Arterial and coronary sinus catecholamines in the course of spontaneous coronary artery spasm

alpha-Adrenergic receptors and coronary spasm: an elusive link.

“…1, January 1984 itated by paroxysmal bursts of sympathetic hyperactivity caused by rapid eye movement sleep, because no changes in heart rate and QT interval were observed before these episodes and because, with the exception of one anecdotal report,23 no consistent association between rapid eye movement and episodes of variant angina has been found. 24 The observation of an increase in heart rate and corrected QT interval during, but not before, ischemia is in keeping with the results of Robertson et al , 25 who measured arterial and coronary sinus epinephrine and norepinephrine during spontaneous episodes of variant angina. Although a significant increase in catecholamine levels was measureable in the late phase of the episodes, no changes relative to control were detectable at the very onset of electrocardiographic changes.…”

Coronary Artery Spasm: Review and Update

“…In addition, acetylcholine is known to induce CAS 66, suggesting a role for vagal activity as a trigger of CAS. However, it has been shown that spontaneous ischemic episodes of CAS are often preceded by a reduction, rather than by an increase, of vagal activity 67, and followed by an increase in coronary levels of catecholamines 68. Studies have also shown that CAS at night more frequently occurs during the rapid eye movement phases of sleep, when a reduction in vagal activity is associated with an increase in adrenergic activity 29,69, suggesting that CAS is not necessarily induced by vagal activity.…”

“…Although clinical studies have shown that CAS can be induced by catecholamines 63 or other sympathetic related stimuli 70,71, α-blockade has been shown to be ineffective in controlling CAS symptoms 68. In Japanese patients with acute myocardial infarction, atenolol does not promote coronary vasoreactivity to ergonovine 72, which can be explained by its selective β-1 adrenoceptor (chronotropic response) blocker effect without intrinsic sympathomimetic activity 73.…”

Use of Hypnosis before and during Angioplasty

“…They also may develop angina while the coronary artery is temporarily occluded (Robertson, Bernard, & Robertson, 1983).…”

“…Several reports indicate that these parameters are not altered by changes in catecholamine levels (Robertson, Bernard, & Robertson, 1983;Jakobsen & Blom, 1989). Jakobsen and Blom (1989) state: "The lack of correlation between blood pressure and plasma catecholamines and between blood pressure and anxiety suggests that blood pressure is a poor indicator of anxiety.…”