Plasma norepinephrine

Plasma norepinephrine concentrations are elevated proportionally to HF severity, with highest levels correlating to the... 

Lake, C. R., Pickar, D., Ziegler, M. G. etal. (1982). High plasma norepinephrine levels in patients with major affective disorder. Am. J. Psychiatry 139, 1315-18. 

More specific laboratory tests are used to diagnose secondary hypertension. These include plasma norepinephrine and urinary metanephrine levels for pheochromocytoma, plasma and urinary aldosterone levels for primary aldosteronism, and plasma renin activity, captopril stimulation test, renal vein renins, and renal artery angiography for renovascular disease. 

Blanchard EB, Kolb LC, Prins A, Gates S, McCoy GC (1991) Changes in plasma norepinephrine to combat-related stimuli among Vietnam veterans with post traumatic stress disorder. J Nerv Ment Dis 179 371-373... 

Southwick SM, Krystal JH, Bremner JD, Morgan CA, Nicolaou A, Nagy LM, Johnson DR, Heninger GR, Charney DS (1997) Noradrenergic and serotonergic fimction in posttraumatic stress disorder. Arch Gen Psychiatry 54 749-758 Stein MB, Tancer ME, Uhde TW (1992) Heart rate and plasma norepinephrine responsivity to orthostatic challenge in anxiety disorders. Comparison of patients with panic disorder and social phobia and normal control subjects. Arch Gen Psychiatry 49 311-317 Stein MB, Huzel LL, Delaney SM (1993) Lymphocyte b-adrenoceptors in social phobia. Biol Psychiatry 34 45-50... 

Circulating plasma norepinephrine levels correlate inversely with survival in CHE that is, higher levels of norepinephrine are associated with a decrease in survival. It appears that norepinephrine levels are more than just markers of disease severity norepinephrine is actually directly toxic to cardiac myocytes, at least in culture. The addition of either an a- or p-blocker confers partial protection from norepinephrine damage. Combined a- and (3-blockade confers additive protection. These data from animal studies may be relevant to human heart failure, since they suggest that both a- and (3- adrenoceptor blockade may be beneficial in the man-... 

CS449 Mirochnick, M., ]. Meyer, D. A. Frank, H. Cabral, E. Z. Tronick, and B. Zuckerman. Elevated plasma norepinephrine after in utero exposure to cocaine and marijuana. Pediatrics 1997 99(4) 555-559. 

Murphy DL, Donnelly C, Moskowitz J Inhibition by lithium of prostaglandin El and norepinephrine effects on cyclic adenosine monophosphate production in human platelets. Chn Pharmacol Ther 14 810-814, 1974b Murphy DL, Lake CR, et al Psychoactive drug effects on plasma norepinephrine and plasma dopamine B-hydroxylase in man, in Catecholamines Basic and Clinical Frontiers. Edited by Usdin E, Kopin IJ, Barchas J. Ehnsford, NY, Pergamon, 1979, pp 918-920... 

Cholinesterase inhibitors have minimal effects by direct action on vascular smooth muscle because most vascular beds lack cholinergic innervation (coronary vasculature is an exception). At moderate doses, cholinesterase inhibitors cause an increase in systemic vascular resistance and blood pressure that is initiated at sympathetic ganglia in the case of quaternary nitrogen compounds and also at central sympathetic centers in the case of lipid-soluble agents. Atropine, acting in the central and peripheral nervous systems, can prevent the increase of blood pressure and the increased plasma norepinephrine. 

Keywords plasma norepinephrine, sympathetic nerve activity, renal injury, end-stage renal disease, hypertension... 

Many investigators have shown heightened sympathetic nerve activity observed in plasma norepinephrine or microneurography in patients with ESRD in cross-sectional studies [20, 21], These observations show renal injury or ESRD is a consequence of hypertension and obesity, however, most of previous studies regarding the relationships between sympathetic nerve activity and renal function have investigated proteinuria or microalbuminuria as a maker for renal injury. Few investigations have simultaneously taken into account... 

