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The acute cardiovascular actions of intravenous thyrotrophin releasing hormone (TRH) in man are mediated by non-catecholaminergic mechanisms
Authors:PIERRE-MARC BOULOUX  SALVATORE CORSELLO  MICHAEL BESSER  ASHLEY GROSSMAN
Affiliation:1.Academic Department of Medicine Royal Free Hospital, West Smithfield, London, UK;2.Medical Professorial Unit and Department of Endocrinology, St Bartholomew''s Hospital, West Smithfield, London, UK
Abstract:
  1. Intravenous bolus doses of thyrotrophin releasing hormone (TRH, 50–1000 μg) caused statistically significant, non-dose dependent and transient rises in blood pressure, heart rate and plasma catecholamines in healthy young males.
  2. Mean peak incremental rises in systolic blood pressure (mean ± s.e. mean) following 50, 200 and 500 μg TRH were 14.3 ± 2.9 mmHg, 15.7 ± 3.2 mmHg and 17.1 ± 3.9 mmHg respectively (all P < 0.05 vs placebo). Mean incremental rises in heart rate for the three doses of TRH were 8.2 ± 2.2 beats min−1, 7.1 ± 1.8 beats min−1, and 1O.7 ± 2.9 beats min−1 respectively (all P < 0.05 vs placebo).
  3. Following the 50 μg and 1000 μg doses of TRH, plasma noradrenaline and adrenaline rose significantly (P < 0.05) between 4 and 8 min. Mean ± s.e. mean incremental plasma noradrenaline rise following 50, 200 and 1000 μg TRH were 0.4 ± O.13 nmol 1−1, 0.37 ± 0.21 nmol 1−1 and 0.41 ± 0.18 nmol 1−1 respectively. Mean ± s.e. mean incremental rise in adrenaline for the 50, 200 and 1000 μg dose were 0.13 ± 0.04 nmol 1−1, 0.08 ± 0.03 nmol 1−1, and 0.11 ± 0.05 nmol l−1 respectively.
  4. Following administration of the ganglion blocking drug pentolinium (5 mg) the incremental systolic blood pressure and heart rate rises following 500 μg TRH alone 16.6 ± 2.8 mmHg and 1O.4 ± 3.1 beats min−1 respectively.
  5. The rises in plasma noradrenaline and adrenaline following TRH were attenuated by prior ganglion blockade.
  6. α-adrenoceptor blockade with thymoxamine (0.3 mg kg−1 bolus + 0.3 mg kg−1 h−1 infusion), singly and combined with intravenous propranolol (10 mg i.v. over 10 min), did not alter the pressor or tachycardic effects of 500 μg TRH.
  7. In conclusion, although plasma noradrenaline rises following i.v. TRH, suggesting activation of the sympathetic nervous system, this effect is not responsible for the pressor response to TRH, which appears to be due to either a direct vasoconstrictive effect on the peripheral resistance vessels or a direct inotropic/chronotropic effect on the heart.
Keywords:thyrotrophin   releasing hormone   blood pressure   pulse   plasma   catecholamines   ganglion blockade   adrenoreceptor blockade
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