson C,Sleight P,Teo K,ONTARGET\/TRANSCEND Investigators.

    更新日期:2007-03-20 00:00:00

  • Myocardial strain analysis in acute coronary occlusion: a tool to assess myocardial viability and reperfusion.

    abstract:BACKGROUND:This study proposes 2 new echocardiographic indices with potential application in acute coronary artery occlusion to differentiate between viable and necrotic myocardium and to identify reperfusion. We investigated whether the ratio between systolic lengthening and combined late and postsystolic shortening (...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.105.533372

    authors: Lyseggen E,Skulstad H,Helle-Valle T,Vartdal T,Urheim S,Rabben SI,Opdahl A,Ihlen H,Smiseth OA

    更新日期:2005-12-20 00:00:00

  • Systemic delivery of bone marrow-derived mesenchymal stem cells to the infarcted myocardium: feasibility, cell migration, and body distribution.

    abstract:BACKGROUND:Systemic delivery of bone marrow-derived mesenchymal stem cells (BM-MSCs) is an attractive approach for myocardial repair. We aimed to test this strategy in a rat model after myocardial infarction (MI). METHODS AND RESULTS:BM-MSCs were obtained from rat bone marrow, expanded in vitro to a purity of >50%, an...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000084828.50310.6A

    authors: Barbash IM,Chouraqui P,Baron J,Feinberg MS,Etzion S,Tessone A,Miller L,Guetta E,Zipori D,Kedes LH,Kloner RA,Leor J

    更新日期:2003-08-19 00:00:00

  • Berlin Heart EXCOR pediatric ventricular assist device for bridge to heart transplantation in US children.

    abstract:BACKGROUND:Recent data suggest that the Berlin Heart EXCOR Pediatric ventricular assist device is superior to extracorporeal membrane oxygenation for bridge to heart transplantation. Published data are limited to 1 in 4 children who received the device as part of the US clinical trial. We analyzed outcomes for all US c...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1161/CIRCULATIONAHA.112.000685

    authors: Almond CS,Morales DL,Blackstone EH,Turrentine MW,Imamura M,Massicotte MP,Jordan LC,Devaney EJ,Ravishankar C,Kanter KR,Holman W,Kroslowitz R,Tjossem C,Thuita L,Cohen GA,Buchholz H,St Louis JD,Nguyen K,Niebler RA,Walt

    更新日期:2013-04-23 00:00:00

  • Evaluation of Microvascular Injury in Revascularized Patients With ST-Segment-Elevation Myocardial Infarction Treated With Ticagrelor Versus Prasugrel.

    abstract:BACKGROUND:Despite successful restoration of epicardial vessel patency with primary percutaneous coronary intervention, coronary microvascular injury occurs in a large proportion of patients with ST-segment-elevation myocardial infarction, adversely affecting clinical and functional outcome. Ticagrelor has been reporte...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.118.035931

    authors: van Leeuwen MAH,van der Hoeven NW,Janssens GN,Everaars H,Nap A,Lemkes JS,de Waard GA,van de Ven PM,van Rossum AC,Ten Cate TJF,Piek JJ,von Birgelen C,Escaned J,Valgimigli M,Diletti R,Riksen NP,van Mieghem NM,Nijveldt R,

    更新日期:2019-01-29 00:00:00