Ephedrine increases ventricular arrhythmias in conscious dogs after myocardial infarction
This study examined the hypothesis that the sympathomimetic activity of ephedrine increases the risk of lethal arrhythmias. The sympathomimetic amine, ephedrine, is used to augment physical performance and as a weight loss aid, but little is known about the cardiovascular consequences in individuals...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2004-10, Vol.44 (8), p.1675-1678 |
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| creator | Adamson, Philip B. Suarez, Jennifer Ellis, Ethannah Kanaly, Travis Vanoli, Emilio |
| description | This study examined the hypothesis that the sympathomimetic activity of ephedrine increases the risk of lethal arrhythmias.
The sympathomimetic amine, ephedrine, is used to augment physical performance and as a weight loss aid, but little is known about the cardiovascular consequences in individuals with ischemic heart disease.
Fifteen dogs at low risk for ventricular fibrillation (VF) during exercise and transient myocardial ischemia 30 days after a small anterior myocardial infarction were retested after five days of ephedrine use (Xenadrine, 0.4 mg/kg/day orally). To assess the effects of ephedrine on cardiac autonomic control, baroreceptor reflex sensitivity (BRS), heart rate (HR) variability, HR response to acute myocardial ischemia, and resting catecholamines were measured before and after ephedrine. Dogs were used as their own control when possible.
Nine of 15 animals had increased ventricular arrhythmias during ephedrine treatment (p = 0.01) and four had VF. Three dogs that had VF could not be resuscitated. Five animals with increased arrhythmias during ephedrine treatment had none during a third exercise and ischemia test after drug washout. Heart rates were higher after 30 s of myocardial ischemia during ephedrine treatment (204 ± 25 beats/min no drug vs. 218 ± 26 beats/min with ephedrine, p = 0.03). All plasma catecholamines increased after ephedrine administration. No changes in BRS, HR variability, or exercise HR were noted.
Ephedrine increases ischemia-dependent arrhythmias at doses recommended in over-the-counter preparations. Increased arrhythmia risk was associated with augmented ischemia-dependent sympathetic reflex activation. |
| doi_str_mv | 10.1016/j.jacc.2004.07.041 |
| format | Article |
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The sympathomimetic amine, ephedrine, is used to augment physical performance and as a weight loss aid, but little is known about the cardiovascular consequences in individuals with ischemic heart disease.
Fifteen dogs at low risk for ventricular fibrillation (VF) during exercise and transient myocardial ischemia 30 days after a small anterior myocardial infarction were retested after five days of ephedrine use (Xenadrine, 0.4 mg/kg/day orally). To assess the effects of ephedrine on cardiac autonomic control, baroreceptor reflex sensitivity (BRS), heart rate (HR) variability, HR response to acute myocardial ischemia, and resting catecholamines were measured before and after ephedrine. Dogs were used as their own control when possible.
Nine of 15 animals had increased ventricular arrhythmias during ephedrine treatment (p = 0.01) and four had VF. Three dogs that had VF could not be resuscitated. Five animals with increased arrhythmias during ephedrine treatment had none during a third exercise and ischemia test after drug washout. Heart rates were higher after 30 s of myocardial ischemia during ephedrine treatment (204 ± 25 beats/min no drug vs. 218 ± 26 beats/min with ephedrine, p = 0.03). All plasma catecholamines increased after ephedrine administration. No changes in BRS, HR variability, or exercise HR were noted.
Ephedrine increases ischemia-dependent arrhythmias at doses recommended in over-the-counter preparations. Increased arrhythmia risk was associated with augmented ischemia-dependent sympathetic reflex activation.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2004.07.041</identifier><identifier>PMID: 15489103</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Animals ; Autonomic Nervous System - drug effects ; Autonomic Nervous System - physiopathology ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiology ; Cardiology. Vascular system ; Cardiovascular disease ; Catecholamines - blood ; Coronary heart disease ; Dogs ; Dose-Response Relationship, Drug ; Electrocardiography - drug effects ; Ephedrine - toxicity ; Exercise Test ; Health risk assessment ; Heart ; Heart - innervation ; Heart attacks ; Heart Rate - drug effects ; Heart Rate - physiology ; Medical sciences ; Myocardial Infarction - complications ; Myocardial Infarction - physiopathology ; Myocardial Ischemia - complications ; Myocardial Ischemia - physiopathology ; Myocarditis. Cardiomyopathies ; Postoperative period ; Reference Values ; Risk Factors ; Sympathomimetics - toxicity ; Ventricular Fibrillation - chemically induced ; Ventricular Fibrillation - physiopathology</subject><ispartof>Journal of the American College of Cardiology, 2004-10, Vol.44 (8), p.1675-1678</ispartof><rights>2004 American College of Cardiology Foundation</rights><rights>2005 INIST-CNRS</rights><rights>Copyright Elsevier Limited Oct 19, 2004</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-6a0a5107c3fe0ee688f3d3bdafbea417cade88bdbf47b3bea900f49771a1fc2a3</citedby><cites>FETCH-LOGICAL-c445t-6a0a5107c3fe0ee688f3d3bdafbea417cade88bdbf47b3bea900f49771a1fc2a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jacc.2004.07.041$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16206817$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15489103$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adamson, Philip B.</creatorcontrib><creatorcontrib>Suarez, Jennifer</creatorcontrib><creatorcontrib>Ellis, Ethannah</creatorcontrib><creatorcontrib>Kanaly, Travis</creatorcontrib><creatorcontrib>Vanoli, Emilio</creatorcontrib><title>Ephedrine increases ventricular arrhythmias in conscious dogs after myocardial infarction</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>This study examined the hypothesis that the sympathomimetic activity of ephedrine increases the risk of lethal arrhythmias.
