November 1, 1990Clinical Science
Elevated Plasma Noradrenaline Concentrations in Patients with Low-Output Cardiac Failure: Dependence on Increased Noradrenaline Secretion Rates
Why the study?
Does low-output cardiac failure increase noradrenaline secretion rates or decrease clearance compared to normal controls?
Population
6 otherwise healthy patients with moderate degrees of low-output cardiac failure and 6 normal control subjects
Comparison
Whole-body steady-state radionuclide tracer… vs Normal control subjects
Design
Case-control
Authors
Discussion
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Implication
Supports increased secretion as driver of elevated noradrenaline in low-output HF; leaves open confirmation in larger cohorts and modern therapies.
Key Points
- To investigate the mechanisms of elevated plasma noradrenaline concentrations in patients with low-output cardiac failure.
- Determined plasma noradrenaline clearance and secretion rates using a whole-body steady-state radionuclide tracer method.
- Compared six patients with low-output cardiac failure to six normal control subjects.
- Measured venous plasma levels of noradrenaline and adrenaline.
- Patients with low-output cardiac failure had significantly higher plasma noradrenaline levels (4.18 +/- 1.34 nmol/l) compared to controls (1.54 +/- 0.16 nmol/l, P < 0.05).
- The apparent secretion rate of noradrenaline was elevated in patients (4.75 +/- 1.95 nmol min-1 m-2) vs. controls (1.78 +/- 0.18 nmol min-1 m-2, P < 0.05).
- The clearance rate of noradrenaline was similar in both groups (1.26 +/- 0.27 vs. 1.16 +/- 0.02 l min-1 m-2, not significant).
Structured PICO
Does low-output cardiac failure increase noradrenaline secretion rates or decrease clearance compared to normal controls?
P
Population
6 otherwise healthy patients with moderate degrees of low-output cardiac failure and 6 normal control subjects (total n=12)
I
Intervention
Whole-body steady-state radionuclide tracer method to determine plasma noradrenaline clearance and apparent secretion rates
C
Comparator
Normal control subjects
O
Outcome
Plasma noradrenaline clearance and apparent secretion ratessurrogate
Elevated plasma noradrenaline concentrations in patients with mildly decompensated low-output cardiac failure are primarily driven by increased secretion rather than decreased metabolic clearance.
Cite This Study
Abraham et al. (1990) studied this question.