The significance of plasma catecholamine levels in the pathogenesis of arteriosclerosis

Summary

Experiments, with animals and with cultured vascular wall cells as well as clinical observations on patients suffering from pheochromocytoma, favour the hypothesis that catecholamines could play an important role in the pathogenesis of arteriosclerosis. As the catecholamines, adrenaline and/or noradrenaline, promote metabolic dysfunctions in vascular wall cells, which are important in the pathogenesis of arteriosclerosis, these compounds may well be acting as chemical mediators during atherogenesis. Therefore investigations on plasma catecholamine levels in patients, exposed to atherogenic risk factors, with different stages of arteriosclerosis, and in patients suffering from thrombotic complications of an arteriosclerotic vascular disease, may lead to an answer for the question of whether or not plasma catecholamine levels are of clinical importance in the pathogenesis of arteriosclerosis in man.

In individuals subjected to the atherogenic risk factors, smoking, essential hypertension, and mental stress, plasma catecholamine levels were statistically significantly elevated. In patients suffering from diabetes mellitus plasma adrenaline and noradrenaline concentrations however were similar to those of healthy controls. In dialysis patients, who often develop arteriosclerosis which progresses with great rapidity, plasma adrenaline and noradrenaline concentration showed a positive correlation with different stages of arteriosclerosis; i.e. plasma catecholamine concentration increases with the severity of this disease. Arteriosclerotic vascular diseases sometimes give rise to thrombotic complications, the most prominent ones being myocardial infarction and stroke. Compared with healthy controls, even one year after infarction, 70% of the patients who had had a myocardial infarction and 50% of the stroke patients had significantly elevated plasma adrenaline and/or noradrenaline levels. Further investigations on patients suffering from coronary heart disease showed that elevated plasma catecholamine concentration is more probably related to the pathogenesis of the vascular disease than to the incurrence of myocardial infarction.

From these data we conclude that catecholamines are substances that can act as chemical mediators during the pathogenesis of arteriosclerosis in man and thus may contribute to the development and subsequent complications of this important vascular disease.