The sympathomimetic amine, ephedrine, is used to augment physical performance and as a weight loss aid, but little is known about the cardiovascular consequences in individuals with ischemic heart disease.
Fifteen dogs at low risk for ventricular fibrillation (VF) during exercise and transient myocardial ischemia 30 days after a small anterior myocardial infarction were retested after five days of ephedrine use (Xenadrine, 0.4 mg/kg/day orally). To assess the effects of ephedrine on cardiac autonomic control, baroreceptor reflex sensitivity (BRS), heart rate (HR) variability, HR response to acute myocardial ischemia, and resting catecholamines were measured before and after ephedrine. Dogs were used as their own control when possible.
Nine of 15 animals had increased ventricular arrhythmias during ephedrine treatment (p = 0.01) and four had VF. Three dogs that had VF could not be resuscitated. Five animals with increased arrhythmias during ephedrine treatment had none during a third exercise and ischemia test after drug washout. Heart rates were higher after 30 s of myocardial ischemia during ephedrine treatment (204 ± 25 beats/min no drug vs. 218 ± 26 beats/min with ephedrine, p = 0.03). All plasma catecholamines increased after ephedrine administration. No changes in BRS, HR variability, or exercise HR were noted.
Ephedrine increases ischemia-dependent arrhythmias at doses recommended in over-the-counter preparations. Increased arrhythmia risk was associated with augmented ischemia-dependent sympathetic reflex activation.</description><subject>Animals</subject><subject>Autonomic Nervous System - drug effects</subject><subject>Autonomic Nervous System - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Catecholamines - blood</subject><subject>Coronary heart disease</subject><subject>Dogs</subject><subject>Dose-Response Relationship, Drug</subject><subject>Electrocardiography - drug effects</subject><subject>Ephedrine - toxicity</subject><subject>Exercise Test</subject><subject>Health risk assessment</subject><subject>Heart</subject><subject>Heart - innervation</subject><subject>Heart attacks</subject><subject>Heart Rate - drug effects</subject><subject>Heart Rate - physiology</subject><subject>Medical sciences</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Ischemia - complications</subject><subject>Myocardial Ischemia - physiopathology</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Postoperative period</subject><subject>Reference Values</subject><subject>Risk Factors</subject><subject>Sympathomimetics - toxicity</subject><subject>Ventricular Fibrillation - chemically induced</subject><subject>Ventricular Fibrillation - physiopathology</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90EGL1DAUwPEgyu647hfwIAXx2PrStE0LXmTZXYUFL3rwFF6TFydlphlf2oX59maYgb15CoTfewl_Id5LqCTI7vNUTWhtVQM0FegKGvlKbGTb9qVqB_1abECrtpQw6GvxNqUJALpeDlfiWrZNP0hQG_H7_rAlx2GmIsyWCROl4pnmhYNdd8gFMm-Py3YfMGVR2DgnG-KaChf_pAL9Qlzsj9Eiu4C7TDyyXUKc34k3HneJbi_njfj1cP_z7lv59OPx-93Xp9I2TbuUHQK2ErRVnoCo63uvnBod-pGwkdqio74f3egbPap8NwD4ZtBaovS2RnUjPp73Hjj-XSktZoorz_lJI1voZFuDUlnVZ2U5psTkzYHDHvloJJhTTTOZU01zqmlAm1wzD324rF7HPbmXkUu-DD5dACaLO88425BeXFefiuvsvpwd5RDPgdjkiDRbcoHJLsbF8L9__AM7fJU7</recordid><startdate>20041019</startdate><enddate>20041019</enddate><creator>Adamson, Philip B.</creator><creator>Suarez, Jennifer</creator><creator>Ellis, Ethannah</creator><creator>Kanaly, Travis</creator><creator>Vanoli, Emilio</creator><general>Elsevier Inc</general><general>Elsevier Science</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>20041019</creationdate><title>Ephedrine increases ventricular arrhythmias in conscious dogs after myocardial infarction</title><author>Adamson, Philip B. ; Suarez, Jennifer ; Ellis, Ethannah ; Kanaly, Travis ; Vanoli, Emilio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-6a0a5107c3fe0ee688f3d3bdafbea417cade88bdbf47b3bea900f49771a1fc2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Animals</topic><topic>Autonomic Nervous System - drug effects</topic><topic>Autonomic Nervous System - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Catecholamines - blood</topic><topic>Coronary heart disease</topic><topic>Dogs</topic><topic>Dose-Response Relationship, Drug</topic><topic>Electrocardiography - drug effects</topic><topic>Ephedrine - toxicity</topic><topic>Exercise