气候变化领域集成服务门户(CCPortal): Cardiac sympathetic dysfunction in pulmonary arterial hypertension: lesson from left-sided heart failure

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DOI	10.1177/2045894019868620
	Cardiac sympathetic dysfunction in pulmonary arterial hypertension: lesson from left-sided heart failure
	Mercurio V.; Pellegrino T.; Bosso G.; Campi G.; Parrella P.; Piscopo V.; Tocchetti C.G.; Hassoun P.M.; Petretta M.; Cuocolo A.; Bonaduce D.
发表日期	2019
ISSN	20458932
卷号	9 期号:3
英文摘要	Sympathetic nervous system hyperactivity has a well-recognized role in the pathophysiology of heart failure with reduced left ventricular ejection fraction. Alterations in sympathetic nervous system have been related to the pathophysiology of pulmonary arterial hypertension, but it is unclear whether cardiac sympathetic nervous system is impaired and how sympathetic dysfunction correlates with hemodynamics and clinical status in pulmonary arterial hypertension patients. The aim of this study was to evaluate the cardiac sympathetic nervous system activity by means of 123Iodine-metaiodobenzylguanidine nuclear imaging in pulmonary arterial hypertension patients and to explore its possible correlation with markers of disease severity. Twelve consecutive pulmonary arterial hypertension patients (nine women, median age 56.5 (17.8), eight idiopathic and four connective tissue-associated pulmonary arterial hypertension) underwent cardiac 123Iodine-metaiodobenzylguanidine scintigraphy. The results were compared with those of 12 subjects with a negative history of cardiovascular or pulmonary disease who underwent the same nuclear imaging test because of a suspected paraganglioma or pheochromocytoma, with a negative result (controls), and 12 patients with heart failure with reduced left ventricular ejection fraction. Hemodynamics, echocardiography, six-minute walking distance, cardiopulmonary exercise testing, and N-terminal pro brain natriuretic peptide were collected in pulmonary arterial hypertension patients within one week from 123Iodine-metaiodobenzylguanidine scintigraphy. Cardiac 123Iodine-metaiodobenzylguanidine uptake, assessed as early and late heart-to-mediastinum ratio, was significantly lower in pulmonary arterial hypertension compared to controls (p = 0.001), but similar to heart failure with reduced left ventricular ejection fraction. Myocardial 123Iodine-metaiodobenzylguanidine turnover, expressed as washout rate, was similar in pulmonary arterial hypertension and heart failure with reduced left ventricular ejection fraction and significantly higher compared to controls (p = 0.016). In the pulmonary arterial hypertension group, both early and late heart-to-mediastinum ratios and washout rate correlated with parameters of pulmonary arterial hypertension severity including pulmonary vascular resistance, right atrial pressure, tricuspid annular plane systolic excursion, N-terminal pro brain natriuretic peptide, and peak VO2. Although we evaluated a small number of subjects, our study showed a significant impairment in cardiac sympathetic nervous system in pulmonary arterial hypertension, similarly to that observed in heart failure with reduced left ventricular ejection fraction. This impairment correlated with indices of pulmonary arterial hypertension severity. Cardiac sympathetic dysfunction may be a contributing factor to the development of right-sided heart failure in pulmonary arterial hypertension. © The Author(s) 2019.
英文关键词	123I-metaiodobenzylguanidine; nuclear imaging; pulmonary arterial hypertension; sympathetic nervous system
scopus关键词	(3 iodobenzyl)guanidine i 123; ambrisentan; amino terminal pro brain natriuretic peptide; bosentan; covidien; tadalafil; adult; aortic valve stenosis; Article; cardiac imaging; cardiac sympathetic dysfunction; cardiopulmonary exercise test; cardiopulmonary hemodynamics; cardiovascular parameters; clinical article; controlled study; diastolic blood pressure; disease severity; end tidal carbon dioxide tension; female; fluoroscopy; forced expiratory volume; heart catheterization; heart failure; heart function; heart left ventricle ejection fraction; heart right atrium pressure; human; lung artery pressure; lung gas exchange; lung vascular resistance; male; middle aged; New York Heart Association class; oxygen consumption; oxygen saturation; paraganglioma; pheochromocytoma; positron emission tomography-computed tomography; pulmonary artery occlusion pressure; pulmonary hypertension; scintigraphy; single photon emission computed tomography; six minute walk test; supine position; systolic blood pressure; thorax radiography; transthoracic echocardiography; tricuspid annular plane systolic excursion; vascular access
来源期刊	Pulmonary Circulation
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/176398
作者单位	Department of Translational Medical Sciences, Federico II University, Naples, Italy; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, United States; Referral Cancer Center of Basilicata, Scientific Institute for Hospitalization and Care, Rionero in Vulture, Italy; Department of Advanced Biomedical Science, Federico II University, Naples, Italy
推荐引用方式 GB/T 7714	Mercurio V.,Pellegrino T.,Bosso G.,et al. Cardiac sympathetic dysfunction in pulmonary arterial hypertension: lesson from left-sided heart failure[J],2019,9(3).
APA	Mercurio V..,Pellegrino T..,Bosso G..,Campi G..,Parrella P..,...&Bonaduce D..(2019).Cardiac sympathetic dysfunction in pulmonary arterial hypertension: lesson from left-sided heart failure.Pulmonary Circulation,9(3).
MLA	Mercurio V.,et al."Cardiac sympathetic dysfunction in pulmonary arterial hypertension: lesson from left-sided heart failure".Pulmonary Circulation 9.3(2019).