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Published on: February 10, 2013
Myocardial catecholamine concentrations in dilated cardiomyopathy and heart failure of different origins
V Regitz1, B Leuchs, C Bossaller
1Abteilung für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Germany.
Insights
Heart failure significantly reduces myocardial norepinephrine levels, a key neurotransmitter. This reduction is consistent across different heart disease causes and correlates with impaired left ventricular function.
Area of Science:
- Cardiology
- Neuroscience
- Biochemistry
Background:
- Myocardial catecholamine levels are crucial in heart function and disease.
- Previous research suggests altered catecholamine levels in heart failure, but direct tissue measurements and their correlation with disease severity are less understood.
Purpose of the Study:
- To investigate myocardial catecholamine concentrations in patients with heart failure.
- To determine if these levels correlate with the severity of myocardial damage or the underlying disease aetiology.
Main Methods:
- Endomyocardial biopsies were obtained from patients with heart failure.
- Catecholamine concentrations were measured and normalized to non-collagen protein (NCP).
- Levels were compared between patient groups and with controls, and correlated with left ventricular ejection fraction (LVEF).
Main Results:
- Myocardial norepinephrine levels were significantly reduced in heart failure patients compared to controls (P < 0.0006).
- Norepinephrine levels were comparable in dilated cardiomyopathy and coronary/valvular heart disease groups.
- Lower norepinephrine levels were observed in patients with LVEF < 30% compared to those with LVEF 31-55% (P < 0.05).
- A strong correlation was found between myocardial norepinephrine and LVEF in dilated cardiomyopathy (P < 0.001, r = 0.70).
Conclusions:
- Reduced myocardial norepinephrine is a hallmark of heart failure, irrespective of its cause.
- The depletion of myocardial norepinephrine is associated with the severity of left ventricular dysfunction.
Abstract:
Myocardial catecholamine concentrations were determined in endomyocardial biopsies from patients with heart failure to assess if tissue catecholamine levels relate to the severity of myocardial damage or the aetiology of the underlying disease. Methodological studies revealed a good reproducibility of catecholamine determinations in biopsies; the variance between paired biopsies was below 17% when myocardial catecholamines were related to non-collagen protein (NCP). Myocardial norepinephrine (in pg micrograms-1 NCP) levels were comparable in patients with dilated cardiomyopathy (DCM, 5.3 +/- 3.4, n = 22) and in patients with coronary or valvular heart disease (5.6 +/- 4.7, n = 14). In both groups, a significant reduction of myocardial norepinephrine was found (controls 12.0 +/- 3.4, P less than 0.0006). In a subgroup of patients with heart failure and a LVEF less than 30% (3.9 +/- 3.5, n = 17) myocardial norepinephrine content was lower than in patients with heart failure and LVEF of 31-55% (6.6 +/- 3.4, n = 19) (both P less than 0.05 against controls: 12.0 +/- 3.4, n = 16). A correlation between myocardial norepinephrine and LVEF was found in DCM (P less than 0.001, r = 0.70). The loss of myocardial norepinephrine is a characteristic feature of heart failure. It is independent of the origin of failure, but correlates with the impairment of LV function.
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