| Silent ischemia in unstable angina is related to an altered cardiac norepinephrine handling. | |
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MedLine Citation:
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PMID: 8504506 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Inferential evidence suggests that silent ischemia might be related to sympathetic activity. Study of [3H]norepinephrine kinetics is a suitable tool to assess the regional sympathetic activity. This method was applied to investigate whether silent myocardial ischemia in unstable angina is related to and depends on cardiac sympathetic overactivity. METHODS AND RESULTS: Patients with active unstable angina were compared with patients with inactive unstable angina, stable effort angina, and controls. Silent myocardial ischemia was evaluated by three 24-hour Holter monitoring periods on alternate days, and [3H]norepinephrine kinetics was assessed under rest conditions and following the cold pressor test. Simultaneously, catecholamine concentrations were measured in the aortic, coronary sinus, and peripheral venous blood. Different than the other groups (p = 0.0013), in patients with active unstable angina, the majority of silent ischemic episodes occurred without increase in heart rate. These patients had a positive coronary sinus-aorta norepinephrine gradient, both at rest and following the cold pressor test. [3H]Norepinephrine kinetics demonstrated an increased selective cardiac spillover, both at rest and, even more, after the cold pressor test. Reduced cardiac [3H]norepinephrine extraction also was found. A significant relation was found between the number of ischemic episodes or the overall duration of silent ischemia and norepinephrine spillover, both at rest and following cold application. CONCLUSIONS: During the acute phase of unstable angina (but not in the quiescent phase or in stable effort angina), a disorder in cardiac norepinephrine handling occurs. This results in a reflex cardiac sympathetic overactivity that plays a major role in the occurrence of silent myocardial ischemia. |
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Authors:
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G G Neri Serneri; M Boddi; L Arata; C Rostagno; P Dabizzi; M Coppo; M Bini; S Lazzerini; A Dagianti; G F Gensini |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 87 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1993 Jun |
Date Detail:
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Created Date: 1993-07-02 Completed Date: 1993-07-02 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1928-37 Citation Subset: AIM; IM |
Affiliation:
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Center for Heart and Thrombosis Research, University of Florence, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angina, Unstable
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physiopathology* Cold Temperature / diagnostic use Electrocardiography, Ambulatory Female Heart / innervation* Humans Male Middle Aged Myocardial Ischemia / diagnosis, etiology* Norepinephrine / diagnostic use, metabolism* Sympathetic Nervous System / physiopathology* Tritium / diagnostic use |
| Chemical | |
Reg. No./Substance:
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10028-17-8/Tritium; 51-41-2/Norepinephrine |
| Comments/Corrections | |
Comment In:
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Circulation. 1994 Apr;89(4):1905-6
[PMID:
8192772
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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