Related Experiment Video

Updated: Aug 14, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
06:39

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

Assessment of myocardial sympathetic activity in coronary heart disease

M C Michelet, B Lasserre, E Mievis

    Cardiology
    |January 1, 1981
    PubMed

    Insights

    In patients with coronary artery disease, pacing increased adrenaline and noradrenaline levels. The heart extracts adrenaline and releases noradrenaline, with these changes unaffected by pacing or propranolol.

    Area of Science:

    • Cardiology
    • Neuroendocrinology
    • Biochemistry

    Background:

    • Coronary artery disease (CAD) impacts cardiac function and neurohormonal regulation.
    • Understanding catecholamine dynamics in the heart is crucial for managing CAD.
    • Adrenaline, noradrenaline, and dopamine beta-hydroxylase play key roles in cardiovascular stress responses.

    Purpose of the Study:

    • To investigate the release and extraction of catecholamines (adrenaline and noradrenaline) by the heart in patients with CAD.
    • To determine the effect of pacing-induced ischemia on cardiac catecholamine metabolism.
    • To assess the influence of propranolol on these neurohormonal responses during ischemia.

    Main Methods:

    • Measurement of adrenaline, noradrenaline, and dopamine beta-hydroxylase concentrations in arterial and coronary sinus blood.
    • Analysis of blood samples at rest and during pacing-induced ischemia in 14 CAD patients.
    • Administration of propranolol to evaluate its effect on catecholamine levels and cardiac release/extraction.

    Main Results:

    • Pacing significantly increased arterial and coronary sinus concentrations of adrenaline and noradrenaline.
    • The heart demonstrated extraction of adrenaline and release of noradrenaline, independent of pacing.
    • Propranolol did not alter these arteriovenous differences during pacing-induced ischemia.
    • Dopamine beta-hydroxylase levels showed no significant change, except for a release from the heart during pacing after propranolol administration.

    Conclusions:

    • Cardiac sympathetic activity and circulating catecholamines are elevated during ischemia in CAD patients.
    • The heart acts as a site for adrenaline extraction and noradrenaline release, a function largely preserved during pacing-induced ischemia.
    • Propranolol's effects on cardiac catecholamine handling in this context require further investigation.

    More Related Videos

    Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

    Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

    Published on: February 3, 2021

    Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm06:18

    Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm

    Published on: September 17, 2021

    Related Concept Videos

    Pathophysiology of Cardiac Performance01:29

    Pathophysiology of Cardiac Performance

    Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
    Acute Coronary Syndrome I: Introduction01:30

    Acute Coronary Syndrome I: Introduction

    Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
    Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

    Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

    The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
    Acute Coronary Syndrome III: Diagnostic Studies01:30

    Acute Coronary Syndrome III: Diagnostic Studies

    Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
    Acute Coronary Syndrome V: Nursing Management01:26

    Acute Coronary Syndrome V: Nursing Management

    Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
    Angina III: Clinical Manifestations and Assessment01:29

    Angina III: Clinical Manifestations and Assessment

    Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...