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PubMed1983

Electroconvulsive treatment and lithium carbonate. Their effects on norepinephrine metabolism in patients with primary, major depressions.

Effects of electroconvulsive treatment (ECT) and lithium carbonate on norepinephrine metabolism were investigated in eight patients with primary, major depressions. A series of 12 ECTs reduced urinary norepinephrine and normetanephrine output significantly, and showed a tendency to reduce urinary vanillylmandelic acid output as well as whole-body norepinephrine turnover. Treatment with lithium carbonate significantly reduced urinary norepinephrine, normetanephrine, 3-methoxy-4-hydroxyphenylglycol, and vanillylmandelic acid output as well as whole-body norepinephrine turnover. These findings point to a common effect of antidepressant treatments since they are similar to results produced by administration of three other types of antidepressant drugs: clorgiline, a specific monoamine oxidase A inhibitor; desipramine, a relatively specific norepinephrine reuptake Inhibitor; and zimelidine, a relatively specific serotonin reuptake Inhibitor. These drugs reduce total production of norepinephrine and/or its major metabolites in depressed patients. Thus, five antidepressant treatments with different mechanisms of action have a common overall effect on the system.

Brompheniramine↗

PubMed1992

Urinary excretion of catecholamines and their metabolites in relation to circulating catecholamines. Six-hour infusion of epinephrine and norepinephrine in healthy volunteers.

Some depressed patients have been shown to excrete abnormal amounts of catecholamines and their metabolites in urine. Some studies suggest that hypersecretion of epinephrine by the adrenals and of norepinephrine by the peripheral sympathetic system cause increased excretion of urinary catecholamines and their metabolites in a subgroup of patients. To evaluate the effect of increased catecholamine levels in the peripheral circulation on urinary catecholamine and metabolite levels, we infused healthy volunteers during 6 hours with epinephrine, norepinephrine, or placebo, respectively, in a three-period, double-blind, crossover design. The results indicate that (1) urinary epinephrine and norepinephrine levels were the most sensitive indicators of increased circulating epinephrine and norepinephrine levels, respectively; (2) changes in circulating epinephrine or norepinephrine levels were not readily reflected in changes in urinary vanillylmandelic acid or 3-methoxy-4-hydroxyphenylglycol levels; and (3) increased normetanephrine excretion was not only induced by infusion of norepinephrine but also by epinephrine. This last finding may be due to activation of the sympathetic nervous system by circulating epinephrine. These results may help to explain the mechanism of adrenal epinephrine and sympathetic nervous system norepinephrine hypersecretion observed in subgroups of depressed patients.

Adult↗

PubMed1994

Comparison of the lipolytic effects of norepinephrine and BRL 37344 in rat brown and white adipocytes.

The lipolytic effects of norepinephrine (a non-selective beta-agonist) and BRL 37344 (a selective beta3-agonist) were compared in isolated rat brown and white adipocytes. Norepinephrine and BRL 37344 maximally stimulated lipolysis in brown and white adipocytes, approximately 10 times above basal values. However, adipocyte sensitivity for BRL 37344 was greater than that for norepinephrine, particularly in brown adipocytes [the EC50 values (nM) for BRL 37344 and norepinephrine were 5 +/- 1 and 103 +/- 31 in brown adipocytes (P < 0.01) versus 56 +/- 9 and 124 +/- 17 in white adipocytes (P < 0.05), respectively]. On the other hand, the lipolytic effects of norepinephrine were totally blocked by 20-40 times superior concentrations of propranolol or bupranolol in brown as well as in white adipocytes. In contrast, the lipolytic effects of BRL 37344 were fully inhibited by concentrations of propranolol or bupranolol that were 200-1000 superior to the beta3 agonist concentration. The results demonstrate that: (1) the beta3-agonist BRL 37344 is as effective as norepinephrine for maximally stimulating lipolysis in rat brown and white adipocytes, (2) both adipocyte types are more sensitive to the lipolytic effects of BRL 37344 than to those of norepinephrine, (3) although bupranolol is a better antagonist than propranolol on BRL 37344-stimulated lipolysis, it cannot be considered as a specific beta3-antagonist, (4) brown adipocytes are 10 times more sensitive than white adipocytes to the lipolytic effects of BRL 37344, suggesting an important role of beta3-receptors in brown adipose tissue.

