Sympathetic activation in congestive heart failure: reproducibility of neuroadrenergic markers.
OBJECTIVE
To assess the reproducibility of the two markers of adrenergic drive, venous plasma norepinephrine (NE) and efferent postganglionic muscle sympathetic nerve activity (MSNA), in reflecting the sympathetic activation characterizing congestive heart failure (CHF).


METHODS
In 19 CHF male normotensive patients (mean age: 53.0+/-2.1 years, NYHA classes II and III, left ventricular ejection fraction 35.9+/-2.9%), blood pressure (BP, Finapres), heart rate (EKG), plasma NE (HPLC assay) and MSNA (microneurography, peroneal nerve) were measured in two experimental sessions separated by a week interval. At each session, three NE samples were obtained and NE reproducibility between sessions was assessed by considering single NE samples or averaging 2-3 samples.


RESULTS
While MSNA values showed a highly significant correlation between sessions (r=0.85, P<0.001), NE values based on a single blood sample evaluation did not correlate with each other (r=0.41, P=NS). NE correlation coefficients improved and achieved statistical significance when average data from 2 and 3 blood samples were examined (r=0.54 and r=0.57, P<0.02 for both).


CONCLUSIONS
In CHF, MSNA displays a better reproducibility pattern than plasma NE. The reproducibility of the NE approach, however, can be improved by performing the assay on multiple blood samples.
Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo, Monza (Milan), Italy. guido.grassi@unimib.it
Guido
G
Grassi
Gianbattista
G
Bolla
Fosca
F
Quarti-Trevano
Francesca
F
Arenare
Gianmaria
G
Brambilla
Giuseppe
G
Mancia
D015415:Biomarkers; D006333:Heart Failure / Q000097:blood / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood*; D015203:Reproducibility of Results; D013223:Statistics as Topic; D013318:Stroke Volume; D017779:Sympathetic Fibers, Postganglionic / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D016277:Ventricular Function, Left
D015415:Biomarkers; D009638:Norepinephrine