Plasma Norepinephrine as a Predictor for Future Cardiovascular and Renal Events... 

Masuo et al. [19] measured renal function (creatinine, BUN, creatinine clearance) and plasma norepinephrine levels over a 5-year period in nonobese, normotensive men with normal renal function. Subjects who had a significant deterioration of renal function (>10% increases from baseline of creatinine and BUN or decrease in creatinine clearance) over a 5-year period had higher plasma norepinephrine at the entry period and greater increases in plasma norepinephrine over 5 years (Figure 2). In this study, subjects who had significant changes in body weight or blood pressure were excluded. 

Plasma norepinephrine levels are higher in patients with ESRD than those in BMP and blood pressure-mate lied healthy normotensive subjects and hypertensive patients. 

Figure 1. ESRD patients with end-stage renal disease. Plasma norepinephrine levels decreased with the duration of hemodyalisis. Plasma norepinephrine levels were significantly higher in patients with ESRD with hemodialysis than BMLmatched normotensive subjects or BMI- and blood pressure-matched essential hypertensive patients. [Reference 21, Masuo K, et al. 2008]...

Figure 2. NE, norepinephrine Normal NE, normal plasma norepinephrine concentrations at entry period HighNE, high (>mean +2SD) plasma norepinephrine concentrations at entry period. [Reference 19, Masuo K, et al.2007].

Figure 4. Correlation between whole-body plasma norepinephrine spillover and venous plasma norepinephine concentrations. [Reference 29, Masuo K, et al. 2008].

Cohn JN, Levine TB, Olivari MT, Garberg V, Lura D, Francis GS, Simon AB, Rector T. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N. Engl JMed 1984 31 819-823. 

Benedict CR, Shelton B, Johnstone DE, Francis G, Greenberg B, Koustam M, Probstfield JL, Yusuf S. for the SOLVD Investigators. Prognostic significance of plasma norepinephrine in patients with asymptomatic left ventricular dysfunction. Circulation. 1996 94 690-697. 

Zoccali C, Mallamaci F, Parlongo S, Cutrupi S, Benedetto AB, Tripepi G, Bonanno G, Rapisarda F, Fatuzzo P, seminara G, Cateliotti A, Stancanelli B, Malatino S. Plasma norepinephrine predicts survival and incident cardiovascular events in patients with end-stage renal disease. Circulation. 2002 105 1354-1359. 

Masuo K, Kawaguchi H, Mikami H, Ogihara T, Tuck ML. Serum uric acid and plasma norepinephrine concentrations predict subsequent weight gain and blood pressure elevation. Hypertension. 2003 42 474-480. 

Masuo K, Katsuya T, Sugimoto K, Kawaguchi H, Rakugi H, Ogihara T, Tuck ML. High plasma norepinephrine levels associated with 32-adrenoceptor polymorphisms predict future renal damage in nonobese normotensive individuals. Hypertens. Res. 2007 30 503-511. 

Thomas JA, Marks BH. Plasma norepinephrine in congestive heart failure. Am J Cardiol 1978 41(2) 233-43. 

King BD, Sack D, Kichuk MR, Hintze TH. Absence of hypertension despite chronic marked elevations in plasma norepinephrine in conscious dogs. Hypertension 1987 9 582-590. 

Biochemically, norepinephrine possesses a higher affinity for the o c-AR subtype, suggesting that this receptor is able to respond to low-level circulating catecholamines and minute alterations of them. Alternatively, higher concentrations of norepinephrine will occupy the lower affinity o a-ARs and involve them in regulating neurotransmitter release. The unique properties of these subtypes play a critical role in vivo o c-AR / mice display significantly elevated plasma norepinephrine levels in contrast to wild-type, o a-AR , a2, -ARw. and a2C-AR mice. Assessment of hearts from a2 AC-AR / mice at 4 mo of age revealed marked hypertrophy with decreased left ventricular contractility (21,90). Thus,... 

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