Adipocytes↗

PubMed1995

Local and systemic phentolamine antagonism of norepinephrine-induced hand vein constriction.

The dorsal hand vein distention technique has been used to study the effects of alpha-adrenergic receptor antagonists on alpha-agonist-induced venoconstriction. Using this technique, we investigated the dose-effect relationships between different intravenous routes of phentolamine (an alpha-antagonist) administration on norepinephrine (an alpha-agonist)-induced hand vein constriction. Hand vein studies were done on healthy men; each man was studied on up to four occasions. On one occasion for each man, graded doses of phentolamine were infused into a hand vein preconstricted (submaximally) with norepinephrine. The dose of phentolamine producing a half maximal response (ED50) for reversal of venoconstriction, and the maximal reversal were calculated. On the other three occasions (randomly allocated) for each man, graded doses of norepinephrine were infused into a hand vein before and during intravenous infusions of (1) control (vehicle solutions); (2) systemic (other arm vein) phentolamine; and (3) local (hand vein) phentolamine. Systemic and local phentolamine dose ratios (ED50 of norepinephrine during phentolamine, divided by ED50 of norepinephrine before phentolamine; divided by the control dose ratio) were calculated. These studies show that phentolamine (administered directly into a preconstricted hand vein) can completely reverse norepinephrine-induced venoconstriction. Phentolamine, administered by either local or systemic intravenous infusion, induces a significant rightward shift (approximately 10-fold) in responsiveness to norepinephrine-induced venoconstriction. To achieve comparable degrees of alpha-antagonism, however, systemic phentolamine must be administered intravenously at a dose approximately 3,000-fold higher than that of local phentolamine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1985

Cyclazocine and norepinephrine uptake, metabolism, and turnover in the rat brain.

The effects of cyclazocine, a narcotic agonist/antagonist, on the uptake, metabolism, and turnover of norepinephrine in rat brains were studied. Cyclazocine significantly depressed the accumulation of intracisternally administered [3H]norepinephrine and the formation of 3,4-[3H]dihydroxymandelic acid but did not alter the formation of [3H]-normetanephrine. Comparatively, imipramine reduced the uptake of [3H]norepinephrine, decreased the formation of 3,4-[3H]dihydroxymandelic acid, and increased the formation of [3H]normetanephrine. Moreover, cyclazocine increased the formation of endogenous 3-methoxy-4-hydroxyphenylethylene glycol and produced a fall in endogenous norepinephrine. It is suggested that cyclazocine reduces the accumulation of [3H]norepinephrine, decreases endogenous norepinephrine levels, and increases the formation of 3-methoxy-4-hydroxyphenylethylene glycol by interacting with brain adrenergic nerves, presumably by inhibiting neuronal uptake and facilitating norepinephrine turnover.

Animals↗

PubMed1988

Norepinephrine stimulation of adenylate cyclase potentiates protein kinase C action: electrophysiological studies in the dentate gyrus.

Protein kinase C and norepinephrine-stimulated adenylate cyclase have been linked to formation of long-term potentiation in the dentate gyrus. However, little is known about second messenger system interactions regulating synaptic transmission. In electrophysiological studies of the dentate gyrus, we observe synergistic interactions between norepinephrine and phorbol esters, activators of protein kinase C. Norepinephrine markedly potentiates the block of adenosine's inhibitory action by phorbol esters. Norepinephrine's action is mimicked by the beta-adrenoceptor agonist isoproterenol and blocked by the beta-adrenoceptor antagonists timolol and propranolol. Forskolin also mimicks norepinephrine's action. Accordingly, norepinephrine's potentiation of protein kinase C appears to be mediated by the cyclic AMP second messenger system. This mechanism may contribute to norepinephrine's facilitation of long-term potentiation in the dentate gyrus.

Adenylyl Cyclases↗

PubMed1997

Norepinephrine-induced expression of the K99 pilus adhesin of enterotoxigenic Escherichia coli.

