Plasma noradrenaline as an indicator of functional state in hearts with mitral stenosis: The influence of acutely reduced left atrial pressure by balloon mitral commissurotomy
| Autor: | Shuji Yonekura, Kazufumi Tsuchihashi, Naoko Takahashi, Toshiya Ishiguro, Niro Sawai, Hitoko Ogata, Kazuaki Shimamoto, Osamu Iimura, Hideki Takizawa, Nobuichi Hikita |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty Cardiac index Hemodynamics Blood Pressure Catheterization Norepinephrine Mitral valve stenosis Mitral valve Internal medicine medicine Humans Mitral Valve Stenosis Pulmonary wedge pressure Aged Heart Failure business.industry musculoskeletal neural and ocular physiology Middle Aged medicine.disease Cardiac surgery medicine.anatomical_structure Blood pressure Heart failure biological sciences cardiovascular system Cardiology Mitral Valve Atrial Function Left Female Cardiology and Cardiovascular Medicine business tissues |
| Zdroj: | Heart and Vessels. 8:85-90 |
| ISSN: | 1615-2573 0910-8327 |
| DOI: | 10.1007/bf01744388 |
| Popis: | To investigate the mechanism in which plasma noradrenaline concentration (pNA) is elevated in heart failure, the effect of balloon mitral valvuloplasty was used as a model of acute manipulation of the left atrial pressure reduction in ten patients with mitral stenosis. Gorlin mitral valve area and pNA were correlated with New York Heart Association functional class and found to have a significant exponential inverse relationship with each other ([pNA, pg/ml] = 198.9 x [mitral valve area, cm2]-0.696; P = 0.003). Elevated pNA could be partially explained by a reduced cardiac index (CI) ([pNA, pg/ml] = 403.4 x [CI, l/min/m2]-0.889; P = 0.027; r = 0.495), especially in severely failed hearts, but not by pulmonary capillary wedge pressure (PCWP). However, the percent changes (% delta) of variables early after balloon valvuloplasty exhibited a paradoxical contrast; % delta pNA showing a clear negative exponential correlation with % delta PCWP ([% delta pNA] = 436.0 x [% delta PCWP + 80]-0.679 - 80; P = 0.021), but not with % delta CI. These results suggest that pNA should be considered an indicator of cardiac functional class in mitral stenosis. PNA is modulated by both cardiac index and pulmonary capillary pressure, but in different ways. |
| Databáze: | OpenAIRE |
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