Test</topic><topic>Health risk assessment</topic><topic>Heart</topic><topic>Heart - innervation</topic><topic>Heart attacks</topic><topic>Heart Rate - drug effects</topic><topic>Heart Rate - physiology</topic><topic>Medical sciences</topic><topic>Myocardial Infarction - complications</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Ischemia - complications</topic><topic>Myocardial Ischemia - physiopathology</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Postoperative period</topic><topic>Reference Values</topic><topic>Risk Factors</topic><topic>Sympathomimetics - toxicity</topic><topic>Ventricular Fibrillation - chemically induced</topic><topic>Ventricular Fibrillation - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adamson, Philip B.</creatorcontrib><creatorcontrib>Suarez, Jennifer</creatorcontrib><creatorcontrib>Ellis, Ethannah</creatorcontrib><creatorcontrib>Kanaly, Travis</creatorcontrib><creatorcontrib>Vanoli, Emilio</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adamson, Philip B.</au><au>Suarez, Jennifer</au><au>Ellis, Ethannah</au><au>Kanaly, Travis</au><au>Vanoli, Emilio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ephedrine increases ventricular arrhythmias in conscious dogs after myocardial infarction</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2004-10-19</date><risdate>2004</risdate><volume>44</volume><issue>8</issue><spage>1675</spage><epage>1678</epage><pages>1675-1678</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>This study examined the hypothesis that the sympathomimetic activity of ephedrine increases the risk of lethal arrhythmias.
The sympathomimetic amine, ephedrine, is used to augment physical performance and as a weight loss aid, but little is known about the cardiovascular consequences in individuals with ischemic heart disease.
Fifteen dogs at low risk for ventricular fibrillation (VF) during exercise and transient myocardial ischemia 30 days after a small anterior myocardial infarction were retested after five days of ephedrine use (Xenadrine, 0.4 mg/kg/day orally). To assess the effects of ephedrine on cardiac autonomic control, baroreceptor reflex sensitivity (BRS), heart rate (HR) variability, HR response to acute myocardial ischemia, and resting catecholamines were measured before and after ephedrine. Dogs were used as their own control when possible.
Nine of 15 animals had increased ventricular arrhythmias during ephedrine treatment (p = 0.01) and four had VF. Three dogs that had VF could not be resuscitated. Five animals with increased arrhythmias during ephedrine treatment had none during a third exercise and ischemia test after drug washout. Heart rates were higher after 30 s of myocardial ischemia during ephedrine treatment (204 ± 25 beats/min no drug vs. 218 ± 26 beats/min with ephedrine, p = 0.03). All plasma catecholamines increased after ephedrine administration. No changes in BRS, HR variability, or exercise HR were noted.
Ephedrine increases ischemia-dependent arrhythmias at doses recommended in over-the-counter preparations. Increased arrhythmia risk was associated with augmented ischemia-dependent sympathetic reflex activation.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15489103</pmid><doi>10.1016/j.jacc.2004.07.041</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Animals Autonomic Nervous System - drug effects Autonomic Nervous System - physiopathology Biological and medical sciences Cardiac arrhythmia Cardiac dysrhythmias Cardiology Cardiology. Vascular system Cardiovascular disease Catecholamines - blood Coronary heart disease Dogs Dose-Response Relationship, Drug Electrocardiography - drug effects Ephedrine - toxicity Exercise Test Health risk assessment Heart Heart - innervation Heart attacks Heart Rate - drug effects Heart Rate - physiology Medical sciences Myocardial Infarction - complications Myocardial Infarction - physiopathology Myocardial Ischemia - complications Myocardial Ischemia - physiopathology Myocarditis. Cardiomyopathies Postoperative period Reference Values Risk Factors Sympathomimetics - toxicity Ventricular Fibrillation - chemically induced Ventricular Fibrillation - physiopathology |
| title | Ephedrine increases ventricular arrhythmias in conscious dogs after myocardial infarction |
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