Urinary Excretion of Free Noradrenaline and Adrenaline Following Acute Myocardial Infarction

Valori, C; Thomas, Michael; Shillingford, John

doi:10.1016/s0140-6736(67)91033-1

Cited by 79 publications

(15 citation statements)

References 11 publications

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“…One physiological role of such a system may be to protect normal individuals from ketoacidosis during periods of great stress such as burns, severe congestive heart fail-ure, and myocardial infarction. Although these states have been associated with increased catechol output (11)(12)(13) and severe inhibition of acute insulin release (14)(15)(16), the maintenance of normal or elevated basal insulin levels appears adequate to suppress lipolysis and may account for the rarity of ketoacidosis in these conditions.…”

Section: Discussionmentioning

confidence: 99%

Epinephrine: selective inhibition of the acute insulin response to glucose

Lerner¹,

Porte²

1971

J. Clin. Invest.

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A B S T R A C T An epinephrine infusion of 6 gsg/min decreased the rapid insulin response to a 5 g glucose pulse by 96% (P < 0.001) compared with the preinfusion control. In contrast when an identical epinephrine infusion was superimposed on a prolonged glucose infusion, elevated steady-state insulin levels did not decrease, but increased from 26.9 ±6 (mean -+SD, UU/ml) to 56.8 ±15 AU/ml (P < 0.05) in parallel with the epinephrineinduced hyperglycemia. Thus epinephrine inhibition of insulin secretion was observed during acute but not chronic glucose stimulation. To evaluate further the insulin responses during a prolonged glucose infusion, a 5 g glucose pulse was given iefore and 60 min later during a concomitant epinephrine infusion. Although the acute insulin response to the first glucose pulse was observed during the elevated steady-state glucose and insulin levels associated with the glucose infusion, epinephrine again inhibited the acute insulin response to the subsequent 5 g glucose pulse by 91% (P < 0.01 ). Thus epinephrine appears to inhibit selectively the rapid insulin response to glucose but not to influence insulin output stimulated by prolonged hyperglycemia. These observations provide further evidence for a model of insulin secretion which includes a small storage pool available for immediate release to a glucose challenge and a more slowly responding pool regulating insulin secretion in the basal and steady state.

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Section: Discussionmentioning

confidence: 99%

Epinephrine: selective inhibition of the acute insulin response to glucose

Lerner¹,

Porte²

1971

J. Clin. Invest.

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show abstract

“…This accepted clinical definition (Wenckebach and Winterberg, 1927) was at variance with the electrophysiological criteria described by Lewis (1925). He agreed that the faster rhythm of the ventricle and the slower rhythm of the atria might remain independent, "for a short or long period", but he emphasized the frequent retrograde conduction from ventricle to atria: " falling with each ventricular complex is an anomalous auricular complex: it is anomalous because the course of the contraction wave in the auricle is abnormal".…”

mentioning

confidence: 97%

New look at arrhythmias.

Papp¹

1969

Heart

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“…The care and research unit at Hammersmith Hospital (Shillingford and Thomas, 1964) was designed for the study of the physiological consequences of acute myocardial infarction as well as providing facilities for immediate handling of emergencies. The factors contributing to the patient's illness and the effects of treatment have been analysed by means of continuous monitoring of the electrocardiogram (Fluck et al, 1967) and haemodynamic Shillingford and Thomas, 1967), respiratory (Valentine et al, 1966), and metabolic (Valori et al, 1967) investigations. The purpose of this paper is to present an outline of the major clinical problems encountered in the first 150 patients treated in this unit, to relate the findings to the practical use of intensive care units, and to consider some problems in the assessment of new forms of treatment.…”

mentioning

confidence: 99%