Is adrenaline released by sympathetic nerves in man?
Radiotracer methods were used to measure the rates of regional release of adrenaline and noradrenaline into plasma in man. This was done as a partial test of a theory of essential hypertension pathogenesis which envisages an important cotransmitter function for neuronally released adrenaline. In healthy resting men no release of adrenaline could be detected from the heart, lungs or liver. Adrenaline was released into the right renal vein but an adrenal medullary source is suspected. With the relatively limited activation of the cardiac sympathetic outflow which accompanied mental challenge and isometric exercise, cardiac adrenaline release remained undetectable. During supine bicycle exercise, which increased cardiac noradrenaline release 10-30 fold, to a mean value of 197 ng/min, cardiac adrenaline release averaged 2.36 ng/min. In two clinical conditions associated with persistently elevated plasma adrenaline concentrations, cardiac failure and adrenaline-secreting phaeochromocytoma, regional release of adrenaline was clearly evident. Thus, in normal man during exercise, and in patients with cardiac failure at rest, adrenaline is released from non-adrenal sources, and probably from sympathetic nerves. Whether neuronal adrenaline release of the degree found would be sufficient to facilitate noradrenaline release, augment sympathetically-mediated cardiovascular responses and contribute to the development of arterial hypertension remains to be tested.
Esler
M
M
Alfred Baker Medical Unit, Alfred Hospital, Melbourne, Australia.
Eisenhofer
G
G
Chin
J
J
Jennings
G
G
Meredith
I
I
Cox
H
H
Lambert
G
G
Thompson
J
J
Dart
A
A
D000310:Adrenal Gland Neoplasms / Q000378:metabolism; D000328:Adult; D002395:Catecholamines / Q000097:blood; D003891:Desipramine / Q000494:pharmacology; D004837:Epinephrine / Q000378:metabolism*; D015444:Exercise / Q000502:physiology; D006333:Heart Failure / Q000378:metabolism; D006801:Humans; D008297:Male; D009206:Myocardium / Q000378:metabolism; D009638:Norepinephrine / Q000097:blood; D010673:Pheochromocytoma / Q000378:metabolism; D013315:Stress, Psychological / Q000097:blood; D013564:Sympathetic Nervous System / Q000378:metabolism*
D002395:Catecholamines; D003891:Desipramine; D009638:Norepinephrine; D004837:Epinephrine