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-adrenergic responsiveness in heart failure
Cardiology Unit, Department of Medicine, and Department of Neurobiology and Anatomy, University of Rochester Medical Center, Rochester, New York 14642
Selegiline is a
centrally acting sympatholytic agent with neuroprotective properties.
It also has been shown to promote sympathetic reinnervation after
sympathectomy. These actions of selegiline may be beneficial in heart
failure that is characterized by increased sympathetic nervous activity
and functional sympathetic denervation. Twenty-seven rabbits with rapid
cardiac pacing (360 beats/min, 8 wk) and twenty-three rabbits without
pacing were randomly assigned to receive selegiline (1 mg/day, 8 wk) or
placebo. Rapid pacing increased plasma norepinephrine (NE) and
decreased left ventricular fractional shortening, baroreflex
sensitivity, cardiac sympathetic nerve terminal profiles, cardiac NE
uptake activity, and myocardial
-adrenoceptor density. Selegiline
administration to animals with rapid ventricular pacing attenuated the
increase in plasma NE and decreases in fractional shortening,
baroreflex sensitivity, sympathetic nerve profiles, NE uptake activity
and
-adrenoceptor density. Thus selegiline appears to exert a
sympatholytic and cardiac neuroprotective effect in pacing-induced
cardiomyopathy. The effects are potentially beneficial because
selegiline not only improves cardiac function but also increases
baroreflex sensitivity in heart failure.
hemodynamics; baroreflex; noradrenergic neurotransmitter profiles
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