Author + information
- Received December 18, 1988
- Revision received February 24, 1989
- Accepted April 12, 1999
- Published online September 1, 1989.
- ↵1Address for reprints: Joseph A. Franciosa, MD, Vice President-Research and Development, Zambon Corporation, I Meadowlands Plaza, East Rutherford, New Jersey 07073.
The pathophysiologic role of high levels of circulating catecholamines in patients with congestive heart failure remains unclear. To assess the hemodynamic contribution of circulating catecholamines, metyrosine (alpha-methylp-tyrosine), an inhibitor of catecholamine synthesis, was administered to nine patients with acutely decompensated chronic congestive heart failure. Baseline left ventricular ejection fraction averaged 23.3 ± 9.9%, whereas cardiac output averaged 3.69 ± 1.03 liters/min, with a pulmonary wedge pressure of 27.4 ± 8.5 mm Hg.
After 48 h of metyrosine administration, plasma norepinephrine concentration decreased from 919.4 ± 810.6 to 335.4 ± 143.1 pg/ml (p < 0.05). Plasma epinephrine concentration averaged 176.4 ± 166.0 pg/ml at baseline, and was unchanged during metyrosine administration. Despite the significant decrease in circulating norepinephrine, no significant hemodynamic changes were observed during metyrosine administration.
These results suggest that high levels of circulating norepinephrine may be more a marker of severe congestive heart failure than an important contributor to the underlying pathophysiology at this advanced stage of the disease process.
↵∗ Present addresss: The Medical Building, Beverly. Massachusetts 019152781.
☆ This study was supported in part by a grant from the Medical Research Service, Veterans Administration, Washington, D.C.
- Received December 18, 1988.
- Revision received February 24, 1989.
- Accepted April 12, 1999.