[The heart and catecholamines from the viewpoint of the adaptive-trophic function of the sympathetico-adrenal system]

Basal excretion of DOPA, dopamine, noradrenaline and adrenalin and its variation in response to oral administration of L-DOPA, a catecholamine precursor, were measured in 491 patients with essential hypertension, cardiomyopathy and myocardial infarction to assess catecholamine synthesis reserves at the systemic level. It is suggested that the development and progress of these diseases is associated with initial activation of the system, accompanied by increased noradrenaline release, which is followed by a gradual decrease in mediator synthesis reserves. The physiologic noradrenaline/adrenalin constant hypothesis, based on clinical and experimental evidence, is supported by the results of catecholamine studies in the heart and the central nervous system in cases of sudden human cardiac death, demonstrating an abrupt drop in noradrenaline. A conclusion is made that adaptive-trophic adrenosympathetic function is linked with biochemical events maintaining noradrenaline content within a normal range.