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(Chest. 1997;111:19-22.)
© 1997 American College of Chest Physicians

Plasma β-Endorphin Response to Exercise in Patients With Congestive Heart Failure

Gian Piero Perna MD1; Sergio Modoni MD2; Guido Valle MD2; Mario Stanislao MD1; and Francesco Loperfido MD3

1 From the Department of Cardiology, Casa Sollievo della Sofferenza Hospital, IRCCS, S. Giovanni Rotondo, Italy
2 From the Department of Nuclear Medicine, Casa Sollievo della Sofferenza Hospital, IRCCS, S. Giovanni Rotondo, Italy
3 From the Institute of Cardiology, Catholic University "Sacro Cuore," Rome, Italy

Objective: To determine whether the net release of β-endorphin during exercise, similar to that of norepinephrine, is related to functional disability in patients with congestive heart failure.

Background: Plasma β-endorphin and norepinephrine levels are elevated at rest in patients with heart failure, reflecting a functional disability. The net release of β-endorphin during exercise in patients with heart failure is unknown.

Methods: We measured plasma β-endorphin and norepinephrine levels (respectively: radioimmune and radioenzymatic assay) at rest and during graded exercise testing in 28 patients with congestive heart failure (Weber's class A, 10; B, 9; and C, 9) and in 9 normal subjects.

Results: At rest, plasma β-endorphin levels were higher in patients in classes B and C than in normal subjects (p<0.05 and <0.01, respectively). At peak exercise, patients in different functional classes and normal subjects reached similar β-endorphin levels. However, the net release of β-endorphin during exercise was lower in patients in classes B and C than in those in class A and normal subjects (p<0.01 for both). At rest, plasma norepinephrine levels were significantly higher in patients than in normal subjects (p<0.01). At peak exercise, norepinephrine levels were significantly lower in class C patients than in normal subjects (p<0.05), and tended to be lower in patients in classes A and B (p=NS). The net release of norepinephrine during exercise was lower in patients than in normal subjects (p<0.01). In patients, releases of both β-endorphin and norepinephrine during exercise were related to peak oxygen consumption and duration of exercise, but not to resting left ventricular ejection fraction.

Conclusions: In patients with congestive heart failure, the net release of plasma β-endorphin during exercise is decreased, like norepinephrine, and reflects a functional disability.

Submitted on March 1, 1996
Accepted on July 25, 2007






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