gms | German Medical Science

28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

24. bis 27.11.2004, Hannover

Evidence for reduced myocardial sympathetic innervation in human essential hypertension

Reduzierte myokardiale sympathische Innervation bei essentieller Hypertonie

Meeting Abstract (Hypertonie 2004)

  • M.P. Schlaich - Universität Erlangen-Nürnberg (Erlangen, D)
  • E.A. Lambert - Universität Erlangen-Nürnberg (Erlangen, D)
  • G.W. Lambert - Universität Erlangen-Nürnberg (Erlangen, D)
  • M.D. Esler - Baker Heart Research Institute (Melbourne, AUS)

Hypertonie 2004. 28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Hannover, 24.-27.11.2004. Düsseldorf, Köln: German Medical Science; 2005. Doc04hochP109

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hoch2004/04hoch109.shtml

Veröffentlicht: 10. August 2005

© 2005 Schlaich et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Background: Essential hypertension is commonly associated with sympathetic activation. The precise causal mechanisms leading to sympathetic activation in hypertensive subjects are still poorly understood. Amongst others, possible explanations include sympathetic hyperinnervation of target tissues, as evident in the spontaneously hypertensive rat.

Methods: To further address this issue we combined biochemical measurements of cardiac NE stores (n=112), measured from the rate of overflow of the NE metabolite, dihydroxyphenylglycol (DHPG), and its tritiated form into the coronary sinus during an infusion of [3H]NE), with 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy (n=16) as indices of cardiac sympathetic innervation in normotensive (NT: n=73/8) and hypertensive (EH: n=39/8) subjects. To complement these data, we also determined the transcardiac gradients for plasma nerve growth factor (NGF) (ELISA), a neurotrophin produced and released by target tissues which plays a pivotal role in the differentiation, maturation and survival of sympathetic neurons.

Results: Cardiac NE stores were substantially reduced in hypertensive subjects (NT: 713plusminus67 vs EH: 328plusminus180 nmol; p<0.05). The heart-to-mediastinum (H/M) uptake ratio of MIBG was significantly lower in the hypertensive group (NT: 2.31plusminus0.12 vs EH: 1.98plusminus0.20; p<0.01). Furthermore, the plasma NGF gradient across the heart was reduced in hypertensive patients (NT: 21.1plusminus6.6 vs EH: -5.8plusminus6.2pg/ml; p<0.05).

Conclusions: In contrast to animal models of hypertension, these data provide biochemical, scintigraphic and biological evidence for reduced myocardial sympathetic innervation in human essential hypertension.