March 5, 2002Clinical Science
Nitric oxide and cardiac parasympathetic control in human heart failure
Why the study?
Does inhibition of endogenous NO production with l-NMMA reduce heart rate variability and baroreflex sensitivity compared to phenylephrine in heart failure patients?
Population
24 subjects: 12 heart failure patients and 12 age/sex-matched healthy control subjects.
Comparison
Inhibition of endogenous NO production with… vs Administration of an equipressor dose of the…
Design
Case-control
Authors
Discussion
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Implication
Supports NO dependence of baroreflex parasympathetic activation in heart failure; hypothesis-generating and should not yet change practice.
Structured PICO
Does inhibition of endogenous NO production with l-NMMA reduce heart rate variability and baroreflex sensitivity compared to phenylephrine in heart failure patients?
P
Population
24 subjects: 12 heart failure patients (NYHA class II-III; mean age 52 years, range 38-67 years) and 12 age/sex-matched healthy control subjects (mean age 50 years, range 36-62 years).
I
Intervention
Inhibition of endogenous NO production with N(G)-monomethyl-l-arginine (l-NMMA; 3 mg.h(-1).kg(-1))
C
Comparator
Administration of an equipressor dose of the control vasoconstrictor phenylephrine (12-36 microg.h(-1).kg(-1))
O
Outcome
Heart rate variability (RMSSD and high-frequency power) and baroreflex sensitivity (cross-spectral baroreflex sensitivity, high-frequency alpha-index, low-frequency alpha-index)surrogate
Baroreflex-mediated cardiac parasympathetic activation in human heart failure is dependent upon endogenous NO synthesis, similar to healthy subjects.
Cite This Study
Chowdhary et al. (2002) studied this question.