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Biomedical subjects

V DeQuattro

Publications and source records attributed to V DeQuattro.

At least 91 records · Page 5Linked to original sources

Increased plasma catecholamines in high renin hypertension.

Plasma catecholamines, indexes of sympathetic nervous tonicity, were measured simultaneously with renin both supine and after standing plus furosemide in patients with primary hypertension and normotensive volunteers. Seventy percent of hypertensive patients with high renin levels had increased catecholamines compared with a 14% incidence in the combined group with low and normal renin (P less than 0.001). Basal catecholamines were related directly to renin in the hypertensive patients and to blood pressure in the normal (P less than 0.05), but not in the high and low renin subgroups, and inversely to percent increase of catecholamines after standing plus furosemide in hypertensive and normotensive patients (P less than 0.01). Sympathetic nervous hypertonicity may be responsible for the elevation of blood pressure and for the activation of the renin-angiotensin system in patients with high renin hypertension.

Adolescent↗

High-renin essential hypertension: adrenergic cardiovascular correlates.

1. Patients with mild essential hypertension and elevated plasma renin activity, when compared with normal subjects and hypertensive subjects with normal plasma renin, demonstrated features of sympathetic nervous cardiovascular excitation, accompanied by a raised plasma noradrenaline concentration. 2. An elevated heart rate at rest, shortened cardiac pre-ejection period, and greater heart rate reduction with acute beta-adrenoreceptor blockade (intravenous propranolol) in high-renin essential hypertension were indicative of adrenergic cardiac excitation. An elevated total of peripheral vascular resistance at rest and a greater fall in peripheral resistance with alpha-adrenoreceptor blockade (intravenous phentolamine) suggested the existence of a neurogenic increase in arteriolar resistance. 3. Blood pressure was normalized by 'total' autonomic blockade (atropine plus propranolol plus phentolamine) in the hypertensive subjects with elevated plasma renin activity. 4. These findings suggest that in mild high-renin essential hypertension increased adrenergic drive to the heart and resistance vessels exists. The elevation of blood pressure is sustained predominantly by neurogenic mechanisms. The high plasma renin activity is seen as an expression of sympathetic nervous system overactivity.

Adolescent↗

Sympathotonia in primary hypertension and in a caricature resembling dysautonomia.

1. Plasma catecholamines and adrenergic correlates of cardiac function were compared in young men with borderline hypetension, classified according to renin status (group 1). Plasma catecholamines were increased and cardiac pre-ejection periods were shortened in 'high'-renin patients. 2. Plasma catecholamines were raised in 70% of 'high'-renin patients with primary hypertension (group 2), were related directly with age in normotensive females and were related inversely with catecholamine responses to postural stress in both normotensive and hypertensive subject (P less than 0-01). 3. The raised catecholamines of four 'high'-renin patients with pronounced features of sympathetic nerve activity-acricatures were elevated further during,hypertensive periods. Mean arterial blood pressures were reduced 20-30% after either alpha- or beta-receptor blockade. Catecholamines were reduced after beta-receptor blockade. 4. There appears to be a spectrum of neurogenic 'gain' in primary hypertension; it is suppressed in 'low'-renin hypertension, directly related to blood pressure in 'normal'-renin hypertension, increased in 'high'-renin hypertension and achieves a maximum in caricatures. Neurogenic factors seem to be important in the cause and maintenance of 'high'- and 'normal'-renin hypertension respectively. The caricatures may be examples of a severe form of hypothalamic stimulation.

Adolescent↗

Aldosteronoma in a child with localization by adrenal vein aldosterone: collective review of the literature.

Hyperaldosteronism due to aldosteronoma is a rare but potentially curable form of pediatric hypertension. We have presented a patient who had symptoms of enuresis and fatigue, and in whom the diagnosis was suggested by low serum potassium and persistent hypertension. Diagnosis was confirmed by increased plasma and urinary aldosterone and decreased plasma renin. The tumor was localized with the aid of adrenal venography and catheterization, which showed greatly increased plasma aldosterone levels in the right adrenal vein. The pathologic findings were totally reversed by right adrenalectomy. The clinical picture and results following surgical removal of aldosterone-producing tumors in six children are reviewed.

