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Role of catecholamines and sympathetic activation as a risk factor for coronary artery disease
A Amadi1, P Ponikowski, A J Coats
1Academic Department of Cardiovascular Medicine, Charing Cross Hospital, London, UK.
Insights
Following heart attack and chronic heart failure, autonomic control of the heart is abnormal, with increased sympathetic activation. Heart rate variability analysis is a popular, less invasive method to assess this neurohumoral activation.
Area of Science:
- Cardiology
- Autonomic Neuroscience
Background:
- Abnormalities in cardiac autonomic control are observed after acute myocardial infarction and in chronic heart failure.
- Evidence suggests marked neurohumoral activation in these cardiac conditions.
Purpose of the Study:
- To review methods for identifying increased sympathetic activation in heart failure.
- To highlight the growing importance and advantages of heart rate variability analysis.
Main Methods:
- Review of methods for assessing sympathetic activation, including catecholamine measurement and baroreceptor sensitivity.
- Focus on heart rate variability (HRV) analysis as a key technique.
Main Results:
- Increased sympathetic activation is a common finding in myocardial infarction and heart failure.
- Heart rate variability analysis is presented as a valuable, non-invasive tool.
Conclusions:
- Autonomic dysfunction and neurohumoral imbalance are significant in heart failure.
- Heart rate variability offers a practical and advantageous approach to evaluating cardiac autonomic control.
Abstract:
After acute myocardial infarction and in chronic heart failure, several abnormalities of the autonomic control of the heart have been described, and evidence of marked neurohumoral activation has been found. Increased sympathetic activation can be identified using a number of methods, including simple or dynamic measurement of catecholamines and the study of heart rate variability by direct sympathetic nerve or muscle activity and by measurement of baroreceptor sensitivity. The analysis of heart rate variability is becoming more popular and has advantages over other more invasive methods.