REGULATION OF BETA(2)-ADRENERGIC RECEPTORS ON MONONUCLEAR LEUKOCYTES IN PATIENTS WITH ACUTE ISCHEMIC-HEART-DISEASE

Objective: To investigate relationships between acute adrenergic stres s, plasma catecholamine concentrations, and beta(2)-adrenergic recepto rs. Design: Prospective, descriptive study. Setting: Emergency medical service at a university hospital. Patients: Twenty-seven patients wit h out-of-hospital cardiac arrest (n = 11), myocardial infarction (n = 6), and angina pectoris (n = 10), and 12 control subjects. Interventio ns: None. Measurements and Main Results: Mononuclear leukocyte beta(2) -adrenergic receptor density and affinity were measured in patients 15 mins after successful cardiopulmonary resuscitation and after the dia gnosis of myocardial infarction or angina pectoris, respectively, and were measured as well in control subjects. plasma concentrations of ca techolamines, glucose, and lactate were simultaneously measured with h eart rate and blood pressure. After cardiac arrest, the density of bet a(2)-adrenergic receptors (1858 +/- 188 sites/cell [p < .01]), plasma epinephrine concentration (31,990 +/- 14,526 pg/mL [174.6 +/- 79.3 nmo l/L] [p < .01]), heart rate (100 +/- 6 beats/min [p < .01]), glucose c oncentration (14.9 +/- 0.8 mmol/L in [p < .01]), and lactate concentra tion (10.9 +/- 0.6 mmol/L [p < .01]) were increased in patients compar ed with those values in healthy controls. Conclusion: Acute maximal st ress, such as after cardiac arrest, is associated with an increase in the density of beta(2)-adrenergic receptors an mononuclear leukocytes derived from patients after successful cardiopulmonary resuscitation.