Regional epinephrine kinetics in human heart failure: evidence for extra-adrenal, nonneural release
Key result
Severe heart failure was associated with a 34% reduction in the whole body clearance rate of epinephrine from plasma (P < 0.001) and increased extra-adrenal, nonneural epinephrine release.
Why the study?
Do patients with severe heart failure have altered regional epinephrine kinetics and extra-adrenal release compared to healthy volunteers?
Population
42 patients with severe heart failure and 31 healthy volunteers (n=73)
Comparison
Radiotracer methods with regional venous… vs Healthy volunteers
Design
Cross-sectional
Authors
Discussion
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Implication
Reduced epinephrine clearance may drive elevated levels in severe HF; hypothesis-generating and requires prospective confirmation before clinical consideration.
Study Design
Type
Observational (n=73)
Structured PICO
Do patients with severe heart failure have altered regional epinephrine kinetics and extra-adrenal release compared to healthy volunteers?
P
Population
73 participants comprising 42 patients with severe heart failure and 31 healthy volunteers.
E
Exposure
Radiotracer methods with regional venous sampling from the heart, lungs, and hepatomesenteric beds, and application of physical (cycling) or mental (difficult mental arithmetic) stressors
C
Comparator
Healthy volunteers
O
Outcome
Whole body clearance rate of epinephrine and rate of epinephrine release to plasmasurrogate
Main Result
p-value: p=< 0.001
In severe heart failure, elevated plasma epinephrine is driven by reduced clearance and increased extra-adrenal, non-neuronal release rather than solely by sympathetic nervous system activation.
Cite This Study
Kaye et al. (1995) conducted an observational in Severe heart failure (n=73). Severe heart failure vs. Healthy volunteers was evaluated on Whole body clearance rate of epinephrine from plasma (p=< 0.001). Severe heart failure was associated with a 34% reduction in the whole body clearance rate of epinephrine from plasma (P < 0.001) and increased extra-adrenal, nonneural epinephrine release.