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Cardiac Uptake-1 Inhibition by High Circulating Norepinephrine Levels in Patients with Pheochromocytoma

 

作者: Basil Eldadah,   Karel Pacak,   Graeme Eisenhofer,   Courtney Holmes,   Irwin Kopin,   David Goldstein,  

 

期刊: Hypertension: Journal of The American Heart Association  (OVID Available online 2004)
卷期: Volume 43, issue 6  

页码: 1227-1232

 

ISSN:0194-911X

 

年代: 2004

 

出版商: OVID

 

关键词: heart;norepinephrine;pheochromocytoma;radiography

 

数据来源: OVID

 

摘要:

Neuronal reuptake (uptake-1) constitutes the main route of inactivation of the sympathetic neurotransmitter norepinephrine in the heart and therefore contributes importantly to cardiac sympathetic neuroeffector function. In laboratory animals and in vitro preparations, half saturation of the transporter occurs at norepinephrine concentrations of 0.1 to 1 μmol/L. This study addressed whether endogenous norepinephrine can attain high enough plasma concentrations in humans to inhibit cardiac uptake-1. Patients with increased plasma norepinephrine levels due to pheochromocytoma were assessed by 6-[18F]fluorodopamine positron emission tomography. Above an antecubital venous plasma concentration of 3 nmol/L (≈500 pg/mL), left ventricular myocardial 6-[18F]fluorodopamine–derived radioactivity varied inversely with the logarithm of the plasma norepinephrine concentration (r=−0.77,P<0.0001). Reduction of plasma norepinephrine levels by treatment of the pheochromocytoma increased myocardial 6-[18F]fluoro-dopamine–derived radioactivity. At sufficiently high plasma concentrations, endogenous norepinephrine can compete with sympathetic imaging agents for uptake-1. The results call for caution in drawing quantitative conclusions about uptake-1 in the setting of high circulating concentrations of endogenous norepinephrine.

 

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