Neuroendocrine response in acute heart failure and the influence of treatment

Vasoactive humoral factors were measured in 27 patients before and during the first week of conventional treatment of acute heart failure. On admission, all patients were given frusemide intravenously, followed by oral digoxin and diuretic therapy. Before drug treatment, plasma renin activity and pl...

Full description

Saved in:
Bibliographic Details
Published in:European heart journal 1989-12, Vol.10 (12), p.1075-1083
Main Authors: BROQVIST, M., DAHLSTRÖM, U., KARLBERG, B. E., KARLSSON, E., MARKLUND, T.
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Aldosterone - analysis
Angiotensin II - blood
Arginine vasopressin
Arginine Vasopressin - blood
Atrial Natriuretic Factor - blood
atrial natriuretic peptide
Catecholamines - blood
cyclic GMP
Cyclic GMP - blood
Diuretics - therapeutic use
Female
Furosemide - therapeutic use
heart failure
Heart Failure - blood
Heart Failure - drug therapy
Humans
Male
Middle Aged
Neurotransmitter Agents - blood
norepineph-rine
renin-angiotensin system
treatment
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Vasoactive humoral factors were measured in 27 patients before and during the first week of conventional treatment of acute heart failure. On admission, all patients were given frusemide intravenously, followed by oral digoxin and diuretic therapy. Before drug treatment, plasma renin activity and plasma angiotensin II concentrations were within normal ranges in the group of patients without previous diuretic treatment, but were significantly higher in those 16 patients already on diuretic drugs when admitted to hospital. After diuretic treatment, however, even the former group revealed activation of the renin-angiotensin system. Plasma concentrations of catecholamines were increased initially but normalized within 1 day. A majority of the patients initially had very high plasma concentrations of atrial natriuretic peptide (mean 276.9 ± 39.0 pg ml−1) which decreased but did not normalize during the study period. High plasma levels of arginine vasopressin (mean 56.8 ± 14.6 pg ml−1) were found, but tended to be reduced during treatment. Thus, patients with acute heart failure displayed increased plasma concentrations of atrial natriuretic peptide, arginine vasopressin and catecholamines, but these vasoactive hormones decreased in parallel to clinical improvement during diuretic therapy. In contrast, the renin-angiotensin system became clearly activated.
ISSN:0195-668X
1522-9645
DOI:10.1093/oxfordjournals.eurheartj.a059429