This study examined whether the provision of norepinephrine, as would be encountered within the highly innervated gastrointestinal system, affected the growth rate of enterotoxigenic Escherichia coli (ETEC) and the expression of the K99 pilus adhesin virulence-related factor. The addition of norepinephrine to serum-containing medium resulted in a 3- to 7-fold increase in the growth rate of the K99+ ETEC strain B44 as compared to growth in vehicle supplemented medium or medium supplemented with normetanephrine, a norepinephrine metabolite that contains one more methyl group than norepinephrine. ELISA analysis revealed that K99 pilus adhesin expression was increased in norepinephrine supplemented culture as compared to normetanephrine and vehicle supplemented controls. This increase occurred from 9 to 15 hours of incubation which represented the exponential growth phase for the norepinephrine supplemented culture. These results indicate that addition of norepinephrine affects both ETEC growth and expression of a specific virulence factor.

Adhesins, Bacterial↗

PubMed1991

Propranolol and atenolol inhibit norepinephrine spillover rate into plasma in conscious spontaneously hypertensive rats.

Radiotracer techniques capable of measuring norepinephrine clearance and spillover rate into plasma were used to test the hypothesis that the antihypertensive effects of propranolol and atenolol in conscious spontaneously hypertensive rats are associated with an inhibition of norepinephrine release from postganglionic sympathetic neurons. The 10%-15% fall in mean arterial pressure produced over 4 h by propranolol (1, 3.3 and 10 mg/kg, s.c.) and atenolol (1, 3.3 and 10 mg/kg, s.c.) was not dose-related, and only the largest dose of propranolol caused a significant bradycardia. Each dose of atenolol significantly lowered heart rate. The decrease in blood pressure caused by propranolol and atenolol was not related to the decrease in heart rate. Both propranolol and atenolol inhibited norepinephrine clearance by 12% to 16%. The 1 mg/kg doses of propranolol and atenolol significantly suppressed norepinephrine spillover rate by 21% and 32%, respectively, at 4 h postinjection. As the dose of propranolol was increased, the inhibition of norepinephrine spillover was reversed as plasma epinephrine concentration rose by 125%. The suppression of norepinephrine spillover rate caused by atenolol was more persistent but did diminish after the 10 mg/kg dose, when plasma epinephrine concentration was elevated by 55%. Both drugs suppressed plasma renin concentration, but the inhibition of norepinephrine spillover rate by propranolol and atenolol was not related to the fall in plasma renin concentration. By comparison, treatment with the adrenergic neuron blocking agent bretylium (5, 10, 20 and 40 mg/kg, s.c.) elicited a dose-related vasodepression with no change in heart rate or plasma renin concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗

PubMed1991

Excitatory and inhibitory effects of norepinephrine on myenteric neurons of the guinea-pig gastric corpus.

The effects of norepinephrine on the electrical and synaptic behaviour of gastric myenteric neurons were investigated in vitro by using conventional intracellular recording methods. Application of norepinephrine (0.1-10 microM) evoked an excitatory effect in 40% of all cells tested. Excitation consisted of a depolarization of the membrane potential associated with increased spike discharge. Phentolamine or prazosin reversibly abolished and (-)phenylephrine mimicked the excitatory norepinephrine response. Yohimbine and clonidine had no effect. Focal electrical stimulation of interganglionic fibre tracts evoked fast excitatory postsynaptic potentials (fEPSPs) in all neurons. Only a minority of these fEPSPs were blocked by norepinephrine. However, fEPSPs evoked by stimulating presumably extrinsic nerves were always totally blocked by norepinephrine. The inhibitory effect of norepinephrine on fEPSPs could be reversed by phentolamine and yohimbine and mimicked by clonidine. Prazosin and phenylephrine had no effect. Isoproterenol and propranolol modified neither the excitatory nor the inhibitory effects. The results indicate that the excitatory effects of norepinephrine on gastric myenteric neurons are mediated by postsynaptic alpha 1 receptors, whereas the inhibitory effects are mediated by presynaptic alpha 2 receptors, which are located presumably on vagal extrinsic nerves. There was no evidence for beta-receptor-mediated effects in gastric myenteric neurons.

Animals↗

PubMed1986

Chronic clorgyline treatment enhances release of norepinephrine following sympathetic stimulation in the rat.

