摘要: In order to analyse plasma norepinephrine (NE) and neuropeptide Y like immunoreactivity(NPY LI)in relation to cardiac function,41 patients with congestive heart failure(CHF) and 10 healthy volunteers were studied.Blood samples were obtained from the arterial and coronary circulations.NE was measured by high performance liquid chromatography and NPY LI by radioimmunoassay.Haemodynamic data were derived by right heart catheterization.Ejection fraction(EF) was measured by radionuclide angiography ,cine angiography or M mode echocardiograms. Groups of CHF patients with high EF (31.3± 1.3% ) and low EF (17.7±1.1%) were compared with the normal subjects.There were pronounced and significant increases in circulating arterial NPY LI and NA in both the high and low EF groups compared to the controls.In CHF patients,myocardial NPY LI release tended to be increased compared with normal subjects,however,this was not statistically significant(P=n.s.).While normal subjects showed myocardial NE uptake,patients with CHF demonstrated significant and progressive myocardial NE release.Arterial as well as coronary sinus NPY LI correlated significantly with plasma NE concentrations from the respective sites.Plasma NE concentrations in the artery and coronary sinus were negatively correlated with EF and cardiac index while no such relationships were found for NPY LI.The results suggest that NPY LI is released together with NE in moderate to severe forms of CHF.However,only plasma NE correlates with EF and CI.Thus,plasma NE concentration measurements seem to be the more sensitive index of cardiac dysfunction in CHF than NPY LI.