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Bisoprolol therapy does not reduce right ventricular sympathetic activity in pulmonary arterial hypertension patients

Authors :
Hendrik J. Harms
Berend E. Westerhof
Cathelijne Emma van der Bruggen
Adriaan A. Lammertsma
Joanne A. Groeneveldt
Pieter G. Raijmakers
Frances S. de Man
Anton Vonk Noordegraaf
Cornelis P Allaart
Paul Knaapen
Harm Jan Bogaard
Karin de Boer
Mischa T Rijnierse
Jasmijn van Campen
Cardiology
Pulmonary medicine
ACS - Pulmonary hypertension & thrombosis
ACS - Heart failure & arrhythmias
Radiology and nuclear medicine
Amsterdam Movement Sciences - Restoration and Development
ACS - Atherosclerosis & ischemic syndromes
APH - Quality of Care
ACS - Microcirculation
Source :
Pulmonary Circulation, Vol 10 (2020), Rijnierse, M T, Groeneveldt, J A, van Campen, J S J A, de Boer, K, van der Bruggen, C E E, Harms, H J, Raijmakers, P G, Lammertsma, A A, Knaapen, P, Bogaard, H J, Westerhof, B E, Vonk-Noordegraaf, A, Allaart, C P & deMan, F 2019, ' EXPRESS: Bisoprolol therapy does not reduce right ventricular sympathetic activity in pulmonary arterial hypertension patients ', Pulmonary Circulation, pp. 204589401987354 . https://doi.org/10.1177/2045894019873548, Pulmonary Circulation, Pulmonary Circulation. University of Chicago Press
Publication Year :
2020
Publisher :
Wiley, 2020.

Abstract

Right ventricular (RV) function and autonomic dysfunction are important determinants of morbidity and mortality in patients with pulmonary arterial hypertension (PAH). Although successful in animal studies, effects of beta-blocker therapy on RV function in clinical trials were disappointing. To understand this discrepancy, we studied whether beta-blocker therapy changes RV sympathetic activity. Idiopathic PAH (IPAH) patients received beta-blocker therapy (uptitrated to a maximal tolerated dose) and underwent cardiac magnetic resonance imaging, right heart catheterization, and a [ 11 C]-hydroxyephedrine positron emission tomography ([ 11 C]HED PET) scan at baseline to determine, respectively, RV ejection fraction (RVEF), RV pressures, and sympathetic activity. [ 11 C]HED, a norepinephrine analogue, allows determination of sympathetic innervation of the RV. [ 11 C]HED retention index reflects norepinephrine transporter activity. As a consequence of excessive catecholamine levels in the synaptic cleft, this transporter may be downregulated. Therefore, low [ 11 C]HED retention index indicates high sympathetic activity. 13 IPAH patients underwent [ 11 C]HED PET scans at baseline and after bisoprolol treatment. Although heart rate was reduced, systemic modulation of autonomic activity by bisoprolol did not affect local RV sympathetic nerve activity, RV function, or RV wall tension. In PAH patients, RV [ 11 C]HED retention index was lower compared to LV tracer uptake (p

Details

ISSN :
20458940
Volume :
10
Database :
OpenAIRE
Journal :
Pulmonary Circulation
Accession number :
edsair.doi.dedup.....db4680b12583675638df630eb2ace6ae