What is the clinical evidence from this study?

Study design: Other. Intervention: Intracoronary epinephrine infusion vs. Basal conditions. Primary outcome: Norepinephrine concentrations in myocardial interstitial fluid (NE(MIF)).

What question did this study set out to answer?

To evaluate whether epinephrine taken up and released by cardiac sympathetic nerves increases myocardial interstitial fluid norepinephrine concentrations under basal conditions and during sympathetic activation.

August 13, 2002CirculationOpen Access

Epinephrine in the Heart

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Key result

Intracoronary epinephrine infusion in the porcine heart did not augment cardiac sympathoneural norepinephrine release under basal conditions or during sympathetic activation.

Why the study?

Does epinephrine augment cardiac sympathoneural norepinephrine release under basal conditions or during sympathetic activation in the porcine heart?

Population

Porcine heart model

Comparison

Intracoronary epinephrine infusion under basal… vs Basal conditions

Design

Preclinical

Authors

TLThomas W. LamerisErasmus MC SZSandra de ZeeuwAlbert Schweitzer Ziekenhuis DDDirk J. DunckerGeneral Cardiology

Discussion

Member takes

Implication

Epinephrine does not augment norepinephrine release in porcine cardiac neurons; leaves open relevance to human sympathetic regulation.

Key Points

To evaluate whether epinephrine taken up and released by cardiac sympathetic nerves increases myocardial interstitial fluid norepinephrine concentrations under basal conditions and during sympathetic activation.
Utilized cardiac microdialysis in a porcine model during graded intracoronary infusions of epinephrine (10, 50, and 100 ng/kg per minute).
Measured interstitial fluid and coronary venous catecholamine levels at baseline, during left stellate ganglion stimulation, and following tyramine administration with or without neuronal reuptake inhibition.
Intracoronary epinephrine markedly elevated interstitial epinephrine (0.31±0.05 to 140±30 nmol/L) and coronary venous epinephrine (0.16±0.08 to 228±39 nmol/L) under basal conditions without altering interstitial norepinephrine concentrations.
Left stellate ganglion stimulation increased interstitial norepinephrine from 3.4±0.5 to 8.2±1.5 nmol/L, which was not further augmented by simultaneous intracoronary epinephrine infusion.
Myocardial tissue extracted 68% to 78% of infused epinephrine, and tyramine evoked a 9.5 nmol/L release of interstitial epinephrine post-infusion, confirming neuronal uptake without enhancing norepinephrine release.

Structured PICO

Does epinephrine augment cardiac sympathoneural norepinephrine release under basal conditions or during sympathetic activation in the porcine heart?

Population

Porcine heart model

Intervention

Intracoronary epinephrine infusion (10, 50, and 100 ng/kg per minute) under basal conditions and during left stellate ganglion stimulation; intracoronary tyramine infusion

Comparator

Basal conditions

Outcome

Norepinephrine concentrations in myocardial interstitial fluid (NE(MIF))surrogate

Epinephrine is taken up and released by cardiac sympathetic neurons but does not augment cardiac sympathoneural norepinephrine release in the porcine heart.

Cite This Study

Lameris et al. (2002) studied this question. Intracoronary epinephrine infusion vs. Basal conditions was evaluated on Norepinephrine concentrations in myocardial interstitial fluid (NE(MIF)). Intracoronary epinephrine infusion in the porcine heart did not augment cardiac sympathoneural norepinephrine release under basal conditions or during sympathetic activation.

synapsesocial.com/papers/6a78ca06e5601668f501f188 https://doi.org/10.1161/01.cir.0000000000.00000.00

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Epinephrine in the Heart

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Epinephrine in the Heart

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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