Coronary venous noradrenaline during coronary angioplasty

Abstract

Coronary venous and arterial noradrenaline concentrations were measured during percutaneous transluminal coronary angioplasty in 14 patients. Coronary venous noradrenaline did not increase significantly during balloon inflation but was increased during early reperfusion in patients undergoing left anterior descending angioplasty ( n = 8), from 157 ± 38 pg/ml to 295 ± 94 pg/ml ( P < 0.05). Coronary blood flow, measured by thermodilution in 7 further patients during left anterior descending angioplasty, was 69 ± 9 ml/min, decreased to 80 ± 3% of basal flow during ballon inflation ( P < 0.01) and increased to 135 ± 5% during early reperfusion ( P < 0.01). It was estimated using these results that cardiac spillover of noradrenaline did not change during occlusion of the left anterior descending artery, but increased almost 3-fold during early reperfusion. During the period of ballon inflations, there was a modest increase in overall sympathetic tone, as assessed by total noradrenaline spillover to plasma (400 ± 77 ng/min to 473 ± 87 ng/min, P < 0.01). These results, suggesting an increase in release of noradrenaline during early reperfusion following brief occlusion of the left anterior descending artery, may be relevant to the genesis of reperfusion arrhythmias.