One year temporal pattern of neurohumoral factors and natriuretic peptides compared with clinical variables in patients with dilated cardiomyopathy.
BACKGROUND
Elevated levels of neuroendocrine peptides and hormones are some of the compensatory mechanisms activated in patients with congestive heart failure. The aim of this study was to describe their time related variability in clinically stable patients and to compare hormones and peptides levels to clinical variables.


METHODS
Nineteen patients with history of congestive heart failure due to dilated cardiomyopathy and in sinus rhythm were recruited. At baseline, after 3 months, and at 1 year they underwent 6-min walk test, Minnesota Living with Heart Failure Questionnaire, and blood measurements of ANP, BNP, plasma renin activity, aldosterone, norepinephrine and epinephrine.


RESULTS
After 1 year, 17 patients remained clinically stable, and did not change their therapy and functional class. Also echocardiographic data and neurohormonal parameters did not change significantly except for epinephrine that decreased significantly after 3 months and returned to a value similar to the basal one at 1 year. Two outliner values were observed for norepinephrine belonging to the only 2 patients that spontaneously withdrew the ace-inhibitor therapy during the follow-up.


CONCLUSIONS
This study indicates that plasma concentration of neurohormones and peptides were fairly stable over 1 year interval in stable patients with mild-moderate heart failure due to dilated cardiomyopathy and that norepinephrine could be considered as the most sensible parameters to monitor therapy compliance.
Rolfo
C
C
Department of Cardiology, University of Turin, Molinette Hospital, Turin.
Bobbio
M
M
Brossa
C
C
Bisi
G
G
Trevi
G P
GP
D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000097:blood*; D013997:Time Factors
D018377:Neurotransmitter Agents; D009320:Atrial Natriuretic Factor