Ischemic versus idiopathic cardiomyopathy: differing neurohumoral profiles despite comparable peak oxygen uptake.
OBJECTIVE
We tested the hypothesis that neurohormonal and immunological activation differs in ischemic and idiopathic dilated cardiomyopathy since recent intervention trials indicate that ischemic cardiomyopathy seems to carry a worse prognosis than idiopathic cardiomyopathy of comparable clinical severity.


METHODS
In ten patients with ischemic cardiomyopathy undergoing spiroergometric evaluation venous levels of norepinephrine, epinephrine, renin, angiotensin, atrial natriuretic peptide as well as soluble interleukin-2-receptor were determined before, during and 10 min after exercise. Results were compared to sixteen patients with idiopathic cardiomyopathy with similar peak oxygen uptake (13.3+/-3 vs. 13.6+/-3 ml/kg/min; P=ns).


RESULTS
In ischemic patients, norepinephrine, angiotensin, and interleukin-2 receptor levels were significantly higher before, during and after exercise. Interleukin-2-receptor levels correlated with angiotensin.


CONCLUSIONS
We conclude that in ischemic as compared to idiopathic cardiomyopathy, a more pronounced activation of the sympathetic, renin-angiotensin and T-cell immune system is present at rest, during and after exercise. These data may contribute to explain differences in response to intervention and in prognosis. They warrant further investigation.
Deng
M C
MC
Muenster University Hospital, Department of Thoracic and Cardiovascular Surgery, Germany.
Brisse
B
B
Erren
M
M
Khurana
C
C
Breithardt
G
G
Scheld
H H
HH
D000328:Adult; D000368:Aged; D000804:Angiotensin II / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000503:physiopathology*; D004837:Epinephrine / Q000097:blood; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000503:physiopathology*; D009638:Norepinephrine / Q000097:blood; D010865:Pilot Projects; D015375:Receptors, Interleukin-2 / Q000097:blood; D012044:Regression Analysis; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000502:physiology*; D018709:Statistics, Nonparametric; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D013601:T-Lymphocytes / Q000502:physiology*
D015375:Receptors, Interleukin-2; D000804:Angiotensin II; D009320:Atrial Natriuretic Factor; D012083:Renin; D009638:Norepinephrine; D004837:Epinephrine