Plasma Catecholamines and Ischemic Heart Disease

Abstract

SummaryPlasma levels of norepinephrine and epinephrine were measured in 84 patients aged 56 ± 9 (mean ± SD) years with chronic ischemic heart disease (IHD), anterior acute myocardial infarction (AMI), posterior AMI, acute or chronic IHD associated with various types of electrical instability and in the control subjects. During the first day of hospitalization, plasma epinephrine levels were higher in patients with AMI in both localizations and chronic IHD in comparison with control values. There were no significant differences in plasma epinephrine levels among these groups of patients. However, in the same time period, plasma norepinephrine concentrations in patients with chronic IHD and posterior AMI did not differ from the control values; in patients with anterior AMI they reached by ∼ 60% higher values than in the control group. Moreover, all myocardial lesions showing different types of electrical instability were associated with increased plasma levels of both norepinephrine and epinephrine. In conclusion, high plasma levels of epinephrine may result from sympathoadrenal activation. High plasma levels of norepinephrine in patients with anterior AMI and no change in patients with posterior AMI suggest a rather myocardial than an extramyocardial origin of plasma norepinephrine level in anterior AMI. Norepinephrine released from the ischemic area might contribute to the electrical instability of the myocardium and generation of dysrrhythmias.

Beta1-Adrenoceptor Polymorphism Predicts Flecainide Action in Patients with Atrial Fibrillation

“…Compared to more healthy subjects we noticed a poorer cardioversion rate in population with organic heart diseases despite the expected higher susceptibility to flecainide due to elevated catecholamine concentrations in these patients [1], [2], [25], [26]. But contrarily, diseased cardiomyocytes promote AF due to complex electrical and structural remodeling [27], [28], [29], [30].…”

Circulating primers enhance platelet function and induce resistance to antiplatelet therapy

“…S1). As IGF-1, TPO and epinephrine levels are elevated in various disease states [22,34,35,[48][49][50] and in patients who present with CHD [31][32][33][34]36,37], we wanted to evaluate their potential contribution to antiplatelet drug resistance. Platelets were pretreated with ASA, ARC or ASA/ARC in the presence or absence of primers ( Fig.…”

“…Furthermore, coronary heart disease (CHD) patients have been found to have significantly higher serum concentrations of IGF-1, a feature that is believed to contribute to coronary atherosclerosis [31,32]. TPO is another common factor that has been found to be elevated in conditions associated with coronary artery disease, such as unstable angina [33,34], and epinephrine levels are increased in patients presenting with hypertension [35], and ischemic heart disease [36,37]. Elevated levels of these circulating primers may therefore contribute to platelet hyperactivity and, consequently, to the resistance to antiplatelet compounds demonstrated in a population of patients with ACS.…”

Simultaneous determination of plasma epinephrine and norepinephrine using an integrated strategy of a fully automated protein precipitation technique, reductive ethylation labeling and UPLC–MS/MS

“…Simultaneous determination of systemic changes in levels of catecholamines such as epinephrine (E) and norepinephrine (NE) in animal models is an important step in the process of discovery and evaluation of new drugs in many disease areas such as diabetes, heart disease, pain, anxiety, and other neurological disorders [1][2][3][4]. For example, systemic changes in these catecholamines represent a counter regulatory response induced by hypoglycemia, which is helpful for understanding diabetes [5].…”