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. 1988 Aug;60(2):117–124. doi: 10.1136/hrt.60.2.117

Neuroendocrine activation after acute myocardial infarction.

H M McAlpine 1, J J Morton 1, B Leckie 1, A Rumley 1, G Gillen 1, H J Dargie 1
PMCID: PMC1216532  PMID: 3415870

Abstract

The extent of neuroendocrine activation, its time course, and relation to left ventricular dysfunction and arrhythmias were investigated in 78 consecutive patients with suspected acute myocardial infarction. High concentrations of arginine vasopressin were found within six hours of symptoms, even in the absence of myocardial infarction (n = 18). Plasma catecholamine concentrations also were highest on admission, whereas renin and angiotensin II concentrations rose progressively over the first three days, not only in those with heart failure but also in patients with no clinical complications. Heart failure, ventricular tachycardia, and deaths were associated with extensive myocardial infarction, low left ventricular ejection fraction, and persistently high concentrations of catecholamines, renin, and angiotensin II up to 10 days after admission, whereas in uncomplicated cases concentrations had already returned to normal.

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Selected References

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  1. Ader R., Chatterjee K., Ports T., Brundage B., Hiramatsu B., Parmley W. Immediate and sustained hemodynamic and clinical improvement in chronic heart failure by an oral angiotensin-converting enzyme inhibitor. Circulation. 1980 May;61(5):931–937. doi: 10.1161/01.cir.61.5.931. [DOI] [PubMed] [Google Scholar]
  2. BUCHBORN E., KOCZOREK K. R., KOHLER M., WOLFF H. P. Uber die Aldosteronaktivität und Natriumretention bei Herzkranken und ihre pathophysiologische Bedeutung. Klin Wochenschr. 1956 Nov 1;34(41-42):1105–1114. doi: 10.1007/BF01466775. [DOI] [PubMed] [Google Scholar]
  3. Bayliss J., Canepa-Anson R., Norell M. S., Poole-Wilson P., Sutton G. Vasodilatation with captopril and prazosin in chronic heart failure: double blind study at rest and on exercise. Br Heart J. 1986 Mar;55(3):265–273. doi: 10.1136/hrt.55.3.265. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Beller B. M., Trevino A., Urban E. Pitressin-induced myocardial injury and depression in a young woman. Am J Med. 1971 Nov;51(5):675–679. doi: 10.1016/0002-9343(71)90293-2. [DOI] [PubMed] [Google Scholar]
  5. Benedict C. R., Grahame-Smith D. G. Plasma adrenaline and noradrenaline concentrations and dopamine-beta-hydroxylase activity in myocardial infarction with and without cardiogenic shock. Br Heart J. 1979 Aug;42(2):214–220. doi: 10.1136/hrt.42.2.214. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Brivet F., Delfraissy J. F., Giudicelli J. F., Richer C., Legrand A., Dormont J. Immediate effects of captopril in acute left ventricular failure secondary to myocardial infarction. Eur J Clin Invest. 1981 Oct;11(5):369–373. doi: 10.1111/j.1365-2362.1981.tb01998.x. [DOI] [PubMed] [Google Scholar]
  7. Ceremuzyński L. Hormonal and metabolic reactions evoked by acute myocardial infarction. Circ Res. 1981 Jun;48(6 Pt 1):767–776. doi: 10.1161/01.res.48.6.767. [DOI] [PubMed] [Google Scholar]
  8. Cleland J. G., Dargie H. J., Ball S. G., Gillen G., Hodsman G. P., Morton J. J., East B. W., Robertson I., Ford I., Robertson J. I. Effects of enalapril in heart failure: a double blind study of effects on exercise performance, renal function, hormones, and metabolic state. Br Heart J. 1985 Sep;54(3):305–312. doi: 10.1136/hrt.54.3.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Davis J. O., Freeman R. H. Mechanisms regulating renin release. Physiol Rev. 1976 Jan;56(1):1–56. doi: 10.1152/physrev.1976.56.1.1. [DOI] [PubMed] [Google Scholar]
