Acute effects of beta-endorphin on cardiovascular function in patients with mild to moderate chronic heart failure.
BACKGROUND
Cardiomyocytes produce opioid peptides and receptors. beta-Endorphin is increased in the plasma of patients with congestive heart failure (CHF). We evaluated whether an intravenous infusion of beta-endorphin exerted any effect on cardiovascular function and on the neurohormonal milieu in patients with mild to moderate CHF.


METHODS
According to a double-blind, placebo-controlled design, 10 patients (5 men, age 46.9 +/- 8.2 years [mean +/- SD]) with CHF and New York Heart Association functional class II to III received, in random order, 1-hour intravenous infusion of beta-endorphin (500 microg/h) and, on a separate occasion, received placebo and underwent echocardiographic and laboratory measurements at baseline and during infusions.


RESULTS
beta-Endorphin significantly increased left ventricular ejection fraction (LVEF) (P =.0001) and stroke volume (P =.0001), and reduced systemic vascular resistance (P =.031) in patients with CHF. These changes were paralleled by a significant increase in plasma levels of glucagon (P =.0001), GH (P =.0001), and IGF-1 (P =.0001), and a significant decrease in plasma levels of endothelin (P =.0001) and catecholamines (P =.01). No hemodynamic and neurohormonal changes were observed during the placebo study in any patient.


CONCLUSIONS
We conclude that a short-term, high dose infusion of beta-endorphin improves LVEF, reduces systemic vascular resistance, blunts the neurohormonal activation, and stimulates the GH/IGF-1 axis in patients with mild to moderate CHF.
Cozzolino
Domenico
D
Department of Geriatrics and Metabolic Diseases, II University of Naples, Naples, Italy. cozzolino_domenico@libero.it
Sasso
Ferdinando C
FC
Salvatore
Teresa
T
Torella
Michele
M
Cittadini
Antonio
A
Gentile
Sandro
S
Torella
Roberto
R
Giugliano
Dario
D
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D002395:Catecholamines / Q000097:blood; D002908:Chronic Disease; D004452:Echocardiography; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000187:drug effects; D001615:beta-Endorphin / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use
D002395:Catecholamines; D001615:beta-Endorphin