C. Letizia et al., BETA-ENDORPHIN AND PROPIOMELANOCORTIN-CORRELATES PEPTIDES RESPONSE INSUSPECTED AND CONFIRMED ISCHEMIC-HEART-DISEASE DURING EXERCISE, Acta cardiologica, 51(1), 1996, pp. 27-36
In this study, we investigated circulating beta-endorphin, ACTH and co
rtisol in subjects with suspected coronary artery disease (CAD) and in
patients with CAD during stress testing. croup I: 18 subjects, all ma
le (average age 48 +/- 9 yrs) with suspected (CAD) were enroled. Group
II: 35 patients, 30 males and 5 females (average age 54.3 +/- 7 yrs)
with CAD, were enroled. Ten patients had previous myocardial infarctio
n. In all patients that underwent coronarography a stenosis >75% was f
ound in at least one coronary artery. The stress test was performed wi
th a cycloergometer, increasing work loads 25 watt every 2 min. All su
bjects and patients were in the recumbent position for at least 30 min
utes prior to testing. During this period a 3-way catheter was placed
in the antecubital vein and blood was drawn for beta-endorphin, ACTH a
nd cortisol; additional blood samples were drawn using a pre-chilled s
yringe at maximum effort and during the recovery period. Results: grou
p I: 9 of the subjects with suspected CAD had either ECG or clinical s
igns of ischemic during the stress test. In subjects with a negative t
est, the test was carried out for a longer period of time and at a hig
her work load. There was an increase in beta-endorphin and ACTH at pea
k exercise and during recovery. Plasma cortisol increase during the pe
riod of recovery. Group II: 16 of the 35 patients with CAD exhibited E
CG signs of induced myocardial ischemia; there was no difference in wo
rk loads in patients with positive or negative stress test. Exercise t
ime was reduced in all patients and plasma beta-endorphin increased at
peak exercise and recovery, in patients with a negative stress test.
In conclusion our study, revealed a different response of beta-endorph
in, ACTH and cortisol plasma levels in subjects with suspected CAD and
in patients with CAD during exercise testing.