Assessment of myocardial sympathetic activity in coronary heart disease.

We measured adrenaline, noradrenaline and dopamine beta-hydroxylase in arterial and in coronary sinus blood in 14 patients with coronary artery disease, at rest and under pacing-induced ischemia. Pacing increased the concentrations of adrenaline and noradrenaline in both arterial and coronary sinus blood. The origin of the adrenaline increase appears to be extramyocardial. The arteriovenous differences indicated that the heart extracts adrenaline and releases noradrenaline. These differences were not significantly changed by pacing, nor by the administration of propranolol. No marked changes in the concentrations of dopamine beta-hydroxylase were observed, except under pacing after propranolol, in which case a release from the heart occurred.