Effects of catecholamine-β-adrenoceptor-cAMP system on severe patients with heart failure  

作　　者：彭应心 单江 齐晓勇 薛浩 容春莉 姚冬梅 郭志琴 郑师凌 

机构地区：[1]Cardiac Center,Hebei Provincial People's Hospital

出　　处：《Chinese Medical Journal》2003年第10期1459-1463,共5页中华医学杂志（英文版）

基　　金：ThestudywassupportedbyaresearchfoundationofHebeiProvincialScienceandTechnologyCommittee (No 3 99413 )

摘　　要：Objective To investigate the association between catecholamine-β-adrenoceptor (β-AR)-adenosine 3’,5’-monophosphate (cAMP) system and long-term prognosis in patients with chronic heart failure (CHF).Methods The study population comprised 73 patients with CHF (EF: 23%±10%) with a mean follow-up of 3.8±1.9 years. Plasma levels of norepinephrine (NE) were measured using high performance lipid chromatography,β-adrenergic receptor density (Bmax) and the content of cAMP in peripheral lymphocytes were calculated using 3H-dihydroalpneolo as ligand and competitive immunoassay,respectively. Deaths due to cardiovascular events within the follow-up period were registered.Results The total mortality was 64.7%,57.4% of which was for cardiogenic (worsening heart failure: 32.4%; sudden death: 25.0%). In the cardiogenic death group,plasma levels of NE and epinephrine (E) (3.74 nmol/L±0.09 nmol/L and 3.17 nmol/L±1.0nmol/L) and the contents of peripheral lymphocyte cAMP (3.64 pmol/mg protein±1.4 pmol/mg protein) were significantly increased as compared with the survival group (2.68 nmol/L±0.07 nmol/L,2.41 nmol/L±0.24 nmol/L and 2.73 pmol/mg protein±0.9 pmol/mg protein,respectively,all P <0.01). In the sudden death group,plasma levels of NE and E (5.01 nmol/L±0.06 nmol/L and 4.13 nmol/L±0.08 nmol/L) were significantly increased as compared with the worsening heart failure group (2.49 nmol/L±0.07 nmol/L and 2.33 nmol/L±0.8 nmol/L,all P <0.001) and to the survival group (2.68 nmol/L±0.07 nmol/L and 2.41 nmol/L±0.14 nmol/L,all P <0.01). The incidences of sudden death were 0%,75%,and 100% (χ 2=16.018, P <0.01) in patients with plasma NE<2.5 nmol/L,NE 2.5 nmol/L-4.5 nmol/L,and NE>4.5 nmol/L,respectively. In the worsening heart failure group,the content of peripheral lymphocyte cAMP (4.46 pmol/mg protein±0.18 pmol/mg protein) was significantly increased compared with the sudden death group (2.39 pmol/mg protein±0.9 pmol/mg protein,P <0.001) and to the survival group (2.73 pmol/mg protein±1.1 pmol/mg proteObjective To investigate the association between catecholamine-β-adrenoceptor (β-AR)-adenosine 3’,5’-monophosphate (cAMP) system and long-term prognosis in patients with chronic heart failure (CHF).Methods The study population comprised 73 patients with CHF (EF: 23%±10%) with a mean follow-up of 3.8±1.9 years. Plasma levels of norepinephrine (NE) were measured using high performance lipid chromatography,β-adrenergic receptor density (Bmax) and the content of cAMP in peripheral lymphocytes were calculated using 3H-dihydroalpneolo as ligand and competitive immunoassay,respectively. Deaths due to cardiovascular events within the follow-up period were registered.Results The total mortality was 64.7%,57.4% of which was for cardiogenic (worsening heart failure: 32.4%; sudden death: 25.0%). In the cardiogenic death group,plasma levels of NE and epinephrine (E) (3.74 nmol/L±0.09 nmol/L and 3.17 nmol/L±1.0nmol/L) and the contents of peripheral lymphocyte cAMP (3.64 pmol/mg protein±1.4 pmol/mg protein) were significantly increased as compared with the survival group (2.68 nmol/L±0.07 nmol/L,2.41 nmol/L±0.24 nmol/L and 2.73 pmol/mg protein±0.9 pmol/mg protein,respectively,all P <0.01). In the sudden death group,plasma levels of NE and E (5.01 nmol/L±0.06 nmol/L and 4.13 nmol/L±0.08 nmol/L) were significantly increased as compared with the worsening heart failure group (2.49 nmol/L±0.07 nmol/L and 2.33 nmol/L±0.8 nmol/L,all P <0.001) and to the survival group (2.68 nmol/L±0.07 nmol/L and 2.41 nmol/L±0.14 nmol/L,all P <0.01). The incidences of sudden death were 0%,75%,and 100% (χ 2=16.018, P <0.01) in patients with plasma NE<2.5 nmol/L,NE 2.5 nmol/L-4.5 nmol/L,and NE>4.5 nmol/L,respectively. In the worsening heart failure group,the content of peripheral lymphocyte cAMP (4.46 pmol/mg protein±0.18 pmol/mg protein) was significantly increased compared with the sudden death group (2.39 pmol/mg protein±0.9 pmol/mg protein,P <0.001) and to the survival group (2.73 pmol/mg protein±1.1 pmol/mg prote

关 键 词：heart failure · catecholamine ·β-adrenergic receptor · adenosine 3' 5'-monophosphate 

分 类 号：R541.6[医药卫生—心血管疾病]