Relationships among norepinephrine levels, exercise capacity, and chronotropic responses in heart failure patients

被引：7

作者：

Grosman-Rimon, Liza ^{[1
,2
]}

Wright, Evan ^{[3
]}

Sabovich, Solomon ^{[4
]}

Rimon, Jordan ^{[5
]}

Gleitman, Sagi ^{[1
]}

Sudarsky, Doron ^{[1
]}

Lubovich, Alla ^{[1
]}

Gabizon, Itzhak ^{[6
]}

Lalonde, Spencer D. ^{[7
]}

Tsuk, Sharon ^{[2
]}

McDonald, Michael A. ^{[7
]}

Rao, Vivek ^{[7
]}

Gutterman, David ^{[8
]}

Jorde, Ulrich P. ^{[9
]}

Carasso, Shemy ^{[1
]}

Kachel, Erez ^{[1
,10
]}

机构：

[1] Bar Ilan Univ, Azrieli Fac Med, Lydia & Carol Kittner Poriya Med Ctr, Lea & Benjamin Davidai Div Cardiovasc Med & Surg, Lower Galilee, Tiberias, Israel

[2] Wingate Inst Phys Educ & Sports, Acad Coll Wingate, Netanya, Israel

[3] Albert Einstein Coll Med, Jacobi Med Ctr, Lewis M Fraad Dept Pediat, Bronx, NY 10467 USA

[4] Univ Toronto, Fac Med, Toronto, ON, Canada

[5] York Univ, Fac Hlth, Toronto, ON, Canada

[6] Ben Gurion Univ Negev, Soroka Hosp, Fac Hlth Sci, Dept Cardiol, Beer Sheva, Israel

[7] Univ Hlth Network, Toronto Gen Hosp, Peter Munk Cardiac Ctr, Toronto, ON, Canada

[8] Med Coll Wisconsin, Cardiovasc Ctr, Milwaukee, WI 53226 USA

[9] Montefiore Einstein Ctr Heart & Vasc Care, Div Cardiol, Bronx, NY USA

[10] Bar Ilan Univ, Fac Med Galilee, Safed, Israel

来源：

HEART FAILURE REVIEWS | 2023年 / 28卷 / 01期

关键词：

Norepinephrine; Exercise capacity; Chronotropic responses; Heart failure; Rate-adaptive pacing; CLOSED-LOOP STIMULATION; VENTROLATERAL MEDULLA NEURONS; OXYGEN-CONSUMPTION; PLASMA NOREPINEPHRINE; PEAK EXERCISE; RISK STRATIFICATION; FUNCTIONAL-CAPACITY; CARDIAC-OUTPUT; MENTAL STRESS; RATE RESERVE;

D O I：

10.1007/s10741-022-10232-y

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

In heart failure (HF) patients, the pathophysiological mechanisms of severe exercise intolerance and impaired exercise capacity are related to both central and peripheral abnormalities. The central abnormalities in HF patients include impaired cardiac function and chronotropic incompetence (CI). Indeed, CI, the inability to adequately increase heart rate (HR) from rest to exercise often exhibited by HF patients, is related to activation of the sympathetic nervous system (SNS) yielding a rise in circulating norepinephrine (NE). CI may result from downregulation of beta-adrenergic receptors, beta-blocker usage, high baseline HR, or due to a combination of factors. This paper discusses the role of elevated NE in altering chronotropic responses in HF patients and consequently resulting in impaired exercise capacity. We suggest that future research should focus on the potential treatment of CI with rate-adaptive pacing, using a sensor to measure physical activity, without inducing deleterious hormonal activation of the sympathetic system.

引用

页码：35 / 45

页数：11

共 87 条

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