  10. Dzau V. J., Colucci W. S., Hollenberg N. K., Williams G. H. Relation of the renin-angiotensin-aldosterone system to clinical state in congestive heart failure. Circulation. 1981 Mar;63(3):645–651. doi: 10.1161/01.cir.63.3.645. [DOI] [PubMed] [Google Scholar]
  11. Eaton L. W., Weiss J. L., Bulkley B. H., Garrison J. B., Weisfeldt M. L. Regional cardiac dilatation after acute myocardial infarction: recognition by two-dimensional echocardiography. N Engl J Med. 1979 Jan 11;300(2):57–62. doi: 10.1056/NEJM197901113000202. [DOI] [PubMed] [Google Scholar]
  12. Erlebacher J. A., Weiss J. L., Eaton L. W., Kallman C., Weisfeldt M. L., Bulkley B. H. Late effects of acute infarct dilation on heart size: a two dimensional echocardiographic study. Am J Cardiol. 1982 Apr 1;49(5):1120–1126. doi: 10.1016/0002-9149(82)90035-2. [DOI] [PubMed] [Google Scholar]
  13. Ertl G., Kloner R. A., Alexander R. W., Braunwald E. Limitation of experimental infarct size by an angiotensin-converting enzyme inhibitor. Circulation. 1982 Jan;65(1):40–48. doi: 10.1161/01.cir.65.1.40. [DOI] [PubMed] [Google Scholar]
  14. FORSSMAN O., HANSSON G., JENSEN C. The adrenal function in coronary thrombosis. Acta Med Scand. 1952 Apr 30;142(6):441–449. doi: 10.1111/j.0954-6820.1952.tb14242.x. [DOI] [PubMed] [Google Scholar]
  15. Franciosa J. A. Long-term vasodilator therapy of chronic left ventricular failure: does it work? Int J Cardiol. 1984 Apr;5(4):433–439. doi: 10.1016/0167-5273(84)90078-0. [DOI] [PubMed] [Google Scholar]
  16. Gavras H., Kremer D., Brown J. J., Gray B., Lever A. F., MacAdam R. F., medina A., Morton J. J., Robertson J. I. Angiotensin- and norepinephrine-induced myocardial lesions: experimental and clinical studies in rabbits and man. Am Heart J. 1975 Mar;89(3):321–332. doi: 10.1016/0002-8703(75)90082-4. [DOI] [PubMed] [Google Scholar]
  17. Hock C. E., Ribeiro L. G., Lefer A. M. Preservation of ischemic myocardium by a new converting enzyme inhibitor, enalaprilic acid, in acute myocardial infarction. Am Heart J. 1985 Feb;109(2):222–228. doi: 10.1016/0002-8703(85)90587-3. [DOI] [PubMed] [Google Scholar]
  18. Jewitt D. E., Reid D., Thomas M., Mercer C. J., Valori C., Shillingford J. P. Free noradrenaline and adrenaline excretion in relation to the development of cardiac arrhythmias and heart-failure in patients with acute myocardial infarction. Lancet. 1969 Mar 29;1(7596):635–641. doi: 10.1016/s0140-6736(69)92009-1. [DOI] [PubMed] [Google Scholar]
  19. Karlsberg R. P., Cryer P. E., Roberts R. Serial plasma catecholamine response early in the course of clinical acute myocardial infarction: relationship to infarct extent and mortality. Am Heart J. 1981 Jul;102(1):24–29. doi: 10.1016/0002-8703(81)90408-7. [DOI] [PubMed] [Google Scholar]
  20. Keeton T. K., Campbell W. B. The pharmacologic alteration of renin release. Pharmacol Rev. 1980 Jun;32(2):81–227. [PubMed] [Google Scholar]
  21. McDonald L., Baker C., Bray C., McDonald A., Restieaux N. Plasma-catecholamines after cardiac infarction. Lancet. 1969 Nov 15;2(7629):1021–1023. doi: 10.1016/s0140-6736(69)90637-0. [DOI] [PubMed] [Google Scholar]
  22. McGrath B. P., Arnolda L., Matthews P. G., Jackson B., Jennings G., Kiat H., Johnston C. I. Controlled trial of enalapril in congestive cardiac failure. Br Heart J. 1985 Oct;54(4):405–414. doi: 10.1136/hrt.54.4.405. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. McKay R. G., Pfeffer M. A., Pasternak R. C., Markis J. E., Come P. C., Nakao S., Alderman J. D., Ferguson J. J., Safian R. D., Grossman W. Left ventricular remodeling after myocardial infarction: a corollary to infarct expansion. Circulation. 1986 Oct;74(4):693–702. doi: 10.1161/01.cir.74.4.693. [DOI] [PubMed] [Google Scholar]
