Effects of bucindolol on neurohormonal activation in congestive heart failure

Journal Article · Tue Jan 01 04:00:00 EST 1991 · American Journal of Cardiology; (USA)

DOI:https://doi.org/10.1016/0002-9149(91)90102-Q· OSTI ID:6145494

Eichhorn, E J; McGhie, A L; Bedotto, J B; Corbett, J R; Malloy, C R; Hatfield, B A; Deitchman, D; Willard, J E; Grayburn, P A ^[1]

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1. Dallas Veterans Administration Hospital, TX (USA)

To examine the effects of beta-adrenergic blockade on neurohormonal activation in patients with congestive heart failure, 15 men had assessments of hemodynamics and supine peripheral renin and norepinephrine levels before and after 3 months of oral therapy with bucindolol, a nonselective beta antagonist. At baseline, plasma renin activity did not correlate with any hemodynamic parameter. However, norepinephrine levels had a weak correlation with left ventricular end-diastolic pressure (r = 0.74, p less than 0.01), stroke volume index (r = 0.61, p less than 0.02) and pulmonary vascular resistance (r = 0.54, p less than 0.05). Plasma renin decreased with bucindolol therapy, from 11.6 +/- 13.4 to 4.3 +/- 4.1 ng/ml/hour (mean +/- standard deviation; p less than 0.05), whereas plasma norepinephrine was unchanged, from 403 +/- 231 to 408 +/- 217 pg/ml. A wide diversity of the norepinephrine response to bucindolol was observed with reduction of levels in some patients and elevation in others. Although plasma norepinephrine did not decrease, heart rate tended to decrease (from 82 +/- 20 vs 73 +/- 11 min-1, p = 0.059) with beta-adrenergic blockade, suggesting neurohormonal antagonism at the receptor level. No changes in I-123 metaiodobenzylguanidine uptake occurred after bucindolol therapy, suggesting unchanged adrenergic uptake of norepinephrine with beta-blocker therapy. Despite reductions in plasma renin activity and the presence of beta blockade, the response of renin or norepinephrine levels to long-term bucindolol therapy did not predict which patients had improved in hemodynamic status (chi-square = 0.37 for renin, 0.82 for norepinephrine).

• OSTI ID: 6145494
• Journal Information: American Journal of Cardiology; (USA), Journal Name: American Journal of Cardiology; (USA) Vol. 67:1; ISSN 0002-9149; ISSN AJCDA
• Country of Publication: United States
• Language: English

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550901* -- Pathology-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
ADRENAL HORMONES
AUTONOMIC NERVOUS SYSTEM AGENTS
BETA DECAY RADIOISOTOPES
BIOCHEMICAL REACTION KINETICS
BIOSYNTHESIS
CARDIOTONICS
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
ENZYME ACTIVITY
ENZYMES
HOURS LIVING RADIOISOTOPES
HYDROLASES
INTERMEDIATE MASS NUCLEI
IODINE 123
IODINE ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
KINETICS
MEMBRANE PROTEINS
NEUROREGULATORS
NONSPECIFIC PEPTIDASES
NORADRENALINE
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
PATHOGENESIS
PATIENTS
PEPTIDE HYDROLASES
PROTEINS
RADIOISOTOPES
REACTION KINETICS
RECEPTORS
RENIN
SYMPATHOLYTICS
SYMPATHOMIMETICS
SYNTHESIS
TRACER TECHNIQUES