Catecholamine metabolism in heart failure patients and healthy control subjects.
Parameter of catecholamine metabolism were examined in patients (Groups II to V) in chronic, stable stages of coronary heart disease (n = 45), dilated cardiomyopathy (n = 17) and healthy control subjects (Group I). Plasma and urinary catecholamine patterns, catecholamine plasma half-life and catecholamine metabolism following administration of levodopa were determined. In cases of slight (Group II, ejection fraction (EF) 54 +/- 7%) to marked left-heart damage (Group III, EF 44 +/- 5%), the findings indicate elevated catecholamine excretion and a beginning reduction of plasma clearance as the cause of excessive, circulating and renally excreted catecholamines (applies to noradrenaline, less to adrenaline). The renal 24-h dopamine elimination is already slightly reduced in these patients. In cases of severe left-heart damage, the findings are not uniform. In some cases, noradrenaline at rest and at comparable exercise levels are elevated (Group IV, EF 20 +/- 11%), in some cases they are normal (Group V, EF 16 +/- 4%). The 24-h dopamine elimination is reduced in both groups to 34-41% of normal. Noradrenaline and adrenaline elimination is normal, or reduced (Group V, adrenaline). The exercise-induced, maximum plasma noradrenaline concentrations in Group IV and V are much lower (33-40% of normal) than in the healthy control individuals and patients in Groups II and III. Oral administration of 2-4 g levodopa per day result in a 20- to 40-fold dopamine increase in patients with heart failure (Group IV) and healthy control persons (Group I) (free and conjugated plasma dopamine, as well as free urinary dopamine).(ABSTRACT TRUNCATED AT 250 WORDS)
Lehmann
M
M
Medical University Clinic, Department of Sports and Performance Medicine, Freiburg/Brsg., Fed. Rep. of Germany.
Hasenfuss
G
G
Samek
L
L
Gastmann
M
M
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002311:Cardiomyopathy, Dilated / Q000378:metabolism; D002395:Catecholamines / Q000097:blood / Q000378:metabolism*; D015444:Exercise; D006207:Half-Life; D006333:Heart Failure / Q000378:metabolism* / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D026741:Physical Therapy Modalities; D012016:Reference Values; D013564:Sympathetic Nervous System / Q000503:physiopathology
D002395:Catecholamines; D007773:Lactates; D019344:Lactic Acid