  24. Michorowski B., Ceremuzyński L. The renin-angiotensin--aldosterone system and the clinical course of acute myocardial infarction. Eur Heart J. 1983 Apr;4(4):259–264. doi: 10.1093/oxfordjournals.eurheartj.a061457. [DOI] [PubMed] [Google Scholar]
  25. Padfield P. L., Brown J. J., Lever A. F., Morton J. J., Robertson J. I. Changes of vasopressin in hypertension: Cause or effect? Lancet. 1976 Jun 12;1(7972):1255–1257. doi: 10.1016/s0140-6736(76)91734-7. [DOI] [PubMed] [Google Scholar]
  26. Pfeffer J. M., Pfeffer M. A., Braunwald E. Influence of chronic captopril therapy on the infarcted left ventricle of the rat. Circ Res. 1985 Jul;57(1):84–95. doi: 10.1161/01.res.57.1.84. [DOI] [PubMed] [Google Scholar]
  27. Pfeffer M. A., Pfeffer J. M., Steinberg C., Finn P. Survival after an experimental myocardial infarction: beneficial effects of long-term therapy with captopril. Circulation. 1985 Aug;72(2):406–412. doi: 10.1161/01.cir.72.2.406. [DOI] [PubMed] [Google Scholar]
  28. Prakash R., Parmley W. W., Horvat M., Swan H. J. Serum cortisol, plasma free fatty acids, and urinary cathecholamines as indicators of complications in acute myocardial infarction. Circulation. 1972 Apr;45(4):736–745. doi: 10.1161/01.cir.45.4.736. [DOI] [PubMed] [Google Scholar]
  29. Sharpe D. N., Murphy J., Coxon R., Hannan S. F. Enalapril in patients with chronic heart failure: a placebo-controlled, randomized, double-blind study. Circulation. 1984 Aug;70(2):271–278. doi: 10.1161/01.cir.70.2.271. [DOI] [PubMed] [Google Scholar]
  30. Valori C., Thomas M., Shillingford J. Free noradrenaline and adrenaline excretion in relation to clinical syndromes following myocardial infarction. Am J Cardiol. 1967 Nov;20(5):605–617. doi: 10.1016/0002-9149(67)90001-x. [DOI] [PubMed] [Google Scholar]
  31. Vander A. J. Control of renin release. Physiol Rev. 1967 Jul;47(3):359–382. doi: 10.1152/physrev.1967.47.3.359. [DOI] [PubMed] [Google Scholar]
  32. Vander A. J. Inhibition of renin release in the dog by vasopressin and vasotocin. Circ Res. 1968 Nov;23(5):605–609. doi: 10.1161/01.res.23.5.605. [DOI] [PubMed] [Google Scholar]
  33. Vaney C., Waeber B., Turini G., Margalith D., Brunner H. R., Perret C. Renin and the complications of acute myocardial infarction. Chest. 1984 Jul;86(1):40–43. doi: 10.1378/chest.86.1.40. [DOI] [PubMed] [Google Scholar]
  34. Weisman H. F., Bush D. E., Mannisi J. A., Bulkley B. H. Global cardiac remodeling after acute myocardial infarction: a study in the rat model. J Am Coll Cardiol. 1985 Jun;5(6):1355–1362. doi: 10.1016/s0735-1097(85)80348-x. [DOI] [PubMed] [Google Scholar]
  35. Wenting G. J., Man in't veld A. J., Woittiez A. J., Boomsma F., Laird-Meeter K., Simoons M. L., Hugenholtz P. G., Schalekamp M. A. Effects of captopril in acute and chronic heart failure. Correlations with plasma levels of noradrenaline, renin, and aldosterone. Br Heart J. 1983 Jan;49(1):65–76. doi: 10.1136/hrt.49.1.65. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Zimmerman B. G. Adrenergic facilitation by angiotensin: does it serve a physiological function? Clin Sci (Lond) 1981 Apr;60(4):343–348. doi: 10.1042/cs0600343. [DOI] [PubMed] [Google Scholar]
  37. de Graeff P. A., van Gilst W. H., Bel K., de Langen C. D., Kingma J. H., Wesseling H. Concentration-dependent protection by captopril against myocardial damage during ischemia and reperfusion in a closed chest pig model. J Cardiovasc Pharmacol. 1987;9 (Suppl 2):S37–S42. doi: 10.1097/00005344-198700002-00009. [DOI] [PubMed] [Google Scholar]
  38. van Gilst W. H., de Graeff P. A., Wesseling H., de Langen C. D. Reduction of reperfusion arrhythmias in the ischemic isolated rat heart by angiotensin converting enzyme inhibitors: a comparison of captopril, enalapril, and HOE 498. J Cardiovasc Pharmacol. 1986 Jul-Aug;8(4):722–728. [PubMed] [Google Scholar]

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