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Urbancsek R, Csanádi Z, Forgács IN, et al. Sympathetic activation in heart failure with reduced and mildly reduced ejection fraction: the role of aetiology. ESC Heart Fail. 2021;8(6):5112-5120doi: 10.1002/ehf2.13580.
Urbancsek, R., Csanádi, Z., Forgács, I. N., Papp, T. B., Boczán, J., Barta, J., Jenei, C., Nagy, L., & Rudas, L. (2021). Sympathetic activation in heart failure with reduced and mildly reduced ejection fraction: the role of aetiology. ESC heart failure, 8(6), 5112-5120. https://doi.org/10.1002/ehf2.13580
Urbancsek, Réka, et al. "Sympathetic activation in heart failure with reduced and mildly reduced ejection fraction: the role of aetiology." ESC heart failure vol. 8,6 (2021): 5112-5120. doi: https://doi.org/10.1002/ehf2.13580
Urbancsek R, Csanádi Z, Forgács IN, Papp TB, Boczán J, Barta J, Jenei C, Nagy L, Rudas L. Sympathetic activation in heart failure with reduced and mildly reduced ejection fraction: the role of aetiology. ESC Heart Fail. 2021 Dec;8(6):5112-5120. doi: 10.1002/ehf2.13580. Epub 2021 Sep 07. PMID: 34492735; PMCID: PMC8712902.
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ESC Heart Fail. 2021 Dec;8(6):5112-5120. doi: 10.1002/ehf2.13580. Epub 2021 Sep 07.

Sympathetic activation in heart failure with reduced and mildly reduced ejection fraction: the role of aetiology.

ESC heart failure

Réka Urbancsek, Zoltán Csanádi, Ildikó Noémi Forgács, Tímea Bianka Papp, Judit Boczán, Judit Barta, Csaba Jenei, László Nagy, László Rudas

Affiliations

  1. Faculty of Medicine, Department of Cardiology, University of Debrecen, Móricz Zsigmond körút 22, Debrecen, 4032, Hungary.
  2. Faculty of Medicine, Department of Neurology, University of Debrecen, Debrecen, Hungary.
  3. Department of Anaesthesiology and Intensive Care, University of Szeged, Szeged, Hungary.

PMID: 34492735 PMCID: PMC8712902 DOI: 10.1002/ehf2.13580

Abstract

AIM: While sympathetic overactivity in heart failure (HF) with reduced ejection fraction (HFrEF; EF < 40%) is well-documented, it is ill-defined in patients with mildly reduced EF (HFmrEF; EF 40-49%). Furthermore, the significance of ischaemic versus non-ischaemic aetiology in sympathetic activation is also unclear and has yet to be studied in HF. Our goal was to compare muscle sympathetic nerve activity (MSNA) in HFmrEF and HFrEF patients and in healthy subjects, as well as to elucidate the influence of the underlying disease.

METHODS AND RESULTS: Twenty-three HFrEF (age 58 ± 10 years), 33 HFmrEF patients (age 61 ± 10 years), including 11 subjects with non-ischaemic cardiomyopathy in each HF groups and 10 healthy controls (age 55 ± 10 years), were studied. MSNA-detected by peroneal microneurography, continuous arterial pressure, and ECG-was recorded. MSNA frequency (burst/min) and incidence (burst/100 cycles) were calculated. Association with the patients' characteristics were assessed, and aetiology-based comparisons were performed. Burst frequency demonstrated a significant stepwise increase in both HFmrEF (41 ± 11 burst/min) and HFrEF (58 ± 17 burst/min, P < 0.001) patients as compared with controls (27 ± 9; P < 0.001 for both HF groups). Similarly, burst incidences were 66 ± 17, 82 ± 15, and 36 ± 10 burst/100 cycles in HFmrEF, HFrEF patients, and in healthy controls, respectively (P < 0.001 for all). Burst frequencies in HF patients showed significant correlation with NT-proBNP levels, and significant inverse correlations with the subjects' mean RR intervals, stroke volumes, pulse pressures, and EF.

CONCLUSIONS: Muscle sympathetic nerve activity parameters indicated significant sympathetic activation in both HFmrEF and HFrEF patients as compared with healthy controls with no difference in relation to ischaemic versus non-ischaemic aetiology.

© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Keywords: Baroreflex; Ejection fraction; Heart failure; Muscle sympathetic nerve activity

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