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Neurohumoral Activation and Ventricular Arrhythmias in Patients with Decompensated Congestive Heart Failure:.

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Title: Neurohumoral Activation and Ventricular Arrhythmias in Patients with Decompensated Congestive Heart Failure:.
Authors: ARONSON, DORON1 (AUTHOR), BURGER, ANDREW J.2 (AUTHOR)
Source: Pacing & Clinical Electrophysiology. Mar2003, Vol. 26 Issue 3, p703-710. 8p. 3 Charts.
Subjects: Endothelins, Neurohormones, Arrhythmia, Congestive heart failure, Patients
Abstract: ARONSON, D., et al.: Neurohumoral Activation and Ventricular Arrhythmias in Patients with Decompensated Congestive Heart Failure: Role of Endothelin.Patients with congestive heart failure (CHF) have a high incidence of ventricular arrhythmias and sudden arrhythmic death. CHF entails profound and complex abnormalities in humoral responses that are thought to promote arrhythmic events. However, it is unknown which of the many endogenous mediators that accumulate as part of neurohormonal activation is important in arrhythmogenesis in the setting of CHF. The study included 83 patients admitted to the hospital for treatment of decompensated CHF. Neurohormonal and cytokine activation was assessed by measuring plasma renin activity, aldosterone, norepinephrine, endothelin‐1, tumor necrosis factor‐α, and interleukin‐6 levels. Atrial and ventricular arrhythmic events were assessed by 24‐hour Holter monitoring. In a univariate analysis, a highly significant, positive relationship was found between plasma endothelin‐1 levels and the average hourly total premature ventricular beats(P = 0.003), the frequency of ventricular pairs(P = 0.0003), and the frequency of ventricular tachycardia episodes(P = 0.001). After inclusion of clinical variables, drug therapies, neurohormones, and cytokine levels in a multivariate analysis, the positive relationship between plasma endothelin‐1 level and the average hourly total premature ventricular beats(P = 0.008), the frequency of ventricular pairs(P = 0.007), and ventricular tachycardia episodes(P = 0.009)remained independent. No association between other neurohormones or cytokines and arrhythmic events was demonstrated. The results of the present study suggest that increased endothelin‐1 concentrations may be involved in promoting the occurrence of ventricular ectopy in patients with decompensated CHF. Proarrhythmic effects may account, in part, for the poor outcome associated with increased endothelin‐1 levels in patients with decompensated CHF. (PACE 2003; 26:703–710) [ABSTRACT FROM AUTHOR]
Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Neurohumoral Activation and Ventricular Arrhythmias in Patients with Decompensated Congestive Heart Failure:.
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  Data: <searchLink fieldCode="JN" term="%22Pacing+%26+Clinical+Electrophysiology%22">Pacing & Clinical Electrophysiology</searchLink>. Mar2003, Vol. 26 Issue 3, p703-710. 8p. 3 Charts.
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  Data: ARONSON, D., et al.: Neurohumoral Activation and Ventricular Arrhythmias in Patients with Decompensated Congestive Heart Failure: Role of Endothelin.Patients with congestive heart failure (CHF) have a high incidence of ventricular arrhythmias and sudden arrhythmic death. CHF entails profound and complex abnormalities in humoral responses that are thought to promote arrhythmic events. However, it is unknown which of the many endogenous mediators that accumulate as part of neurohormonal activation is important in arrhythmogenesis in the setting of CHF. The study included 83 patients admitted to the hospital for treatment of decompensated CHF. Neurohormonal and cytokine activation was assessed by measuring plasma renin activity, aldosterone, norepinephrine, endothelin‐1, tumor necrosis factor‐α, and interleukin‐6 levels. Atrial and ventricular arrhythmic events were assessed by 24‐hour Holter monitoring. In a univariate analysis, a highly significant, positive relationship was found between plasma endothelin‐1 levels and the average hourly total premature ventricular beats(P = 0.003), the frequency of ventricular pairs(P = 0.0003), and the frequency of ventricular tachycardia episodes(P = 0.001). After inclusion of clinical variables, drug therapies, neurohormones, and cytokine levels in a multivariate analysis, the positive relationship between plasma endothelin‐1 level and the average hourly total premature ventricular beats(P = 0.008), the frequency of ventricular pairs(P = 0.007), and ventricular tachycardia episodes(P = 0.009)remained independent. No association between other neurohormones or cytokines and arrhythmic events was demonstrated. The results of the present study suggest that increased endothelin‐1 concentrations may be involved in promoting the occurrence of ventricular ectopy in patients with decompensated CHF. Proarrhythmic effects may account, in part, for the poor outcome associated with increased endothelin‐1 levels in patients with decompensated CHF. (PACE 2003; 26:703–710) [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1046/j.1460-9592.2003.00120.x
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      – Code: eng
        Text: English
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      – SubjectFull: Endothelins
        Type: general
      – SubjectFull: Neurohormones
        Type: general
      – SubjectFull: Arrhythmia
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      – SubjectFull: Congestive heart failure
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      – TitleFull: Neurohumoral Activation and Ventricular Arrhythmias in Patients with Decompensated Congestive Heart Failure:.
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              Text: Mar2003
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              Y: 2003
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