Experimental and clinical study of catecholamine-induced hypokalemia in acute myocardial infarction

Adrenaline infusion to 8 rabbits led to remarkable dose-dependent hypokalemia; 2 of them died of ventricular arrhythmia (VA) with severe hypokalemia. In 6 rabbits with i.v. propranolol beforehand, no hypokalemia occurred after adrenaline infusion. Plasma catecholamines (CA) in 26 patients with AMI were greatly elevated at admission, 73% of relative hypokalemia (plasma potassium decreased to greater than or equal to 0.3 mmol/L) and a significant lowering of intraerythrocytic rate of Na/K were noted. These findings were inversely correlated with adrenaline. According to the multivariate analysis, both high level of plasma adrenaline and hypokalemia were responsible for VA in early AMI. The mechanism of CA-induced hypokalemia and its implications in AMI were discussed in detail.