Clinical Investigations: Acute Ischemic Heart DiseaseEffect of β2-adrenergic receptor functioning and increased norepinephrine on the hypercoagulable state with mental stress*,**,★
Section snippets
Subjects and study design
The subjects consisted of 19 (13 normotensive and 6 mildly hypertensive) volunteers recruited from the San Diego community through advertisement or word-of-mouth referral to participate in a study on the effects of the SNS on cardiovascular physiology. Subjects gave written consent for the study protocol, which was approved by the University of California San Diego Human Subjects Committee in accordance with institutional guidelines. Subjects took no medications and were excluded if they had
Results
As shown in Figures 1 and 2, mental stress led to a significant increase in TAT (P =.024), DD (P =.026), and norepinephrine (P =.005); there was a trend for epinephrine to increase (P =.072).
Discussion
The physiologic mechanisms by which increased sympathoadrenal activation stimulates hemostasis are not fully understood. Others have found a positive association between increased plasma epinephrine levels and fibrinolytic capacity12 and an inverse relation between plasma epinephrine and antithrombin III.13 In addition, adrenergic receptor blockade studies suggest that the β2-receptor is responsible for increased procoagulant activities of factor VIII and of von Willebrand factor on the one
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Cited by (0)
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Supported by grants HL36005, HL44915, and RR00827 from the National Institutes of Health, fellowship 81BE-56155 from the Swiss National Science Foundation, and an educational grant from Novartis Foundation, Switzerland.
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Reprint requests: Joel E. Dimsdale, MD, Department of Psychiatry, UCSD, 9500 Gilman Drive, La Jolla, CA 92093-0804.
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E-mail: [email protected]