Myocardial turnover of endogenous opioids and calcitonin-gene-related peptide in the human heart and the effects of spinal cord stimulation on pacing-induced angina pectoris.
Earlier studies have shown that spinal cord stimulation (SCS) has antianginal and anti-ischemic effects in severe coronary artery disease. In the present study, 14 patients were subjected to right-sided atrial catheterization and atrial pacing. The patients were paced to angina during a control session and during spinal cord stimulation. Myocardial extraction of beta-endorphin (BE) during control pacing (8 +/- 22%) changed to release at the maximum pacing rate during treatment (-21 +/- 47%, a negative value representing release). Furthermore, the results indicate local myocardial turnover of leuenkephalin, BE and calcitonin-gene-related peptide. In addition, it is implied that SCS may induce myocardial release of BE which could explain the beneficial effects in myocardial ischemia.
Eliasson
T
T
Multidisciplinary Pain Center, Department of Medicine, Ostra University Hospital, Göteborg, Sweden.
Mannheimer
C
C
Waagstein
F
F
Andersson
B
B
Bergh
C H
CH
Augustinsson
L E
LE
Hedner
T
T
Larson
G
G
D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000378:metabolism* / Q000534:rehabilitation; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism*; D006328:Cardiac Catheterization; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D004743:Enkephalin, Leucine / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology / Q000378:metabolism; D009206:Myocardium / Q000378:metabolism*; D011863:Radioimmunoassay; D013116:Spinal Cord / Q000502:physiology*; D001615:beta-Endorphin / Q000378:metabolism*
D004743:Enkephalin, Leucine; D001615:beta-Endorphin; D015740:Calcitonin Gene-Related Peptide