Norepinephrine Leads to More Cardiopulmonary Toxicities than Epinephrine by Catecholamine Overdose in Rats
While catecholamines like epinephrine (E) and norepinephrine (NE) are commonly used in emergency medicine, limited studies have discussed the harm of exogenously induced catecholamine overdose. We investigated the possible toxic effects of excessive catecholamine administration on cardiopulmonary fu...
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MDPI AG
2020-09-01
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| Series: | Toxics |
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| Online Access: | https://www.mdpi.com/2305-6304/8/3/69 |
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| author | Wen-Hsien Lu Hsin-Hung Chen Bo-Hau Chen Jui-Chen Lee Chi-Cheng Lai Che-Hsing Li Ching-Jiunn Tseng |
| author_facet | Wen-Hsien Lu Hsin-Hung Chen Bo-Hau Chen Jui-Chen Lee Chi-Cheng Lai Che-Hsing Li Ching-Jiunn Tseng |
| author_sort | Wen-Hsien Lu |
| collection | DOAJ |
| description | While catecholamines like epinephrine (E) and norepinephrine (NE) are commonly used in emergency medicine, limited studies have discussed the harm of exogenously induced catecholamine overdose. We investigated the possible toxic effects of excessive catecholamine administration on cardiopulmonary function and structure via continuous 6 h intravenous injection of E and/or NE in rats. Heart rate, echocardiography, and ventricular pressure were measured throughout administration. Cardiopulmonary structure was also assessed by examining heart and lung tissue. Consecutive catecholamine injections induced severe tachycardia. Echocardiography results showed NE caused worse dysfunction than E. Simultaneously, both E and NE led to higher expression of Troponin T and connexin43 in the whole ventricles, which increased further with E+NE administration. The NE and E+NE groups showed severe pulmonary edema while all catecholamine-administering groups demonstrated reduced expression of receptor for advanced glycation end products and increased connexin43 levels in lung tissue. The right ventricle was more vulnerable to catecholamine overdose than the left. Rats injected with NE had a lower survival rate than those injected with E within 6 h. Catecholamine overdose induces acute lung injuries and ventricular cardiomyopathy, and E+NE is associated with a more severe outcome. The similarities of the results between the NE and E+NE groups may indicate a predominant role of NE in determining the overall cardiopulmonary damage. The results provide important clinical insights into the pathogenesis of catecholamine storm. |
| first_indexed | 2024-03-10T16:18:14Z |
| format | Article |
| id | doaj.art-077f346de70840e981cb20112c393e33 |
| institution | Directory Open Access Journal |
| issn | 2305-6304 |
| language | English |
| last_indexed | 2024-03-10T16:18:14Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxics |
| spelling | doaj.art-077f346de70840e981cb20112c393e332023-11-20T13:52:51ZengMDPI AGToxics2305-63042020-09-01836910.3390/toxics8030069Norepinephrine Leads to More Cardiopulmonary Toxicities than Epinephrine by Catecholamine Overdose in RatsWen-Hsien Lu0Hsin-Hung Chen1Bo-Hau Chen2Jui-Chen Lee3Chi-Cheng Lai4Che-Hsing Li5Ching-Jiunn Tseng6Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 813, TaiwanDepartment of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, TaiwanDepartment of Pediatrics, Taoyuan Armed Forces General Hospital, Taoyuan 325, TaiwanDepartment of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, TaiwanDepartment of Cardiology, Kaohsiung Municipal United Hospital, Kaohsiung 804, TaiwanSchool of Medicine, Chung Shan Medical University, Taichung 402, TaiwanInstitute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804, TaiwanWhile catecholamines like epinephrine (E) and norepinephrine (NE) are commonly used in emergency medicine, limited studies have discussed the harm of exogenously induced catecholamine overdose. We investigated the possible toxic effects of excessive catecholamine administration on cardiopulmonary function and structure via continuous 6 h intravenous injection of E and/or NE in rats. Heart rate, echocardiography, and ventricular pressure were measured throughout administration. Cardiopulmonary structure was also assessed by examining heart and lung tissue. Consecutive catecholamine injections induced severe tachycardia. Echocardiography results showed NE caused worse dysfunction than E. Simultaneously, both E and NE led to higher expression of Troponin T and connexin43 in the whole ventricles, which increased further with E+NE administration. The NE and E+NE groups showed severe pulmonary edema while all catecholamine-administering groups demonstrated reduced expression of receptor for advanced glycation end products and increased connexin43 levels in lung tissue. The right ventricle was more vulnerable to catecholamine overdose than the left. Rats injected with NE had a lower survival rate than those injected with E within 6 h. Catecholamine overdose induces acute lung injuries and ventricular cardiomyopathy, and E+NE is associated with a more severe outcome. The similarities of the results between the NE and E+NE groups may indicate a predominant role of NE in determining the overall cardiopulmonary damage. The results provide important clinical insights into the pathogenesis of catecholamine storm.https://www.mdpi.com/2305-6304/8/3/69norepinephrineepinephrinecatecholamine overdoseventricular dysfunctionlung injuries |
| spellingShingle | Wen-Hsien Lu Hsin-Hung Chen Bo-Hau Chen Jui-Chen Lee Chi-Cheng Lai Che-Hsing Li Ching-Jiunn Tseng Norepinephrine Leads to More Cardiopulmonary Toxicities than Epinephrine by Catecholamine Overdose in Rats Toxics norepinephrine epinephrine catecholamine overdose ventricular dysfunction lung injuries |
| title | Norepinephrine Leads to More Cardiopulmonary Toxicities than Epinephrine by Catecholamine Overdose in Rats |
| title_full | Norepinephrine Leads to More Cardiopulmonary Toxicities than Epinephrine by Catecholamine Overdose in Rats |
| title_fullStr | Norepinephrine Leads to More Cardiopulmonary Toxicities than Epinephrine by Catecholamine Overdose in Rats |
| title_full_unstemmed | Norepinephrine Leads to More Cardiopulmonary Toxicities than Epinephrine by Catecholamine Overdose in Rats |
| title_short | Norepinephrine Leads to More Cardiopulmonary Toxicities than Epinephrine by Catecholamine Overdose in Rats |
| title_sort | norepinephrine leads to more cardiopulmonary toxicities than epinephrine by catecholamine overdose in rats |
| topic | norepinephrine epinephrine catecholamine overdose ventricular dysfunction lung injuries |
| url | https://www.mdpi.com/2305-6304/8/3/69 |
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