Plasma neuro-endocrine activity in very elderly subjects and patients with and without heart failure

Marked neuro-endocrine activation in patients with heart failure indicates a worse prognosis and a greater prognostic benefit from the use of ACE inhibitors. However, although the incidence of heart failure rises rapidly with age, relatively little is known about activation of the renin-angiotensin...

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Bibliographic Details
Published in:European heart journal 1995-09, Vol.16 (9), p.1223-1230
Main Authors: DUTKA, D. P., OLIVOTTO, I., WARD, S., NIHOYANNOPOULOS, P., AL-SUBAILI, M., OAKLEY, C. M., IMPALLOMENI, M., CLELAND, J. G. F.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging - physiology
Aldosterone - blood
Angiotensin II - blood
Atrial Natriuretic Factor - blood
Biological and medical sciences
Cardiology. Vascular system
Diuretics - administration & dosage
Diuretics - therapeutic use
Elderly
Female
Heart
heart failure
Heart Failure - blood
Heart Failure - diagnosis
Heart Failure - drug therapy
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Linear Models
Male
Medical sciences
neuro-endocrine
Norepinephrine - blood
Reference Values
Renin - blood
Renin-Angiotensin System - drug effects
Renin-Angiotensin System - physiology
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Summary:Marked neuro-endocrine activation in patients with heart failure indicates a worse prognosis and a greater prognostic benefit from the use of ACE inhibitors. However, although the incidence of heart failure rises rapidly with age, relatively little is known about activation of the renin-angiotensin and sympathetic nervous system in patients with heart failure over the age of 75 years. This study was undertaken to investigate plasma concentrations of neurohormonal variables in elderly patients referred to the cardiac clinic with a presumptive, but unconfirmed, diagnosis of heart failure, and to compare these values to plasma concentrations found in age-matched normal subjects. Fifty patients referred with a diagnosis of heart failure were studied. All were receiving a diuretic but not an ACE inhibitor. Patients with renal, haematological and valve disease were excluded Routine biochemistry and neuro-hormonal measurements were performed at their first visit, together with an electrocardiogram, chest X-ray and a full clinical examination by an experienced cardiologist. An echocardiogram and Doppler study was also performed and the diagnosis of heart failure either confirmed or refuted. Plasma concentrations of neuro-endocrine variables in healthy elderly subjects were similar to our normal laboratory range in younger subjects with the exception ofatrial natriuretic peptide (ANP) (40 ± 6 pg. ml−1, normal range
ISSN:0195-668X
1522-9645
DOI:10.1093/oxfordjournals.eurheartj.a061079