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. 2022 Feb 28;7(2):116-127.
doi: 10.1016/j.jacbts.2021.11.007. eCollection 2022 Feb.

Characterization of Cardiac Sympathetic Nervous System and Inflammatory Activation in HFpEF Patients

David M Kaye  1   2   3 , Shane Nanayakkara  1   2 , Bing Wang  2   3 , Waled Shihata  1 , Francine Z Marques  4 , Murray Esler  5 , Gavin Lambert  6 , Justin Mariani  1   2   3
Affiliations

Characterization of Cardiac Sympathetic Nervous System and Inflammatory Activation in HFpEF Patients

David M Kaye et al. JACC Basic Transl Sci. .

Abstract

We have shown that systemic and cardiac sympathetic activation is present in heart failure with preserved ejection fraction (HFpEF) patients. Conversely, whereas systemic inflammatory activation was also detected in HFpEF, we did not detect local myocardial release of inflammatory cytokines. Activation of the sympathetic system correlated with both hemodynamic and demographic factors that characteristically cluster together in HFpEF. Together these data suggest that there may be a role for antiadrenergic therapies in certain HFpEF patients. The study does not implicate locally derived cytokines in the myocardial biology of HFpEF, although systemic sources may contribute to the global pathophysiology of HFpEF.

Keywords: BMI, body mass index; HFpEF, heart failure with preserved ejection fraction; NE, norepinephrine; PCWP, pulmonary capillary wedge pressure; SBP, systolic blood pressure; TCNE gradient, transcardiac NE gradient; cytokines; heart failure with preserved ejection fraction; sympathetic nervous system; transcardiac biomarker gradient.

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Conflict of interest statement

This work was supported by a National Health & Medical Research Council (NHMRC) of Australia Fellowship support to Dr Kaye. Dr Marques is supported by a National Heart Foundation Future Leader Fellowship and National Heart Foundation Grants. The Baker Heart & Diabetes Institute is supported in part by the Victorian Government's Operational Infrastructure Support Program. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Systemic and Cardiac Sympathetic Activity in HFpEF Bar graphs showing the plasma arterial concentration of norepinephrine (NE) and the transcardiac NE plasma concentration gradient and related metabolites dihydroxyphenylglycol (DHPG) and dihydyroxyphenylalanine (DOPA) in healthy subjects and heart failure with preserved ejection fraction (HFpEF) patients.
Figure 2
Figure 2
Physiologic Correlates of Sympathetic Activity in HFpEF Scatterplots showing the correlations between hemodynamic parameters and plasma arterial concentration of NE and the transcardiac NE plasma concentration gradient healthy subjects and HFpEF patients. PCWP= pulmonary capillary wedge pressure; other abbreviations as in Figure 1.
Figure 3
Figure 3
Systemic and Myocardial Cytokine Profiles in HFpEF (A,B) Principal component analysis plots of the profile of plasma arterial concentrations of inflammatory cytokines and of their transcardiac concentration gradients in healthy subjects and HFpEF patients.
See this image and copyright information in PMC

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