Plasma catecholamine levels were determined in pithed rats during electrical stimulation of the entire sympathetic nervous system. In animals treated chronically with clorgyline (1 mg/kg daily for 21 days) the increment in plasma norepinephrine concentration during stimulation was greater than in control animals, whereas a single dose of clorgyline (2 mg/kg 2 h before pithing), which produced the same degree of inhibition of arterial MAO type A and a similar increase in arterial norepinephrine content, had no effect on the plasma norepinephrine response to stimulation. Injection of yohimbine (1 mg/kg) produced the same degree of enhancement of plasma norepinephrine response to stimulation in chronically treated and control animals, showing that the overall gain of the alpha 2-adrenoceptor inhibitory loop in vascular sympathetic nerves was not affected. Plasma epinephrine concentration during electrical stimulation was also increased by chronic but not by acute clorgyline treatment. Chronic clorgyline treatment did not significantly affect the total systemic metabolic clearance rate of infused norepinephrine, thus the increased plasma norepinephrine response to stimulation reflects an increased release rate from sympathetic neurons. In rats treated chronically with clorgyline, the pressor response to norepinephrine in the presence of yohimbine (0.3 mg/kg) was significantly reduced, whereas the pressor response to guanabenz was unchanged. There was also no change in the guanabenz-induced inhibition of the tachycardic response to electrical stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1984

Kinetics of the efflux of 3H-norepinephrine from rabbit irides.

The pigment cell dependent accumulation of 3H(-)-norepinephrine (1 mumol/l) was studied in rabbit irides. Albino irides served as controls. Neuronal uptake, deamination and O-methylation of 3H(-)-norepinephrine were reduced by desipramine, pargyline and U-0521, respectively. Both albino and pigmented irides accumulated the catecholamine from the incubation medium. At 37.5 degrees C and 120 min of incubation, tissue/medium ratios for pigmented and albino irides were 10.70 and 4.30 ml/g respectively. At 0 degrees C, the accumulation of 3H(-)-norepinephrine in the albino iris was abolished, while the pigmented iris accumulated significant amounts. The tissue/medium ratio was approximately 3 ml/g. When irides were loaded with 1 mumol/l of 3H(-)-norepinephrine for 60 min the drug distributed into four different compartments. Most of the pigment cell dependent binding was associated with compartments III and the "bound fraction". The amount bound in these compartments was 73% of total accumulation. In pigmented irides obtained from reserpine-pretreated rabbits the total binding was reduced to 64% of that in pigmented control irides. The half times for efflux from pigmented iris were 1.2 min, 10.7 min and 94.8 min, respectively, for compartments I, II, and III. Irides were loaded with 3H(-)-norepinephrine in normal physiological salt solution and rates of efflux were studied in Ca2+-free medium. In either albino or pigmented iris, the late efflux declined more slowly compared to that from the control irides. When pigmented irides were loaded with a low concentration of 3H(-)-norepinephrine, the displacement of the labeled amine was equal by each stereoisomer of norepinephrine. Results are discussed in relationship to the pigment cell-dependent uptake of the catecholamine.

Animals↗

PubMed1983

The effect of repeated electroconvulsive shock treatment and chronic lithium feeding on the release of norepinephrine from rat cortical vesicular preparations.

The effect of repeated electroconvulsive shock (ECS) treatment and chronic LiCl feeding on calcium-dependent, K+-evoked release of [3H] norepinephrine from rat cortical vesicular preparation was studied. There was no significant effect of either acute or repeated ECS treatment on [3H]norepinephrine release in cortical vesicles obtained from animals treated for either 1 or 10 days. Release of norepinephrine was examined over a range of CaCl2 concentrations. Clonidine effectively inhibited release of [3H]norepinephrine in cortical vesicles obtained from control and ECS-treated animals. K+-evoked release of [3H]norepinephrine at low (0.2 mM) and high (1.0 mM) CaCl2 concentrations was significantly increased in cortical vesicles obtained from LiCl-treated animals. Clonidine effectively inhibited release of [3H]norepinephrine in cortical vesicles obtained from both control and LiCl-fed animals. These results suggest a possible common mechanism of action of antidepressant drug therapy on presynaptic release of norepinephrine from nerve terminals.

Animals↗

PubMed1995

Sympathetic re-innervation after heart transplantation: dual-isotope neurotransmitter scintigraphy, norepinephrine content and histological examination.

