The Effects of Dobutamine on Renal Sympathetic Activity in Human Heart Failure
Bibliographic record
Abstract
The pathophysiology of the cardiorenal syndrome remains poorly understood. Renal sympathetic activity is increased in heart failure. It contributes to the sodium avid state, renal vasoconstriction, and reduced glomerular filtration rate that is characteristic of a large number of heart failure patients. Dobutamine is commonly used in the treatment of decompensated heart failure. We used the norepinephrine spillover technique to examine the effects of dobutamine on renal sympathetic activity in human heart failure. Dobutamine was titrated to increase the peak positive rate of change in left ventricular pressure by 25%. In 11 patients with heart failure, dobutamine infusion reduced efferent renal sympathetic activity by 50% (P < 0.003). This sympatholytic response was associated with an 11% increase in renal plasma flow (P < 0.03) and a 12% increase in glomerular filtration rate (P < 0.04). These findings suggest that dobutamine infusion is acutely associated with a beneficial effect on renal function. This observation is potentially related to a renal sympatholytic response to ventricular mechanoreceptor activation associated with the inotropic effects of beta-adrenergic receptor stimulation.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".