Relationships among norepinephrine levels, exercise capacity, and chronotropic responses in heart failure patients.

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Title: Relationships among norepinephrine levels, exercise capacity, and chronotropic responses in heart failure patients.
Authors: Grosman-Rimon, Liza, Wright, Evan, Sabovich, Solomon, Rimon, Jordan, Gleitman, Sagi, Sudarsky, Doron, Lubovich, Alla, Gabizon, Itzhak, Lalonde, Spencer D., Tsuk, Sharon, McDonald, Michael A., Rao, Vivek, Gutterman, David, Jorde, Ulrich P., Carasso, Shemy, Kachel, Erez
Source: Heart Failure Reviews; Jan2023, Vol. 28 Issue 1, p35-45, 11p
Subject Terms: AEROBIC capacity, HEART failure patients, NORADRENALINE, SYMPATHETIC nervous system, HEART beat
Abstract: In heart failure (HF) patients, the pathophysiological mechanisms of severe exercise intolerance and impaired exercise capacity are related to both central and peripheral abnormalities. The central abnormalities in HF patients include impaired cardiac function and chronotropic incompetence (CI). Indeed, CI, the inability to adequately increase heart rate (HR) from rest to exercise often exhibited by HF patients, is related to activation of the sympathetic nervous system (SNS) yielding a rise in circulating norepinephrine (NE). CI may result from downregulation of β-adrenergic receptors, β-blocker usage, high baseline HR, or due to a combination of factors. This paper discusses the role of elevated NE in altering chronotropic responses in HF patients and consequently resulting in impaired exercise capacity. We suggest that future research should focus on the potential treatment of CI with rate-adaptive pacing, using a sensor to measure physical activity, without inducing deleterious hormonal activation of the sympathetic system. [ABSTRACT FROM AUTHOR]
Copyright of Heart Failure Reviews is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. 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: Relationships among norepinephrine levels, exercise capacity, and chronotropic responses in heart failure patients.
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  Data: Heart Failure Reviews; Jan2023, Vol. 28 Issue 1, p35-45, 11p
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  Data: <searchLink fieldCode="DE" term="%22AEROBIC+capacity%22">AEROBIC capacity</searchLink><br /><searchLink fieldCode="DE" term="%22HEART+failure+patients%22">HEART failure patients</searchLink><br /><searchLink fieldCode="DE" term="%22NORADRENALINE%22">NORADRENALINE</searchLink><br /><searchLink fieldCode="DE" term="%22SYMPATHETIC+nervous+system%22">SYMPATHETIC nervous system</searchLink><br /><searchLink fieldCode="DE" term="%22HEART+beat%22">HEART beat</searchLink>
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  Label: Abstract
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  Data: In heart failure (HF) patients, the pathophysiological mechanisms of severe exercise intolerance and impaired exercise capacity are related to both central and peripheral abnormalities. The central abnormalities in HF patients include impaired cardiac function and chronotropic incompetence (CI). Indeed, CI, the inability to adequately increase heart rate (HR) from rest to exercise often exhibited by HF patients, is related to activation of the sympathetic nervous system (SNS) yielding a rise in circulating norepinephrine (NE). CI may result from downregulation of β-adrenergic receptors, β-blocker usage, high baseline HR, or due to a combination of factors. This paper discusses the role of elevated NE in altering chronotropic responses in HF patients and consequently resulting in impaired exercise capacity. We suggest that future research should focus on the potential treatment of CI with rate-adaptive pacing, using a sensor to measure physical activity, without inducing deleterious hormonal activation of the sympathetic system. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of Heart Failure Reviews is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. 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: 10.1007/s10741-022-10232-y
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        Text: English
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