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Plasma catecholamines, pharmacotherapy and mood of subjects with cardiovascular disorder
S C Stanford1, P Salmon, G Mikhail
1Department of Pharmacology, University College London, UK. c.stanford@ucl.ac.uk
Insights
Drug therapy does not explain higher plasma catecholamines in heart transplant patients. Aspirin use, however, correlates with higher noradrenaline and improved mood, while other cardiac drugs link to increased tension.
Area of Science:
- Cardiology
- Pharmacology
- Psychiatry
Background:
- Patients undergoing orthotopic heart transplant (OHT) or coronary artery bypass graft (CABG) surgery exhibit higher arterial plasma catecholamine concentrations than those with heart failure (HF).
- The role of drug therapy in these observed differences in catecholamine levels remains unclear.
Purpose of the Study:
- To investigate whether drug administration explains the elevated plasma catecholamine concentrations in OHT and CABG patients compared to HF patients.
- To explore the relationship between specific drug classes and plasma catecholamine levels, as well as their impact on psychological status.
Main Methods:
- Analysis of arterial plasma catecholamine concentrations (noradrenaline and adrenaline) in patients across different cardiac conditions (OHT, CABG, HF).
- Assessment of drug regimens, including aspirin, warfarin, Ca2+-channel blockers, and 'mixed cardiac' drugs.
- Evaluation of patients' psychological status using the Profile of Mood States (POMS) questionnaire.
Main Results:
- The study found no significant association between the drug therapies investigated and the differences in plasma catecholamine concentrations between patient groups.
- Aspirin use was linked to higher plasma noradrenaline levels and a more positive mood, characterized by lower fatigue scores.
- Warfarin, Ca2+-channel blockers, and 'mixed cardiac' drugs were associated with negative mood states, specifically higher tension scores, without affecting catecholamine levels.
Conclusions:
- Drug therapy does not appear to be the primary driver for increased plasma catecholamine concentrations in OHT and CABG patients.
- Aspirin may influence noradrenaline levels and improve mood, potentially through mechanisms independent of peripheral catecholamine spillover.
- Certain cardiovascular medications, excluding aspirin, may impact psychological well-being by increasing tension, suggesting a link between peripheral-acting drugs and mood states.
Abstract:
This study investigated whether drug therapy explains why the concentration of arterial plasma catecholamines in patients who have received an orthotopic heart transplant (OHT) or coronary bypass and graft (CABG) is greater than in those with heart failure (HF). The results suggest that the differences in plasma catecholamine concentrations in these groups of patients could not be attributed to administration of any of the drugs studied here. An additional finding is that the use of aspirin is associated with a higher concentration of plasma noradrenaline, but not adrenaline. Patients who were taking aspirin also had a more positive mood, as rated by the Profile of Mood States; this was mainly because they had a lower fatigue score than did patients who were not taking this drug. In contrast, several agents (warfarin, Ca2+-channel blockers and 'mixed cardiac' drugs), which had no effects on catecholamine overspill, were linked with negative mood; this was expressed consistently as a higher tension score. These findings suggest that drugs which are administered for their effects in the periphery could also influence patients' psychological status. With the possible exception of aspirin, this does not involve changes in spillover of catecholamines in the periphery.