Impact of chronic congestive heart failure on pharmacokinetics and vasomotor effects of infused nitrite

Abdul R Maher, Sayqa Arif, Melanie Madhani, Khalid Abozguia, Ibrar Ahmed, Bernadette O Fernandez, Martin Feelisch, A G O'Sullivan, Arthur Christopoulos, Aaron L Sverdlov, Doan Ngo, Rustem Dautov, Philip E James, John David Horowitz, Michael P Frenneaux

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND AND PURPOSE: Nitrite (NO2 - ) has recently been shown to represent a potential source of nitric oxide (NO), in particular under hypoxic conditions. The aim of the current study was to compare the hemodynamic effects of nitrite in healthy volunteers and patients with stable congestive heart failure (CHF). EXPERIMENTAL APPROACH: The acute hemodynamic effects of brachial artery infusion of nitrite (0.31 to 7.8mumoles/min) was assessed in normal subjects (n=20) and CHF patients (n=21). KEY RESULTS: NO2- infusion was well tolerated in all subjects. Forearm blood flow (FBF) increased markedly in CHF-patients at NO2- infusion rates which induced no changes in normal subjects (ANOVA: F=5.5; p=0.02). Unstressed venous volume (UVV) increased even with the lowest NO2- infusion rate in all subjects (indicating venodilation), with CHF patients being relatively hyporesponsive compared with normal subjects (ANOVA: F=6.2; p=0.01). There were no differences in venous blood pH or oxygen concentration between groups or during NO2- infusion. Venous plasma NO2- concentrations were lower in CHF-patients at baseline, and rose substantially less with NO2- infusion, without incremental oxidative generation of nitrate, consistent with accelerated clearance in these patients. Plasma protein-bound NO concentrations were lower in CHF-patients than normal subjects at baseline. This difference was attenuated during NO2- infusion. Prolonged nitrite exposure in-vivo did not induce oxidative stress, nor did it induce tolerance in vitro. CONCLUSIONS AND IMPLICATIONS: The findings of arterial hyper-responsiveness to infused NO2 - in CHF-patients, with evidence of accelerated transvascular NO2 - clearance (presumably with concomitant NO release) suggests that NO2 - effects may be accentuated in such patients. These findings provide a stimulus for the clinical exploration of NO2 - as a therapeutic modality in CHF.
Original languageEnglish
Pages (from-to)659 - 670
Number of pages12
JournalBritish Journal of Pharmacology
Volume169
Issue number3
DOIs
Publication statusPublished - 2013

