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恰加斯病所致严重充血性心力衰竭患者外周及冠状窦儿茶酚胺水平

Peripheral and coronary sinus catecholamine levels in patients with severe congestive heart failure due to Chagas' disease.

作者信息

Bestetti R B, Coutinho-Netto J, Staibano L, Pinto L Z, Muccillo G, Oliveira J S

机构信息

Heart Institute of Santa Casa Hospital, Department of Biochemistry and Pathology, Ribeirão Preto Medical School, São Paulo University, Ribeirão Preto, Brazil.

出版信息

Cardiology. 1995;86(3):202-6. doi: 10.1159/000176874.

Abstract

The aim of this study was to assess the peripheral and cardiac autonomic system by catecholamine measurements in patients with severe chagasic and nonchagasic heart failure. Fifteen chagasic and 16 nonchagasic patients were enrolled in the study. Plasma venous norepinephrine levels (pg/ml) were 397.26 +/- 250.11 for chagasic and 660.05 +/- 455.57 for nonchagasic patients (p > 0.05), plasma venous epinephrine levels 215.84 +/- 254.04 for chagasic and 106.17 +/- 65.90 for nonchagasic patients (p > 0.05), aortic root norepinephrine levels 435.46 +/- 306.60 for chagasic and 668.16 +/- 512.82 for nonchagasic patients (p > 0.05), aortic root epinephrine levels 300.33 +/- 302.69 for chagasic and 199.98 +/- 162.88 for nonchagasic patients (p > 0.05), coronary sinus norepinephrine levels 636.10 +/- 495.22 for chagasic and 552.17 +/- 535.54 for nonchagasic patients (p > 0.05) and coronary sinus epinephrine levels 226.66 +/- 277.47 for chagasic and 69.21 +/- 35.62 for nonchagasic patients (p = 0.02). Myocardial and peripheral norepinephrine and epinephrine extractions were similar for both groups. Taken together, these findings may suggest that chagasic patients with congestive heart failure have biochemical evidence of cardiac autonomic dysfunction with preservation of the peripheral sympathetic activity.

摘要

本研究旨在通过测量重度恰加斯病性和非恰加斯病性心力衰竭患者的儿茶酚胺水平,评估其外周和心脏自主神经系统。15例恰加斯病患者和16例非恰加斯病患者纳入本研究。恰加斯病患者血浆静脉去甲肾上腺素水平(pg/ml)为397.26±250.11,非恰加斯病患者为660.05±455.57(p>0.05);恰加斯病患者血浆静脉肾上腺素水平为215.84±254.04,非恰加斯病患者为106.17±65.90(p>0.05);恰加斯病患者主动脉根部去甲肾上腺素水平为435.46±306.60,非恰加斯病患者为668.16±512.82(p>0.05);恰加斯病患者主动脉根部肾上腺素水平为300.33±302.69,非恰加斯病患者为199.98±162.88(p>0.05);恰加斯病患者冠状窦去甲肾上腺素水平为636.10±495.22,非恰加斯病患者为552.17±535.54(p>0.05);恰加斯病患者冠状窦肾上腺素水平为226.66±277.47,非恰加斯病患者为69.21±35.62(p = 0.02)。两组的心肌和外周去甲肾上腺素及肾上腺素摄取相似。综上所述,这些发现可能提示,充血性心力衰竭的恰加斯病患者存在心脏自主神经功能障碍的生化证据,而外周交感神经活动得以保留。

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