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Coffee, catecholamines and cardiac arrhythmia.

A Wennmalm1, M Wennmalm

  • 1Department of Clinical Physiology, University of Göteborg, Sahlgrenska Hospital, Sweden.

Clinical Physiology (Oxford, England)
|June 1, 1989
PubMed
Summary

Methylxanthines like aminophylline can increase noradrenaline release in the heart. This effect is amplified in patients with ischaemic heart disease, potentially explaining cardiac events linked to these substances.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Neuroscience

Background:

  • High noradrenaline release in the heart is linked to cardiac arrhythmia.
  • Aminophylline administration can trigger ventricular arrhythmias in patients with ischaemic heart disease.

Purpose of the Study:

  • To investigate the mechanism by which methylxanthines may induce cardiac events, particularly in the context of ischaemic heart disease.
  • To explore the role of hypoxia in amplifying methylxanthine-induced noradrenaline release.

Main Methods:

  • Review of existing animal and human data on methylxanthine effects on sympathetic neurotransmitter release.
  • Analysis of the impact of impaired myocardial oxygenation on this process.

Main Results:

  • Methylxanthines (aminophylline, caffeine, theophylline) facilitate noradrenaline release from sympathetic nerve endings.
  • This facilitation is significantly amplified under conditions of impaired myocardial oxygenation.

Conclusions:

  • Hypoxia-induced facilitation of sympathetic noradrenaline release by methylxanthines is a potential mechanism for cardiac events in ischaemic heart disease.
  • This mechanism may explain reported associations between methylxanthine consumption (e.g., coffee) and adverse cardiac outcomes like sudden cardiac death.

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