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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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Autores principales: Lu, Wen-Hsien, Chen, Hsin-Hung, Chen, Bo-Hau, Lee, Jui-Chen, Lai, Chi-Cheng, Li, Che-Hsing, Tseng, Ching-Jiunn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560392/
https://www.ncbi.nlm.nih.gov/pubmed/32947820
http://dx.doi.org/10.3390/toxics8030069
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author Lu, Wen-Hsien
Chen, Hsin-Hung
Chen, Bo-Hau
Lee, Jui-Chen
Lai, Chi-Cheng
Li, Che-Hsing
Tseng, Ching-Jiunn
author_facet Lu, Wen-Hsien
Chen, Hsin-Hung
Chen, Bo-Hau
Lee, Jui-Chen
Lai, Chi-Cheng
Li, Che-Hsing
Tseng, Ching-Jiunn
author_sort Lu, Wen-Hsien
collection PubMed
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.
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spelling pubmed-75603922020-10-22 Norepinephrine Leads to More Cardiopulmonary Toxicities than Epinephrine by Catecholamine Overdose in Rats Lu, Wen-Hsien Chen, Hsin-Hung Chen, Bo-Hau Lee, Jui-Chen Lai, Chi-Cheng Li, Che-Hsing Tseng, Ching-Jiunn Toxics Article 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. MDPI 2020-09-16 /pmc/articles/PMC7560392/ /pubmed/32947820 http://dx.doi.org/10.3390/toxics8030069 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lu, Wen-Hsien
Chen, Hsin-Hung
Chen, Bo-Hau
Lee, Jui-Chen
Lai, Chi-Cheng
Li, Che-Hsing
Tseng, Ching-Jiunn
Norepinephrine Leads to More Cardiopulmonary Toxicities than Epinephrine by Catecholamine Overdose in Rats
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560392/
https://www.ncbi.nlm.nih.gov/pubmed/32947820
http://dx.doi.org/10.3390/toxics8030069
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