The hemodynamic response of man to nor-epinephrine and epinephrine and its relation to the problem of hypertension

Goldenberg, Marcel; Pines, Kermit L.; Baldwin, Eleanor de F.; Greene, David G.; Roh, Charles E.

doi:10.1016/0002-9343(48)90158-2

Cited by 449 publications

(116 citation statements)

References 29 publications

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“…This phenomenon resembled that noted in a recent investigation of intravenous epinephrine in this laboratory (13). Barcroft (18) and Goldenberg (12) also found a definite slowing of the pulse rate in normotensive subjects receiving infusions of l-nor-epinephrine. However, in some hypertensive patients, Goldenberg found an increase in pulse rate as well as in cardiac output, which he attributed to emotional factors sufficient to cause the endogenous release of epinephrine, a known antagonist to nor-epinephrine.…”

Section: Discussionsupporting

confidence: 88%

“…Goldenberg and his co-workers have suggested that hypertensive patients after the administration of 1-nor-epinephrine have a greater response in the systolic and mean arterial pressures than do normotensive subjects (12). In the present study no increased sensitivity to the pressor effects of l-nor-epinephrine could be demonstrated in preoperative hypertensive patients, as contrasted with normotensive sul)jects.…”

Section: Discussioncontrasting

confidence: 53%

“…In a hemodynamic study in man Goldenberg and his co-workers found that the vasoconstrictor effects produced by intravenous l-nor-epinephrine were blocked by equal doses of intravenous epinephrine (12). They found that in normotensive subjects 1-nor-epinephrine produced a hypertension similar to "essential hypertension" with an increase in total peripheral resistance, but no change in cardiac output.…”

Section: Introductionmentioning

confidence: 99%

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The Comparative Effects of Small Intravenous Doses of L-Nor-Epinephrine Upon Arterial Pressure and Pulse Rate in Nor-Motensive Subjects and in Hypertensive Patients Before and After Thoracolumbar Sympathectomy

Judson¹,

Epstein²,

Wilkins³

1950

J. Clin. Invest.

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Section: Discussionsupporting

confidence: 88%

Section: Discussioncontrasting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Comparative Effects of Small Intravenous Doses of L-Nor-Epinephrine Upon Arterial Pressure and Pulse Rate in Nor-Motensive Subjects and in Hypertensive Patients Before and After Thoracolumbar Sympathectomy

Judson¹,

Epstein²,

Wilkins³

1950

J. Clin. Invest.

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“…We conclude the following: 1) dopamine, [5][6][7][8][9][10][11][12][13][14][15] Ag/kg/min; dobutamine, 5-15 ,ug/kg/min; and epinephrine, 0.04 ,ug/kg/min, all are suitable for inotropic support during emergence from cardiopulmonary bypass, to produce increases in cardiac index at constant left atrial pressures, small increases in heart rate, and no severe arrhythmias; 2) dopamine appears about twice as potent as dobutamine for this purpose, although dobutamine appears to be more cardioselective; 3) considerable variance in individual patient responses should be expected. It is recommended that cardiac performance during the period immediately following bypass is best assessed by serial measurements of cardiac output.…”

Section: Cardiac Index Increases Observed In This Studymentioning

confidence: 95%

Efficacy of dopamine, dobutamine, and epinephrine during emergence from cardiopulmonary bypass in man.

Steen¹,

Tinker²,

Pluth³

et al. 1978

Circulation

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In this study, our objectives were twofold: first, to provide a comparison of the effects of three inotropic agents (dobutamine, dopamine, and epinephrine) during the period immediately following emergence from cardiopulmonary bypass; and second, to make recommendations regarding appropriate methods of monitoring the efficacy of inotropic drug administration in this specific situation. MethodsThirty-four patients were studied, usually with two of the three drugs in each patient. Dopamine and dobutamine were usually studied in two infusion rates, epinephrine in one infusion rate. This resulted in 56 patient-inotropic drug exposures, and a total of 81 inotropic drug dosages. Patients were studied who had documented evidence of left ventricular dysfunction preoperatively, based upon review of catheterization data and history/physical exam. Elevated left ventricular end diastolic pressure ( > 15 torr), ventricular hypokinesia, and/or ejection fraction < 50% were present. All patients were New York Heart Association functional class III or IV. Twenty-three underwent valve replacement, seven had coronary artery bypass grafting, and four had both. Table 1 summarizes patient data.From the

