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Erythrocyte Na+, K+-ATPase activity in patients with congestive heart failure
A Baba1, T Yoshikawa, H Mitamura
1Cardiopulmonary Division, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Insights
Sodium-potassium adenosine triphosphatase (Na+, K+-ATPase) activity is reduced in patients with heart failure. Lower activity correlates with increased norepinephrine and predicts electrophysiologic instability, aiding in heart failure management.
Area of Science:
- Cardiology
- Biochemistry
- Physiology
Background:
- Congestive heart failure (CHF) is characterized by impaired cardiac function.
- Alterations in erythrocyte membrane ion transport, specifically Na+, K+-ATPase activity, are implicated in cardiovascular disease.
- Understanding these alterations is crucial for managing CHF and its complications.
Purpose of the Study:
- To investigate Na+, K+-ATPase activity in erythrocyte membranes of patients with CHF.
- To determine the clinical significance of Na+, K+-ATPase activity in relation to other clinical variables.
- To explore the association between Na+, K+-ATPase activity and electrophysiologic instability in CHF.
Main Methods:
- Erythrocyte Na+, K+-ATPase activity was measured in 51 CHF patients (coronary artery disease, n=26; dilated cardiomyopathy, n=25) and 24 controls.
- Plasma norepinephrine levels were quantified.
- The presence of non-sustained ventricular tachycardia was assessed.
Main Results:
- Na+, K+-ATPase activity was significantly lower in both CHF groups compared to controls, irrespective of digitalis use.
- A significant inverse correlation was observed between Na+, K+-ATPase activity and plasma norepinephrine.
- Lower Na+, K+-ATPase activity was associated with non-sustained ventricular tachycardia in CHF patients without digitalis use.
Conclusions:
- Reduced erythrocyte Na+, K+-ATPase activity is a characteristic finding in congestive heart failure.
- Na+, K+-ATPase activity serves as a potential biomarker for predicting electrophysiologic instability in heart failure patients.
- Monitoring Na+, K+-ATPase activity may offer insights into cardiac function and risk stratification in CHF.
Abstract:
In order to determine if the Na+, K+-ATPase activity in erythrocyte membranes is altered in congestive heart failure, and to examine its clinical significance with respect to other clinical variables, erythrocyte Na+, K+-ATPase activity was measured in 51 patients with left ventricular ejection fractions <40% (coronary artery disease, n=26; dilated cardiomyopathy, n=25) and 24 control patients. Na+, K+-ATPase activity was lower in both coronary artery disease and dilated cardiomyopathy groups than control group even in the absence of digitalis use. There was a significant inverse correlation between Na+, K+-ATPase activity and plasma norepinephrine. The presence of non-sustained ventricular tachycardia was associated with a lower Na+, K+-ATPase activity in both groups with congestive heart failure without digitalis use than those without ventricular tachycardia. Plasma norepinephrine was higher in patients with non-sustained ventricular tachycardia than those without in the coronary artery disease group, but not in the dilated cardiomyopathy group. Na+, K+-ATPase activity may be helpful in predicting electrophysiologic instability in patients with heart failure.