INFLUENCE OF HEMODYNAMIC-CHANGES ON NEUROENDOCRINE RESPONSE IN ACUTE HEART-FAILURE

We studied 15 patients with acute deterioration of chronic left ventri cular heart failure. We compared the influence of reduction of ventric ular filling pressures with glyceryl trinitrate versus reduction of ve ntricular filling pressures with diuretics on plasma concentration of epinephrine, norepinephrine, aldosterone and renin activity. Reduction of ventricular filling pressures with glyceryl trinitrate had no infl uence on plasma concentrations of epinephrine, norepinephrine, aldoste rone and renin activity. After reduction of ventricular filling pressu res with diuretics plasma concentrations of epinephrine, norepinephrin e and aldosterone decreased, while plasma renin activity did not chang e. We conclude that there is a difference in the influence of reductio n of ventricular filling pressures with glyceryl trinitrate versus red uction of ventricular filling pressures with diuretics, on neuroendocr ine response in patients with acute deterioration of left ventricular heart failure. Thus some of the neuroendocrine effects of glyceryl tri nitrate are likely to be different from those of diuretics,though that they both produce a reduction in left ventricular filling pressure. ( C) 1997 Elsevier Science Ireland Ltd.