We measured plasma concentrations of
norepinephrine,
cyclic AMP,
cyclic GMP,
atrial natriuretic peptides (
ANP) and beta-
adrenoceptor density (Bmax) and affinity (Kd) of lymphocytes in patients with
congestive heart failure and correlated these parameters with symptoms and hemodynamic indices. Plasma concentration of
norepinephrine,
cyclic AMP,
cyclic GMP and
ANP significantly increased in patients with
congestive heart failure. Plasma concentrations of
norepinephrine were related to the severity of the
heart failure, plasma
cyclic AMP concentrations, and pulmonary artery pressures.
Cyclic AMP concentrations fell rapidly
after treatment of acute left ventricular failure. Peripheral blood lymphocytes were stimulated by
isoproterenol, and
cyclic AMP level in lymphocytes was assayed. In normal subjects the generation of
cyclic AMP after stimulation decreased with age. The response of lymphocytes in patients of NYHA classes III and IV was significantly lower than in the normal age-matched controls. A significant correlation between plasma
norepinephrine concentration and increase of lymphocyte
cyclic AMP was demonstrated. From these results it was suggested that
beta-adrenergic receptors in
congestive heart failure were desensitized. Beta receptor numbers of lymphocytes significantly decreased in NYHA class III and IV, but did not decrease in class I and II. There was no significant difference in Kd associated with
congestive heart failure. Plasma concentrations of
cyclic GMP also depended on the severity of
heart failure and the pulmonary artery pressure, and decreased sharply with treatment, although remaining at a high value. A significant correlation between the
cyclic GMP and
ANP concentration was found in patients with
congestive heart failure.(ABSTRACT TRUNCATED AT 250 WORDS)