Free Noradrenaline and Adrenaline Excretion in Relation to the Development of Cardiac Arrhythmias and Heart-Failure in Patients With Acute Myocardial Infarction

Jewitt, D. E.; Reid, D S; Thomas, Michael; Mercer, C.J.; Valori, C; Shillingford, John

doi:10.1016/s0140-6736(69)92009-1

Cited by 191 publications

(40 citation statements)

References 18 publications

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“…At outpatient follow-up 13 Our results support the latter view since the mortality rate and the incidence of major arrhythmias and heart failure were greater in those patients who had initial systolic hypertension. Furthermore, the significantly higher mean peak SGOT level in this group suggests more extensive myocardial damage."…”

Section: Methodssupporting

confidence: 83%

“…(13) The mortality, incidence of major arrhythmias, and, incidence of cardiac failure in the systolic hypertensive group were greater than in the control group (P<0-01, P<0-001, and P<0-001 respectively; see table I). The clinical progress and mean peak SGOT levels of the 12 patients in the systolic hypertensive group and the six in the control group who were in cardiac failure on admission did not differ significantly from those of their respective groups as a whole.…”

Section: Methodsmentioning

confidence: 82%

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Prognostic significance of acute systolic hypertension after myocardial infarction.

Fox¹,

Tomlinson²,

Portal³

et al. 1975

BMJ

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SummaryThe clinical behaviour and mean peak serum aspartate aminotransferase (SGOT) values of 106 patients admitted to a coronary care unit with acute myocardial infarction who displayed acute systolic hypertension were studied. Another 106 normotensive patients with acute myocardial infarction acted as controls. Neither group had established hypertension. The mortality rate, incidence of cardiac failure, major arrhythmias, and mean peak SGOT were significantly greater in the hypertensive group, within which the duration of hypertension was correlated with mean peak SGOT levels-though there was no definite relation between the height of systolic or diastolic pressure and SGOT.Transient systolic hypertension after acute myocardial infarction was therefore associated with a relatively poor prognosis, but our observations suggest that patients with a systolic blood pressure of at least 170 mm Hg might benefit from early hypotensive treatment. IntroductionPatients with long-standing hypertension who suffer acute myocardial infarction have a relatively poor prognosis compared with those with a previously normal blood pressure.' 2 Some patients, however, enter hospital with acute myocardial infarction and are found to have a raised blood pressure for the first time. This usually resolves without specific treatment and has been considered to reflect catecholamine release from the infarcted area of myocardium combined with sympathetic overactivity as a result of chest pain or anxiety, or both.3' Our study was designed to assess the prognostic significance of acute systolic hypertension in this group of patients.

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Section: Methodssupporting

confidence: 83%

Section: Methodsmentioning

confidence: 82%

Prognostic significance of acute systolic hypertension after myocardial infarction.

Fox¹,

Tomlinson²,

Portal³

et al. 1975

BMJ

View full text Add to dashboard Cite

show abstract

“…1,2 Its components include a rapid rise in plasma catecholamines, plasma free fatty acids, and blood glucose within the first 1 to 2 hours of onset of symptoms. 3 Recent attention has focused on the possible adverse effects of hyperglycemia, 4 now thought to have adverse effects in its own right, such as formation of oxygen free radicals 5 and consequent adverse inflammatory response.…”

mentioning

confidence: 99%

Metabolic Management of Acute Myocardial Infarction Comes to the Fore and Extends Beyond Control of Hyperglycemia

Opie

2008

Circulation

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“…Fifteen mongrel dogs that weighed [19][20][21][22][23][24][25][26][27][28][29][30][31][32] vard infusion pump at a rate of 0.6 ml/min. Based on a flow of approximately 25 ml/min, this infusion rate would raise serum potassium concentration and presumably the extracellular potassium concentration in the myocardium perfused by the LAD to approximately 30 mEq/ 1, which would make this region electrically inexcitable.…”

Section: Methods Experimental Preparationmentioning

confidence: 99%

Contractile reserve and left ventricular function in regional myocardial ischemia in the dog.

Yoran¹,

Sonnenblick²,

Kirk³

1982

Circulation

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SUMMARY Contractile activity remaining in a region made ischemic by acute occlusion of the left anterior descending coronary artery (LAD) was assessed in dogs relative to its role in maintaining left ventricular (LV) function. Compensatory increases in contractility of normal myocardium were eliminated by treating all dogs with reserpine (3 mg/kg) to deplete their catecholamine stores. LV function was determined by measuring stroke volume while increasing the LV filling pressure with a shunt from the aorta to left atrium. Heart rate and mean aortic pressure were kept constant. LV function was studied after occlusion of the LAD alone and after the selective infusion of potassium chloride (1 mEq/ml) into the LAD to raise the regiotal extracellular potassium concentration to 30 mEq/mi. The reduction in LV function induced by LAD ligation was less than the reduction caused by abolishing contraction in the entire zone supplied by the LAD with infusion of potassium. The WHEN a coronary artery is occluded abruptly, loss of segmental shortening in the region of myocardium fed by this artery is generally observed. However, some collateral coronary blood flow remains and residual contractile function may remain in the region. The role of such contractile activity remaining in a region made ischemic by occlusion of a coronary artery on the overall function of the left ventricle has not been defined. Further, the relation between the size of the ischemic area and the extent of reduction in overall left ventricular (LV) function has not been precisely determined. When regional myocardial ischemia is induced, LV function is affected by the lateral dimensions of the ischemic region, the distribution of contractile activity transmurally in this region as determined by the remaining collateral coronary blood flow, the compliance of the ischemic zone, and compensatory increases in contractility in nonischemic zones of myocardium resulting from augmented sympathetic tone. This may explain the marked variation in the reported observations on this subject. '-9 We studied the effects of regional myocardial ischemia and total cardioplegia. The effects of involving varying amounts of the ventricle on overall LV function were also examined. stores.'0 This was done to abolish the compensatory increase in contractility that may occur in the nonischemic myocardium after coronary artery ligation.Dogs were anesthetized with sodium pentobarbital (30 mg/kg i.v.). Additional pentobarbital was administered as required to maintain anesthesia. After intubation with a cuffed endotracheal tube, dogs were ventilated with an intermittent positive pressure respiratory with 100% oxygen. A thoracotomy was performed in the fifth intercostal space and the heart was exposed by incising the pericardium. The left anterior descending coronary artery (LAD) was isolated and ligated 3-20 mm from its origin to vary the size of the ischemic region.After ligation of the LAD, a cannula was inserted distal to the occlusion and perfusion was continued through a pol...

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Free Noradrenaline and Adrenaline Excretion in Relation to the Development of Cardiac Arrhythmias and Heart-Failure in Patients With Acute Myocardial Infarction

Cited by 191 publications

References 18 publications

Prognostic significance of acute systolic hypertension after myocardial infarction.

Prognostic significance of acute systolic hypertension after myocardial infarction.

Metabolic Management of Acute Myocardial Infarction Comes to the Fore and Extends Beyond Control of Hyperglycemia

Contractile reserve and left ventricular function in regional myocardial ischemia in the dog.

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