Adrenal Glands↗

Increased plasma catecholamine concentrations and vas deferens norepinephrine biosynthesis in men with elevated blood pressure.

Systemic biochemical indexes of sympathetic nerve functionplasma catecholamine concentrations and serum dopamine-beta-hydroxylase activitywere correlated with regional indexesnorepinephrine concentration activities of norepinephrine biosynthetic enzymes in the vas deferensānd with blood pressures and pulse rates of 57 men at the time of vasectomy. Mean plasma catecholamine content was increased 66% and 60% in men with elevated systolic and elevated systolic and diastolic blood pressures, respectively. The norepinephrine concentration, tyrosine hydroxylase activity, and dopa decarboxylase activity in the vas deferens were increased in 12%, 26%, and 17% of the men with elevated blood pressure, respectively. Tyrosine hydroxylase and dopa decarboxylase in the men with elevated systolic blood pressure were increased 41% and 68%, respectively, compared with values in the men with normal blood pressure (P less than 0.05 and P less than 0.02). Individual plasma catecholamine content was related directly to both systolic and mean blood pressure (P less than 0.01) and to activities of vas deferens tyrosine hydroxylases (P less than 0.05) and dopa decarboxylase (P less than 0.01). There was a weak, but not significant, correlation of plasma catecholamine concentration with serum dopamine-beta-hydroxylase activity. Raised plasma catecholamine concentration in men with elevated blood pressure prior to vasectomy was associated with increased neurotransmitter biosynthesis in their vas deferens, which may indicate increased sympathetic nerve tonicity and perhaps be a factor contributing to the blood pressure elevation.

Adult↗

Biochemical evaluation of sympathetic nerve tone in essential hypertension.

The concentration of plasma catecholamines (CA), serum dopamine beta-hydoxylase (DBH) activity and plasma renin activity (PRA) were simultaneously measured in 55 patients with essential hypertension (EH). Further the enzyme activities of CA biosynthesis in human vas deferens excised at elective vasectomy were related with the blood pressure, plasma CA, serum DBH of 57 men at the time of vasectomy. Total plasma CA and norepinephrine (NE) were increased in 28 and 35% of patients with benign EH, respectively. Total plasma CA were also increased in 45% of men with elevated blood pressure prior to vasectomy. Total plasma CA were correlated with diastolic blood pressure in EH (p less than 0.01). Further, in men with normal and raised blood pressure prior to vasectomy, there was a significant correlation of total plasma CA with systolic and diastolic blood pressure (p less than 0.01). Total plasma CA were correlated with PRA in patients with EH (r=0.497, p less than 0.001). Capacity for NE biosynthesis, vas deferens tyrosine hydroxylase (TYH) activity and dopa decarboxylase (DDC) activity were increased in men with raised blood pressure. There was a direct correlation of total plasma CA with the activities of TYH and DDC (r=0.46, and 0.54, p less than 0.005). Increased sympathetic nerve tonicity associated with increased neurotransmitter biosynthesis may be an important factor responsible for blood pressure elevation in men prior to vasectomy and in others with EH. The some patients with EH may have a renin-catecholamine relationship and both pressor systems may be linked to be a pathogenic factor for the elevation of blood pressure.

Blood Pressure↗

Multiple endocrine adenomatosis type II (Sipple's syndrome) in twins.

Medullary carcinoma of the thyroid, pheochromocytoma and multiple mucosal neuromas (MEA-II), a familial disorder of neuroectodermal tissue, is believed to be inherited in an autosomal dominant pattern. The occurrence of this syndrome in twins has not previously been reported. We have documented the presence of MEA-II in a pair of twins. The high incidence of bilaterality of pheochromocytoma is emphasized, as well as the usefulness of preoperative catecholamine fractionation, and vena cava catheterization sampling.

Adult↗