Determinants of coronary sinus noradrenaline in patients with ischaemic heart disease: coronary sinus catecholamine concentration in relation to arterial catecholamine concentration, pulmonary artery oxygen saturation and left ventricular end-diastolic pressure

Abstract

Arterial and coronary sinus noradrenaline (NA) and adrenaline (A) concentrations, cardiac output, pulmonary artery oxygen saturation (PAO2), coronary sinus oxygen saturation, left ventricular end-diastolic pressure (LVEDP), and arterial pressure were examined in 21 patients with ischaemic heart disease at rest and during exercise before and after intravenous propranolol. The heart had a net uptake of A and a net release of NA. It can be estimated that at least 50% of NA in the coronary sinus derived from the heart. NA in the coronary sinus and in the arterial blood originated therefore, at least partially, in different tissues. The NA concentration showed close correlation with PAO2, but not with cardiac index or arterial blood pressure. Multiple regression analysis also revealed a relationship between LVEDP and arterial and coronary sinus NA independent of PAO2. A very close correlation between arterial and coronary sinus NA (r = 0.93, P less than 0.001) indicates that they are largely controlled by the same factors.