Correlation between activation of the sympathetic nervous system estimated by plasma concentrations of norepinephrine and Doppler echocardiographic variables in dogs with acquired heart disease

Mário Marcondes Santos Department of Clinical Sciences, Cardiology Service, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil.

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Célia M. C. Strunz Laboratory of Clinical Analysis at the Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil.

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Maria H. M. A. Larsson Department of Clinical Sciences, Cardiology Service, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil.

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 DVM, PhD

Abstract

Objective—To evaluate correlations between plasma concentrations of norepinephrine and Doppler echocardiographic variables for dogs with degenerative mitral valve disease (DMVD) or dilatative cardiomyopathy (DCM) to better understand the time course and magnitude of sympathetic activation in dogs with heart failure (HF).

Animals—15 healthy dogs, 15 dogs with DMVD, and 15 dogs with DCM.

Procedures—Dogs were positioned in lateral recumbency with minimal restraint for at least 20 minutes. Plasma samples were obtained and assayed by use of high-performance liquid chromatography. Concentrations were correlated with HF classification and with the main Doppler echocardiographic variables for each group.

Results—Mean ± SD norepinephrine concentration was significantly higher in dogs with DMVD (494.4 ± 204.8 pg/mL) or DCM (655.7 ± 652.5 pg/mL) than in healthy dogs (205.8 ± 78.9 pg/mL), but concentrations did not differ significantly between the 2 groups with HF. Correlations were not detected between norepinephrine and heart rate or any M-mode echocardiographic variables evaluated, except for fractional shortening (FS) in DCM dogs. In that group, norepinephrine was inversely correlated with FS values. In DMVD dogs, no significant correlation was found between norepinephrine and the left atrium-to-aortic root ratio or mitral regurgitation.

Conclusions and Clinical Relevance—A proportional inverse correlation exists between norepinephrine and FS values in dogs with DCM. However, norepinephrine concentration was not correlated with the evaluated echocardiographic variables in dogs with DMVD. Sympathetic antagonists should be evaluated as a treatment option because of the increased plasma concentrations of norepinephrine detected in dogs with HF.

Abstract

Objective—To evaluate correlations between plasma concentrations of norepinephrine and Doppler echocardiographic variables for dogs with degenerative mitral valve disease (DMVD) or dilatative cardiomyopathy (DCM) to better understand the time course and magnitude of sympathetic activation in dogs with heart failure (HF).

Animals—15 healthy dogs, 15 dogs with DMVD, and 15 dogs with DCM.

Procedures—Dogs were positioned in lateral recumbency with minimal restraint for at least 20 minutes. Plasma samples were obtained and assayed by use of high-performance liquid chromatography. Concentrations were correlated with HF classification and with the main Doppler echocardiographic variables for each group.

Results—Mean ± SD norepinephrine concentration was significantly higher in dogs with DMVD (494.4 ± 204.8 pg/mL) or DCM (655.7 ± 652.5 pg/mL) than in healthy dogs (205.8 ± 78.9 pg/mL), but concentrations did not differ significantly between the 2 groups with HF. Correlations were not detected between norepinephrine and heart rate or any M-mode echocardiographic variables evaluated, except for fractional shortening (FS) in DCM dogs. In that group, norepinephrine was inversely correlated with FS values. In DMVD dogs, no significant correlation was found between norepinephrine and the left atrium-to-aortic root ratio or mitral regurgitation.

Conclusions and Clinical Relevance—A proportional inverse correlation exists between norepinephrine and FS values in dogs with DCM. However, norepinephrine concentration was not correlated with the evaluated echocardiographic variables in dogs with DMVD. Sympathetic antagonists should be evaluated as a treatment option because of the increased plasma concentrations of norepinephrine detected in dogs with HF.

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