Effect of adrenergic blockade on plasma adrenomedullin concentration during static handgrip in patients with heart failure

• Published in: Clinical physiology and functional imaging Vol. 26; no. 6; pp. 328 - 334
• Main Authors: Krzemiński, K., Nazar, K., Cybulski, G., Mikulski, T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2006; Blackwell Science
• Subjects: Adrenergic beta-Antagonists - therapeutic use; adrenomedullin; Adrenomedullin - blood; Adrenomedullin - drug effects; Aged; Analysis of Variance; Biological and medical sciences; Biomarkers - blood; Blood Pressure - drug effects; Carbazoles - therapeutic use; Cardiac Output - drug effects; carvedilol; catecholamines; Chronic Disease; Coronary Artery Disease - blood; Coronary Artery Disease - complications; Coronary Artery Disease - drug therapy; Coronary Artery Disease - physiopathology; Epinephrine - blood; Exercise Test; Fundamental and applied biological sciences. Psychology; haemodynamics; heart failure; Heart Failure - blood; Heart Failure - drug therapy; Heart Failure - etiology; Heart Failure - physiopathology; Heart Rate - drug effects; Humans; Linear Models; Male; Middle Aged; Norepinephrine - blood; Propanolamines - therapeutic use; static handgrip; Sympathetic Nervous System - drug effects; Sympathetic Nervous System - metabolism; Sympathetic Nervous System - physiopathology; Treatment Outcome; Vascular Resistance - drug effects; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Human; Heart failure; static handgrip; catecholamines; α1-Adrenergic receptor; Adrenomedullin; Cardiovascular disease; β2-Adrenergic receptor; Catecholamine; Vertebrata; Alpha blocking agent; β1-Adrenergic receptor; Mammalia; Heart disease; Carvedilol; Antagonist; haemodynamics; Beta blocking agent
• ISSN: 1475-0961; 1475-097X
• DOI: 10.1111/j.1475-097X.2006.00693.x

Summary Our previous study showed that static handgrip caused increases in the plasma adrenomedullin (ADM) both in patients with heart failure (HF) and healthy subjects. The present study was designed to determine the role of the sympathetic nervous system in mediating plasma ADM changes during handgrip in patients with HF. Twelve male HF patients (II class NYHA) treated with carvedilol, a non‐selective adrenergic blocker (TC) and 12 patients untreated with carvedilol (UC) performed two 3‐min bouts of static handgrip at 30% of maximal voluntary contraction, alternately with each hand. At the end of both exercise bouts and in 5 min of the recovery period, plasma ADM and catecholamines were determined. In addition, heart rate, blood pressure and stroke volume (SV) were measured. The baseline plasma ADM, noradrenaline (NA) and adrenaline (A) levels were similar in the two groups of patients, while SV was higher (P<0·05) in TC than in UC. During exercise plasma ADM concentrations were lower (P<0·05) in TC than in UC, but the handgrip‐induced increases in plasma ADM did not differ between the groups. Plasma ADM correlated with NA concentrations (r = 0·764) and with SV (r = −0·435) and increases in plasma ADM expressed as percentage of baseline values correlated with those of plasma NA (r = 0·499), diastolic BP (r = 0·550) and total peripheral resistance (r = 0·435). The study suggests that the sympathetic nervous system may be involved in the stimulation of ADM secretion during static exercise either directly or by changes in the haemodynamic response.