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“…15 -16 Elevated arterial blood pressure responses to injected catecholamines have been well documented in human essential hypertension. 15 l7 - l8 Results from vascular studies in the SHR, an animal model of essential hypertension, have been far less consistent. Some workers have reported equal or decreased responses to catecholamines, 16 l9 -M while others have demonstrated increased responses.…”

mentioning

confidence: 99%

Microvascular pressure, flow, and resistance in spontaneously hypertensive rats.

Roy¹,

Mayrovitz²

1984

Hypertension

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SUMMARY Microvascular resistance (MVR), determined as the ratio of the second-order arteriolar blood pressure (servo-null method) to blood flow (dual-slit), was assessed in the cremaster muscle preparation of 7-to 8-week-old normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR). The MVR was used as an index of resistance during 1) control conditions; 2) superfusion of graded concentrations of the catecholamine norepinephrine (NE; WKY n = 8, SHR n = 8); 3) superfusion with NE and in the presence of a fixed concentration of the vasodilator sodium nitroprusside (NP; 10~5 M); and 4) superfusion with the noncatecholamine phenylephrine (PE; WKY n = 8, SHR n = 9). The vasoconstrictor challenges were carried out to determine if there was any differential vascular sensitivity between the hypertensive and nonhypertensive rats to the exposure of an endogenous-like constrictor possessing a catechol nucleus as opposed to a strictly synthetic analog. The presence of NP was employed to assess the degree of vasoconstriction normally present under control conditions. The combination of NE and NP was used to test for a differential vasoconstrictor sensitivity, beginning from maximally dilated conditions. The MVR, assessed at the second-order arteriolar level, represents approximately 35% of the total resistance of the skeletal muscle and is intimately involved in maintaining proper end-organ perfusion pressure. The microvascular resistance of the SHR group was almost four times greater than that of the WKY group under control conditions. Maximum vasodilation with topical NP reduced the MVR in both groups, but the SHR microvascular resistance remained two times greater than that found in the WKY. The SHR had greater MVR responses following challenge with both NE and PE and also in the presence of NP during NE challenge. The conclusions are: 1) the microvascular resistance of the SHR is elevated under control conditions due to structural modifications of the vasculature and exacerbated following constrictor challenge as a result of heightened vasoconstrictor sensitivity; and 2) the elevated MVR in the SHR is not due to a simple arterial vasoconstriction that can be totally eliminated with vasodilation. (Hypertension 6: 877-886, 1984) KEY WORDS • essential hypertension • microcirculation vascular resistance • spontaneously hypertensive rat T HE complete etiology of essential hypertension is unknown, but it probably involves an interplay between cardiac and peripheral vascular factors.1 " 3 Hypertension as exhibited by the spontaneously hypertensive rat (SHR) is associated with a relatively normal cardiac output (CO), 4 " 6 although the cardiac index has been found to be elevated. 6 This normal CO in both young and mature SHR mirrors the cardiac hemodynamics generally found in human patients with established essential hypertension.

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The hemodynamic response of man to nor-epinephrine and epinephrine and its relation to the problem of hypertension

Cited by 449 publications

References 29 publications

The Comparative Effects of Small Intravenous Doses of L-Nor-Epinephrine Upon Arterial Pressure and Pulse Rate in Nor-Motensive Subjects and in Hypertensive Patients Before and After Thoracolumbar Sympathectomy

The Comparative Effects of Small Intravenous Doses of L-Nor-Epinephrine Upon Arterial Pressure and Pulse Rate in Nor-Motensive Subjects and in Hypertensive Patients Before and After Thoracolumbar Sympathectomy

Efficacy of dopamine, dobutamine, and epinephrine during emergence from cardiopulmonary bypass in man.

Microvascular pressure, flow, and resistance in spontaneously hypertensive rats.

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