Beta endorphin release in patients after spontaneous and provoked acute myocardial ischaemia.

K G Oldroyd, K Harvey, C E Gray, G H Beastall, S M Cobbe

Department of Medical Cardiology, Royal Infirmary, Glasgow.

BACKGROUND--In animal models of circulatory shock and heart failure concentrations of the endogenous opioid peptide beta endorphin are raised and opioid receptor blockade improves haemodynamic variables and survival. This study was performed to identify whether acute myocardial ischaemia provokes the release of beta endorphin in humans. METHODS--Observational study in a university cardiology centre. Serial measurements of beta endorphin made by specific radioimmunoassay were correlated with other clinical and neuroendocrine variables that were measured prospectively. Fifty five patients with acute myocardial ischaemia and 26 patients undergoing elective coronary angioplasty of the left anterior descending coronary artery were studied. RESULTS--beta endorphin concentrations were raised above the upper limit of normal in 31/42 (74%) patients with confirmed myocardial infarction, 3/13 (23%) patients with unstable angina, and 10/24 (42%) patients after coronary angioplasty. There was no evidence of myocardial release of beta endorphin. There were significant positive correlations between beta endorphin and the concentrations of adrenocorticotrophic hormone, cortisol, and arginine vasopressin. In patients with acute myocardial ischaemia there was a significant positive correlation between the peak concentrations of creatine kinase and beta endorphin but no correlation with visual analogue scores of the intensity of chest pain. The highest beta endorphin concentrations were seen in patients whose clinical course was complicated by the development of heart failure. CONCLUSIONS--beta endorphin release is a component of the neuroendocrine activation associated with myocardial ischaemia/infarction.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

ß-Endorphin release in patients after spontaneous and provoked acute myocardial ischaemia

Flemming W Bach and Keith G Oldroyd
Heart 1993 69: 93. [PDF]

This article has been cited by other articles:

• Dweck, M., Miller, D., Campbell, I. W, Francis, C M. (2009). Review: Mechanisms of silent myocardial ischaemia: with particular reference to diabetes mellitus. British Journal of Diabetes & Vascular Disease 9: 99-102 [Abstract]  
• Grosse Hartlage, M. A., Theisen, M. M., Monteiro de Oliveira, N. P., Van Aken, H., Fobker, M., Weber, T. P. (2006). {kappa}-Opioid Receptor Antagonism Improves Recovery from Myocardial Stunning in Chronically Instrumented Dogs. Anesth. Analg. 103: 822-832 [Abstract] [Full Text]  
• Cohn, P. F., Fox, K. M., Daly, C. (2003). Silent Myocardial Ischemia. Circulation 108: 1263-1277 [Full Text]  
• Weber, T. P., Raufhake, C., Gro{beta}e Hartlage, M. A., Rolf, N., Stypmann, J., Van Aken, H., Berendes, E., Mei{beta}ner, A. (2002). Naloxone prevents increased atrial natriuretic peptide release during regional myocardial ischaemia and stunning in awake dogs. Br J Anaesth 88: 87-93 [Abstract] [Full Text]  
• Weber, T. P., Stypmann, J., Mei{beta}ner, A., Gro{beta}e Hartlage, M., Van Aken, H., Rolf, N. (2001). Naloxone improves functional recovery of myocardial stunning in conscious dogs through its action on the central nervous system. Br J Anaesth 86: 545-549 [Abstract] [Full Text]