Cardiac transplantation entails surgical disruption of the sympathetic nerve fibres from their somata, resulting in sympathetic denervation. In order to investigate the occurrence of sympathetic re-innervation, neurotransmitter scintigraphy using the norepinephrine analogue iodine-123 metaiodobenzylguanidine (MIBG) was performed in 15 patients 2-69 months after transplantation. In addition, norepinephrine content and immunohistochemical reactions of antibodies to Schwann cell-associated S100 protein, to neuron-specific enolase (NSE) and to norepinephrine were examined in 34 endomyocardial biopsies of 29 patients 1-88 months after transplantation. Anterobasal 123I-MIBG uptake indicating partial sympathetic re-innervation could be shown in 40% of the scintigraphically investigated patients 37-69 months after transplantation. In immunohistochemical studies 83% of the patients investigated 1-72 months after transplantation showed nerve fibres in their biopsies but not positive reaction to norepinephrine. Significant norepinephrine content indicating re-innervation could not be detected in any biopsy. It was concluded that in spite of the lack of norepinephrine content there seemed to be immunohistological and scintigraphic evidence of sympathetic re-innervation. An explanation for this contradictory finding may be the reduced or missing norepinephrine storage ability compared to the restored uptake ability of regenerated sympathetic nerve fibres.

3-Iodobenzylguanidine↗

PubMed1997

Fluoxetine increases norepinephrine release in rat hypothalamus as measured by tissue levels of MHPG-SO4 and microdialysis in conscious rats.

The selective serotonin uptake inhibitor fluoxetine (10 mg/kg i.p.) increased tissue levels of the norepinephrine metabolite 3-methoxy-4-hydroxyphenylethylene glycol sulfate (MHPG-SO4) in rat hypothalamus, indicating an increased release of norepinephrine. Microdialysis studies in conscious rats showed that fluoxetine (10 mg/kg i.p.) increased extracellular concentrations of norepinephrine as well as serotonin in the hypothalamus. In contrast, desipramine (10 mg/kg i.p.) increased extracellular concentration of norepinephrine but not serotonin in the hypothalamus. Consistent with its mechanism of being a selective serotonin uptake inhibitor, local perfusion of fluoxetine (10 microM) caused a 7-fold increase in hypothalamic extracellular serotonin and a small non-significant increase in extracellular norepinephrine. The subsequent systemic injection of fluoxetine (10 mg/kg s.c.) after local perfusion caused a 3-fold increase in extracellular norepinephrine, indicating that fluoxetine's action leading to an increase in extracellular norepinephrine was not occurring in the terminal areas of the hypothalamus but elsewhere in the brain, possibly cell bodies in the locus coeruleus.

Adrenergic Uptake Inhibitors↗

PubMed1990

Effects of norepinephrine on neonatal rat cardiocyte growth and differentiation.

Norepinephrine stimulates the growth in size of nondividing neonatal cardiocytes. During this time the neonatal cardiocyte is in a period of transition in which the cell can synthesize DNA and yet does not divide. Because the cell undergoes karyokinesis without cytokinesis the objective of this study was to determine whether the norepinephrine-induced growth in size of the neonatal cardiocyte was accompanied by an increase in a) the number of cardiocytes synthesizing DNA, b) the number of binucleate cardiocytes, and c) organized myofibrils. One- to four-d-old neonatal rat heart cells were isolated and placed in serum-free medium which was then supplemented with serum, norepinephrine, norepinephrine plus propranolol, or isoproterenol. After 4 d the number and size of the cells was determined using a Coulter counter. In other cultures cardiocytes were fixed on Days 0, 1, 2, and 4, and an increase in the number of binucleate cardiocytes was found in all treatment groups including controls. However, the rate of binucleation was faster in the norepinephrine group. It was also determined by proliferating cell nuclear antigen (PCNA) antibody staining that by Day 4, over 50% of the cardiocytes were in the cell cycle. The percentage of cells in which PCNA could be detected was higher in the norepinephrine and norepinephrine plus propranolol groups. Furthermore, there was a concomitant increase in the amount and organization of myofibrils in the catecholamine-treated cardiocytes.

Animals↗

PubMed2003

Norepinephrine for hypotensive vasodilatation after cardiac surgery: impact on renal function.

