PMID- 9824004
OWN - NLM
STAT- MEDLINE
DCOM- 19981209
LR  - 20190514
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 114
IP  - 5
DP  - 1998 Nov
TI  - Sympathetic nervous response relative to the adenosine triphosphate supply-demand 
      imbalance during exercise is augmented in patients with heart failure.
PG  - 1295-300
AB  - OBJECTIVE: Increase in plasma hypoxanthine (HX) (purine nucleotide degradation 
      product from working muscle) reflects insufficiency of adenosine triphosphate 
      (ATP) supply during exercise, and the exercise-induced increase in plasma 
      norepinephrine (NE) can be an index of sympathetic nerve activity. The aim of 
      this study was to investigate the relationship between plasma NE and plasma HX 
      during exercise in patients with heart failure (HF) according to its severity. 
      METHODS: Blood lactate, plasma HX, and plasma NE were measured at rest and after 
      symptom-limited cardiopulmonary exercise test in 54 patients with HF (New York 
      Heart Association [NYHA] classes I:18, II:20, III:16) and 19 normal subjects. 
      RESULTS: Peak work rate and peak oxygen uptake decreased as the NYHA functional 
      class increased. Blood lactate and plasma HX levels at rest were comparable, but 
      peak blood lactate (normal, NYHA I, II, III: 6.4+/-0.3, 5.6+/-0.4, 5.3+/-0.3, 
      3.5+/-0.2 mmol/L) and peak plasma HX (3.6+/-0.4, 3.0+/-0.5, 2.4+/-0.3, 1.4+/-0.1 
      micromol/L) were progressively smaller as HF worsened. Resting plasma NE 
      (137+/-15, 180+/-29, 201+/-21, 318+/-55 pg/mL) was significantly higher in NYHA 
      class III HF, but peak plasma NE (2,235+/-356, 2,021+/-326, 2,188+/-292, 
      2,210+/-316 pg/mL) was not different among groups. The ratio of the exercise 
      increments in plasma NE to the increments in plasma HX during exercise 
      (deltaplasma NE/deltaplasma HX: 666+/-96, 1,083+/-229, 1,252+/-222, 2,260+/-351) 
      increased according to the severity of HF. CONCLUSION: These data suggest that 
      plasma levels of HX after maximal exercise are smaller as HF worsened, and 
      sympathetic responsiveness to the imbalance of ATP supply-demand during exercise 
      is augmented according to the severity of HF.
FAU - Kinugawa, T
AU  - Kinugawa T
AD  - First Department of Internal Medicine, Tottori University School of Medicine, 
      Yonago, Japan. kinugawa@grape.med.tottori-u.ac.jp
FAU - Ogino, K
AU  - Ogino K
FAU - Noguchi, N
AU  - Noguchi N
FAU - Mori, M
AU  - Mori M
FAU - Miyakoda, H
AU  - Miyakoda H
FAU - Hisatome, I
AU  - Hisatome I
FAU - Shigemasa, C
AU  - Shigemasa C
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 2TN51YD919 (Hypoxanthine)
RN  - 33X04XA5AT (Lactic Acid)
RN  - 61D2G4IYVH (Adenosine Diphosphate)
RN  - X4W3ENH1CV (Norepinephrine)
SB  - IM
EIN - Chest 1999 May;115(5):1485
MH  - Adenosine Diphosphate/*metabolism
MH  - Anaerobic Threshold
MH  - *Exercise Test
MH  - Female
MH  - Heart Failure/metabolism/*physiopathology
MH  - Humans
MH  - Hypoxanthine/blood
MH  - Lactic Acid/blood
MH  - Male
MH  - Middle Aged
MH  - Norepinephrine/blood
MH  - Oxygen Consumption
MH  - Sympathetic Nervous System/*physiopathology
EDAT- 1998/11/21 00:00
MHDA- 1998/11/21 00:01
CRDT- 1998/11/21 00:00
PHST- 1998/11/21 00:00 [pubmed]
PHST- 1998/11/21 00:01 [medline]
PHST- 1998/11/21 00:00 [entrez]
AID - S0012-3692(16)33063-X [pii]
AID - 10.1378/chest.114.5.1295 [doi]
PST - ppublish
SO  - Chest. 1998 Nov;114(5):1295-300. doi: 10.1378/chest.114.5.1295.