Cite this

Maher, A. R., Arif, S., Madhani, M., Abozguia, K., Ahmed, I., Fernandez, B. O., ... Frenneaux, M. P. (2013). Impact of chronic congestive heart failure on pharmacokinetics and vasomotor effects of infused nitrite. British Journal of Pharmacology, 169(3), 659 - 670. https://doi.org/10.1111/bph.12152
Maher, Abdul R ; Arif, Sayqa ; Madhani, Melanie ; Abozguia, Khalid ; Ahmed, Ibrar ; Fernandez, Bernadette O ; Feelisch, Martin ; O'Sullivan, A G ; Christopoulos, Arthur ; Sverdlov, Aaron L ; Ngo, Doan ; Dautov, Rustem ; James, Philip E ; Horowitz, John David ; Frenneaux, Michael P. / Impact of chronic congestive heart failure on pharmacokinetics and vasomotor effects of infused nitrite. In: British Journal of Pharmacology. 2013 ; Vol. 169, No. 3. pp. 659 - 670.
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title = "Impact of chronic congestive heart failure on pharmacokinetics and vasomotor effects of infused nitrite",
abstract = "BACKGROUND AND PURPOSE: Nitrite (NO2 - ) has recently been shown to represent a potential source of nitric oxide (NO), in particular under hypoxic conditions. The aim of the current study was to compare the hemodynamic effects of nitrite in healthy volunteers and patients with stable congestive heart failure (CHF). EXPERIMENTAL APPROACH: The acute hemodynamic effects of brachial artery infusion of nitrite (0.31 to 7.8mumoles/min) was assessed in normal subjects (n=20) and CHF patients (n=21). KEY RESULTS: NO2- infusion was well tolerated in all subjects. Forearm blood flow (FBF) increased markedly in CHF-patients at NO2- infusion rates which induced no changes in normal subjects (ANOVA: F=5.5; p=0.02). Unstressed venous volume (UVV) increased even with the lowest NO2- infusion rate in all subjects (indicating venodilation), with CHF patients being relatively hyporesponsive compared with normal subjects (ANOVA: F=6.2; p=0.01). There were no differences in venous blood pH or oxygen concentration between groups or during NO2- infusion. Venous plasma NO2- concentrations were lower in CHF-patients at baseline, and rose substantially less with NO2- infusion, without incremental oxidative generation of nitrate, consistent with accelerated clearance in these patients. Plasma protein-bound NO concentrations were lower in CHF-patients than normal subjects at baseline. This difference was attenuated during NO2- infusion. Prolonged nitrite exposure in-vivo did not induce oxidative stress, nor did it induce tolerance in vitro. CONCLUSIONS AND IMPLICATIONS: The findings of arterial hyper-responsiveness to infused NO2 - in CHF-patients, with evidence of accelerated transvascular NO2 - clearance (presumably with concomitant NO release) suggests that NO2 - effects may be accentuated in such patients. These findings provide a stimulus for the clinical exploration of NO2 - as a therapeutic modality in CHF.",
author = "Maher, {Abdul R} and Sayqa Arif and Melanie Madhani and Khalid Abozguia and Ibrar Ahmed and Fernandez, {Bernadette O} and Martin Feelisch and O'Sullivan, {A G} and Arthur Christopoulos and Sverdlov, {Aaron L} and Doan Ngo and Rustem Dautov and James, {Philip E} and Horowitz, {John David} and Frenneaux, {Michael P}",
year = "2013",
doi = "10.1111/bph.12152",
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Maher, AR, Arif, S, Madhani, M, Abozguia, K, Ahmed, I, Fernandez, BO, Feelisch, M, O'Sullivan, AG, Christopoulos, A, Sverdlov, AL, Ngo, D, Dautov, R, James, PE, Horowitz, JD & Frenneaux, MP 2013, 'Impact of chronic congestive heart failure on pharmacokinetics and vasomotor effects of infused nitrite' British Journal of Pharmacology, vol. 169, no. 3, pp. 659 - 670. https://doi.org/10.1111/bph.12152

Impact of chronic congestive heart failure on pharmacokinetics and vasomotor effects of infused nitrite. / Maher, Abdul R; Arif, Sayqa; Madhani, Melanie; Abozguia, Khalid; Ahmed, Ibrar; Fernandez, Bernadette O; Feelisch, Martin; O'Sullivan, A G; Christopoulos, Arthur; Sverdlov, Aaron L; Ngo, Doan; Dautov, Rustem; James, Philip E; Horowitz, John David; Frenneaux, Michael P.

In: British Journal of Pharmacology, Vol. 169, No. 3, 2013, p. 659 - 670.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Impact of chronic congestive heart failure on pharmacokinetics and vasomotor effects of infused nitrite

