[Plasma catecholamines and hemodynamics in patients with heart failure (author's transl)]

Plasma catecholamines and hemodynamic were assessed in 32 patients with heart failure of varying degrees due to coronary artery disease as well as in twelve healthy control subjects. The studies employed the use of a (Swan-Ganz) semi-floating, balloon-tipped, thermodilution catheter during supine bicycle ergometry at incremented workloads (except in four patients with overt symptoms at heart failure at rest). As compared with control subjects, the patients showed increases in radiologically-determined cardiac volumes, right atrial, right ventricular, pulmonary artery and pulmonary capillary wedge pressures proportionately expressing increasing degrees of severity and, accordingly, decreasing values of cardiac output and stroke volume as well as a severity-dependent tendency to increasingly rapid heart rates. Similarly, as compared with control subjects, catecholamine concentrations increased in proportion with the pathologic elevation of pressures and inversely proportional to the cardiac output. With respect to a given catecholamine concentration, the patients showed a severity-dependent decrease in cardiac output, as an expression of the degree of functional myocardial impairment, as well as a lower heart rate and higher total peripheral resistance (at the same catecholamine level). The heart rate reduction at the same catecholamine concentration may be due to a reduced adrenergic receptor sensitivity.