Reflex Systemic Sympatho-Neural Response to Brachial Adenosine Infusion in Treated Heart Failure
Bibliographic record
Abstract
AIMS: In healthy men, brachial artery adenosine infusion elicits a reflex increase in total body norepinephrine (NE) spillover (TBS) that is blunted by oral angiotensin AT(1) receptor blockade. Our objectives were to determine whether a similar reflex is active in treated heart failure (HF) patients and attenuated by ARB. METHODS AND RESULTS: In this double-blind study, 12 patients with an ejection fraction ≤40% were randomized to 2 weeks of oral candesartan up-titrated to 32 mg/day or placebo. Forearm blood flow was measured bilaterally by venous occlusion plethysmography. Total body NE spillover was determined following infusion of tritiated NE. After saline was infused into the non-dominant brachial artery to establish baseline values, adenosine and nitroprusside (as vasodilator control) were administered in random order. Both caused dose-dependent increases in ipsilateral but not contralateral blood flow. Nitroprusside had no TBS effect, whereas adenosine reduced TBS from 3967 (SD 2362) to 3293 pmol/min (SD 2093) (P = 0.03). This decrease was not augmented in candesartan-treated subjects [-1096 (SD 726) vs. -253 pmol/min (SD 1094); placebo vs. candesartan; P = 0.22]. CONCLUSIONS: In contrast to healthy men, in treated HF patients, locally infused adenosine does not elicit a reflex sympatho-excitatory response mediated by angiotensin AT(1)-modulated neurotransmission.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".