AU - Maher, Abdul R

AU - Arif, Sayqa

AU - Madhani, Melanie

AU - Abozguia, Khalid

AU - Ahmed, Ibrar

AU - Fernandez, Bernadette O

AU - Feelisch, Martin

AU - O'Sullivan, A G

AU - Christopoulos, Arthur

AU - Sverdlov, Aaron L

AU - Ngo, Doan

AU - Dautov, Rustem

AU - James, Philip E

AU - Horowitz, John David

AU - Frenneaux, Michael P

PY - 2013

Y1 - 2013

N2 - BACKGROUND AND PURPOSE: Nitrite (NO2 - ) has recently been shown to represent a potential source of nitric oxide (NO), in particular under hypoxic conditions. The aim of the current study was to compare the hemodynamic effects of nitrite in healthy volunteers and patients with stable congestive heart failure (CHF). EXPERIMENTAL APPROACH: The acute hemodynamic effects of brachial artery infusion of nitrite (0.31 to 7.8mumoles/min) was assessed in normal subjects (n=20) and CHF patients (n=21). KEY RESULTS: NO2- infusion was well tolerated in all subjects. Forearm blood flow (FBF) increased markedly in CHF-patients at NO2- infusion rates which induced no changes in normal subjects (ANOVA: F=5.5; p=0.02). Unstressed venous volume (UVV) increased even with the lowest NO2- infusion rate in all subjects (indicating venodilation), with CHF patients being relatively hyporesponsive compared with normal subjects (ANOVA: F=6.2; p=0.01). There were no differences in venous blood pH or oxygen concentration between groups or during NO2- infusion. Venous plasma NO2- concentrations were lower in CHF-patients at baseline, and rose substantially less with NO2- infusion, without incremental oxidative generation of nitrate, consistent with accelerated clearance in these patients. Plasma protein-bound NO concentrations were lower in CHF-patients than normal subjects at baseline. This difference was attenuated during NO2- infusion. Prolonged nitrite exposure in-vivo did not induce oxidative stress, nor did it induce tolerance in vitro. CONCLUSIONS AND IMPLICATIONS: The findings of arterial hyper-responsiveness to infused NO2 - in CHF-patients, with evidence of accelerated transvascular NO2 - clearance (presumably with concomitant NO release) suggests that NO2 - effects may be accentuated in such patients. These findings provide a stimulus for the clinical exploration of NO2 - as a therapeutic modality in CHF.

AB - BACKGROUND AND PURPOSE: Nitrite (NO2 - ) has recently been shown to represent a potential source of nitric oxide (NO), in particular under hypoxic conditions. The aim of the current study was to compare the hemodynamic effects of nitrite in healthy volunteers and patients with stable congestive heart failure (CHF). EXPERIMENTAL APPROACH: The acute hemodynamic effects of brachial artery infusion of nitrite (0.31 to 7.8mumoles/min) was assessed in normal subjects (n=20) and CHF patients (n=21). KEY RESULTS: NO2- infusion was well tolerated in all subjects. Forearm blood flow (FBF) increased markedly in CHF-patients at NO2- infusion rates which induced no changes in normal subjects (ANOVA: F=5.5; p=0.02). Unstressed venous volume (UVV) increased even with the lowest NO2- infusion rate in all subjects (indicating venodilation), with CHF patients being relatively hyporesponsive compared with normal subjects (ANOVA: F=6.2; p=0.01). There were no differences in venous blood pH or oxygen concentration between groups or during NO2- infusion. Venous plasma NO2- concentrations were lower in CHF-patients at baseline, and rose substantially less with NO2- infusion, without incremental oxidative generation of nitrate, consistent with accelerated clearance in these patients. Plasma protein-bound NO concentrations were lower in CHF-patients than normal subjects at baseline. This difference was attenuated during NO2- infusion. Prolonged nitrite exposure in-vivo did not induce oxidative stress, nor did it induce tolerance in vitro. CONCLUSIONS AND IMPLICATIONS: The findings of arterial hyper-responsiveness to infused NO2 - in CHF-patients, with evidence of accelerated transvascular NO2 - clearance (presumably with concomitant NO release) suggests that NO2 - effects may be accentuated in such patients. These findings provide a stimulus for the clinical exploration of NO2 - as a therapeutic modality in CHF.

UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23472879

U2 - 10.1111/bph.12152

DO - 10.1111/bph.12152

M3 - Article

VL - 169

SP - 659

EP - 670

JO - British Journal of Pharmacology

JF - British Journal of Pharmacology

SN - 1476-5381

IS - 3

ER -