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Diurnal Variation in Plasma Norepinephrine in Patients with Heart Failure
Author(s) -
Bleske Barry E.,
Chung HuiSan,
DiMagno Matthew,
Nicklas John M.
Publication year - 1999
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.19.11.984.31571
Subject(s) - heart failure , diurnal temperature variation , medicine , ejection fraction , circadian rhythm , cardiology , norepinephrine , trough (economics) , dopamine , atmospheric sciences , geology , economics , macroeconomics
Diurnal variation in plasma norepinephrine (PNE) levels is well documented in healthy individuals but not in patients with heart failure. Therefore, we attempted to determine variations in PNE levels over 24 hours, measured hourly, in six patients with an ejection fraction below 40% and a history of heart failure of longer than 3 months. Three controls without a history of heart failure also were evaluated. Both patients and controls had diurnal variations in PNE, with highest levels occurring during the day and lowest at night. When data in patients were evaluated by 6‐hour time intervals the mean value for 6:00 A.M.–12:00 noon was approximately twice as high as 12:00 midnight–6:00 A.M. (689 ± 329 vs 338 ± 166 pg/ml, p<0.05, respectively). Patients also had significant peak to trough variation in PNE levels compared with controls (959 ± 396 vs 386 ± 84 pg/ml, p<0.02, respectively). These results suggest that significant intrapatient variations in PNE occur over 24 hours in patients with heart failure. These variations may have to be accounted for when evaluating and treating patients with heart failure.