MYOCARDIAL CATECHOLAMINE CONTENT IN HEART-FAILURE .1. REGIONAL DISTRIBUTION IN EXPLANTED HEARTS, COMPARISON BETWEEN DILATED CARDIOMYOPATHY AND CORONARY-ARTERY DISEASE

  • 1 December 1989
    • journal article
    • research article
    • Vol. 78  (12) , 751-758
Abstract
To quantify the myocardial catecholamine content in heart failure patients and to assess the regional distribution of catecholamines, we investigated norepinephrine and dopamine concentrations in explanted hearts from 34 patients in end-stage heart failure, 28 patients with cardiomyopathy were compared with six patients with coronary artery disease. In comparison with the right atria of a control group without heart failure, reduced myocardial norepinephrine contents (in pg/.mu.g non-collagen protein (NCP)) were found in all areas of the explanted hearts: controls: right atrium 17.6 .+-. 6.6; cardiomyopathy: right atrium 7.1 .+-. 7.9, right ventricle 4.4 .+-. 2.7, septum 3.8 .+-. 1.5, left ventricle 3.5 .+-. 1.4. Coronary artery disease: right atrium 7.0 .+-. 6.9, right ventricle 4.2 .+-. 2.6, septum 3.6 .+-. 1.4, left ventricle 3.4 .+-. 1.4. Highest norepinephrine levels were measured in the right atrium. Right ventricle, septum, base and midventricular portion of the left ventricle had lower concentrations and were not different from each other. In contrast to reduced norepinephrine (NE) levels in all patients, dopamine (Dop) was inhomogenously elevated (only in a subgroup of 44%). Catechoalmine contents in any two arbitrarily selected areas correlated significantly (NA: r = 0.53-0.77; Dop: r = 0.81-0.93, p < 0.05 in all cases). The patients with heart failure due to dilated cardiomyopathy and to coronary artery disease did not differ in myocardial catecholamine levels or distribution. In end-stage heart failure a significant loss of myocardial norepinephrine independent from the underlying disease is found. It affects all areas of the hearts but does not equalize catecholamine content in ventricles and atria. Thus atrial catecholamine content may not be taken as an indicator for ventricular concentrations.