OBJECTIVES: Norepinephrine use in patients after cardiac surgery is controversial because of the fear that norepinephrine might decrease kidney function through regional vasoconstriction. Accordingly, we studied the renal effects of norepinephrine use for hypotensive vasodilatation after cardiac surgery. DESIGN AND SETTING: Retrospective controlled study in the cardiothoracic ICU of tertiary hospital. PATIENTS. 100 cardiac surgery patients with post-operative hypotensive vasodilatation and 100 control cardiac surgery patients. INTERVENTION: Treatment of hypotension (MAP<70 mmHg) with continuous norepinephrine infusion. MEASUREMENTS AND RESULTS: We collected data on demographic and surgical characteristics, haemodynamics, serum creatinine and mortality. Just after surgery the norepinephrine group had a significantly higher mean central venous pressure, lower mean arterial pressure, and lower systemic vascular resistance index with a similarly elevated mean cardiac index. Despite norepinephrine administration at a mean peak dose of 7.3+/-6.4 micro g/min the mean post-operative change in creatinine was not different between two groups on days 0, 2 or 4 after surgery. CONCLUSIONS: Norepinephrine does not increase post-operative serum creatinine concentrations in patients with hypotensive vasodilatation after cardiac surgery. Concerns related to its potential adverse effects on the kidney function in this setting appear unjustified.

Aged↗

PubMed2001

Comparison of the cerebral effects of dopamine and norepinephrine in severely head-injured patients.

OBJECTIVE: To compare the cerebral effects of dopamine and norepinephrine after severe head injury. DESIGN: Prospective, clinical study. SETTING: Surgical intensive care unit in a university hospital. PATIENTS: Nineteen patients with severe head-injuries already requiring vasopressor therapy. Group 1: patients receiving dopamine (n = 9); group 2: patients receiving norepinephrine (n = 10). INTERVENTION: Vasopressor therapy was switched from dopamine to norepinephrine in group 1 and from norepinephrine to dopamine in group 2, maintaining the same mean arterial pressure (MAP). MEASUREMENTS AND RESULTS: MAP, intracranial pressure (ICP), jugular venous oxygen saturation (SjvO2), transcranial Doppler mean velocity in the middle cerebral artery (Vm), and transoesophagal Doppler aortic output (AO) were evaluated under dopamine and norepinephrine. Means for each group were compared with the paired Student's t-test. For the same MAP, ICP was significantly higher with dopamine than norepinephrine in both groups (respectively, group 1: 26 +/- 11 vs 23 +/- 11 mmHg, P < 0.005; group 2: 39 +/- 13 vs 31 +/- 9 mmHg, P < 0.005). SjvO2, Vm, and AO did not change significantly between treatments. The ICP variation between treatments was not correlated with the variation of any other measured parameter. The ICP variation between treatments was significantly higher in group 2 than group 1, which could be explained by autoregulation mechanisms. CONCLUSIONS: For the same MAP, ICP was significantly higher with dopamine than norepinephrine with no argument supporting an increase of cerebral blood flow.

Adolescent↗

PubMed1982

Enhanced transcardiac l-norepinephrine response during cold pressor test in obstructive coronary artery disease.

An increase in cardiac sympathetic activity can enhance coronary vasomotor tone and lower the ventricular fibrillation threshold. We compared the transcardiac l-norepinephrine responses during cold pressor test of 20 patients with normal coronary arteries with those of 23 patients with obstructive coronary artery disease. Baseline hemodynamic data did not differ in the 2 patient groups except for left ventricular end-diastolic pressures; mean values (+/- standard deviation [SD] were 10 +/- 3.7 and 15 +/- 4.5 mm Hg in patients with normal and abnormal coronary arteries (p less than 0.01). Baseline l-norepinephrine contents averaged 295 +/- 152 (normal coronary arteries) and 250 +/- 134 pg/ml (coronary artery disease) in the arterial blood, and 273 +/- 152 and 250 +/- 115 pg/ml, respectively, in the coronary sinus blood. Hemodynamic responses during cold stimulus were similar in both groups. Also, cold pressor-induced increases in arterial and coronary sinus l-norepinephrine contents were balanced in patients with normal coronary arteries, averaging 19 +/- 30 and 17 +/- 37%, respectively. In patients with coronary artery disease, however, a 26 +/- 58% increase in arterial l-norepinephrine contents was associated with a 58 +/- 62% increase in coronary sinus l-norepinephrine contents (p less than 0.02), suggesting myocardial l-norepinephrine net release. It is concluded that transcardiac l-norepinephrine responses during cold stimulus are enhanced in patients with obstructive coronary artery disease. This response to a relatively mild sympathetic stress, reproducible by a variety of analogous stressful situations during daily life, could present an increased risk for acute cardiac events.

Adult↗