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
References (33)
- et al.
Effect of acute psychological stress on the hypercoagulable state in subjects (spouses of patients with Alzheimer's disease) with coronary or cerebrovascular disease and/or systemic hypertension
Am J Cardiol
(2001) - et al.
Earthquake-induced potentiation of acute risk factors in hypertensive elderly patients: possible triggering of cardiovascular events after a major earthquake
J Am Coll Cardiol
(1997) - et al.
The pathophysiology of the prethrombotic state in humans: insights gained from studies using markers of hemostatic system activation
Blood
(1987) - et al.
Differential patterns of dynamic cardiovascular regulation as a function of task
Biol Psychol
(1993) - et al.
A more sensitive and specific radioenzymatic assay for catecholamines
Life Sci
(1990) - et al.
Sympathetic alterations after sodium restriction and short-term captopril administration
J Am Coll Cardiol
(1993) - et al.
Changes of plasma coagulation and fibrinolysis in response to mental stress
Thromb Haemost
(1989) - et al.
Effects of psychological stress and psychiatric disorders on blood coagulation and fibrinolysis: a biobehavioral pathway to coronary artery disease?
Psychosom Med
(2001) - et al.
Platelets and psychiatry: lesions learned from old and new studies
Psychosom Med
(2000) Effects of exercise on blood coagulation, fibrinolysis and platelet aggregation
Sports Med
(1996)
Effects of sympathetic activation by adrenergic infusions on hemostasis in vivo
Eur J Haematol
Is there a hypercoagulable state in military fighter pilots?
Aviat Space Environ Med
Thromboembolic diseases: biochemical mechanisms and new possibilities of biological diagnosis
Semin Thromb Hemost
Factors affecting the coagulation time of blood. IV: the hastening of coagulation in pain and emotional excitement
Am J Physiol
Influence of metoprolol treatment on sympatho-adrenal activation of fibrinolysis
Thromb Haemost
Antithrombin III biological activity and emotional stress in patients with coronary artery disease
Haematologica
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Prothrombotic response to norepinephrine infusion, mimicking norepinephrine stress-reactivity effects, is partly mediated by α-adrenergic mechanisms
2019, PsychoneuroendocrinologyCitation Excerpt :The total dose of the infused NE was selected based on the rationale that it would provoke cardiovascular changes comparable to acute stress (Kuebler et al., 2014). The resulting NE concentrations were about 3- to 5-fold higher than plasma concentrations that are usually reached in response to acute mental stress (von Känel et al., 2002; Beis et al., 2018). We speculate that the high i.v. dosage is required to compensate for stress-induced NE co-secreted from sympathetic nerve endings in addition to secretion from the adrenal medulla.
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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]