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January 1969

Hyperdynamic ß-Adrenergic Circulatory State: Increased ß-Receptor Responsiveness

Arch Intern Med. 1969;123(1):1-7. doi:10.1001/archinte.1969.00300110003001

Hemodynamic and pharmacological characteristics of 14 patients with clinical findings suggesting hyperdynamic β-adrenergic circulatory state (including 12 with hypertension of unknown cause) were compared with 13 essential hypertensive patients and 25 normotensive volunteer subjects. Patients with cardiac symptoms had significantly higher resting cardiac index and heart rate than normotensive or asymptomatic hypertensive individuals. Graded isoproterenol hydrochloride infusion increased heart rate significantly more in the symptomatic group than in the others, indicating increased β-receptor hyperresponsiveness. In nine of the 14 patients, isoproterenol produced an hysterical outburst, almost uncontrollable, which was promptly reversed with propranolol hydrochloride but not placebo. It therefore seems reasonable to ascribe the syndrome of cardiac awareness, increased heart rate responsiveness to various stimuli, and hyperkinetic circulation to increased β-adrenergic receptor reactivity. This conclusion is supported by remission of symptoms and reduction of arterial pressure with propranolol in all treated patients.

Frohlich, E.D.; Dustan, H.P.; and Page, I.H.:  Hyperdynamic Beta-Adrenergic Circulatory State ,  Arch Intern Med 117:614-619 ( (May) ) 1966.Crossref
Frohlich, E.D., et al:  A Hemodynamic Comparison of Essential and Renovascular Hypertension: Cardiac Output and Total Peripheral Resistance Supine and Tilted ,  Circulation 35:289-297 ( (Feb) ) 1967.Crossref
Ulrych, M., et al:  Immediate Hemodynamic Effects of Beta-Adrenergic Blockade With Propranolol in Normotensive and Hypertensive Man ,  Circulation 37:411-416 ( (March) ) 1968.Crossref
Croxton, F.E.:  Elementary Statistics , New York: Dover Publications, Inc., 1953.
Hartshorne, H.:  On Heart Disease in the Army ,  Amer J Med Sci 48:89-92 ( (July) ) 1864.Crossref
Da Costa, J.M.:  On Irritable Heart: A Clinical Study of a Form of Functional Cardiac Disorder and Its Consequences ,  Amer J Med Sci 61:2-52 ( (Jan) ) 1871.Crossref
Friedberg, C.K.:  Diseases of the Heart , Philadelphia: W. B. Saunders Co., 1967, p 1721.
Gorlin, R.:  The Hyperkinetic Heart Syndrome ,  JAMA 182:823-829 ( (Nov 24) ) 1962.Crossref
Gottsegen, G.; Okos, G.; and Romoda, R.:  Essential Circulatory Hyperkinesis ,  Amer J Cardiol 10:785-791 ( (Dec) ) 1962.Crossref
Bollinger, A., et al:  Treatment of the Hyperkinetic Heart Syndrome With Propranolol ,  Cardiologia 49 ( (suppl 2) ):68-82, 1966.Crossref
Sutherland, E.; Robison, G.A.; and Butcher, R.W.:  Some Aspects of the Biological Role of Adenosine 3', 5'-Monophosphate (Cyclic AMP) ,  Circulation 37:279-306 ( (Feb) ) 1968.Crossref
Besterman, E.M.M., and Friedlander, D.H.:  Clinical Experience With Propranolol ,  Postgrad Med J 41:526-535 ( (Sept) ) 1965.Crossref
Nordenfelt, O.:  The Orthostatic ECG Changes and the Adrenergic and Beta-Receptor Blocking Agent, Propranolol (Inderal) ,  Acta Med Scand 178: 393-401 ( (Oct) ) 1965.Crossref
Granville-Grossman, K.L., and Turner, P.:  The Effect of Propranolol in Anxiety ,  Lancet 1: 788-790 ( (April 9) ) 1966.Crossref
Suzman, M.M.:  An Evaluation of the Effects of Propranolol on the Symptoms and Electrocardiographic Changes in Patients With Anxiety and the Hyperventilation Syndrome, abstracted ,  Ann Intern Med , to be published.
Frohlich, E.D., et al:  The Paradox of Beta-Adrenergic Blockade in Hypertension ,  Circulation 37:417-423 ( (March) ) 1968.Crossref
Frohlich, E.D.; Tarazi, R.C.; and Dustan, H.P.: " Use of Beta-Adrenergic Blockade in Hypertensive Diseases , in A. Kattus (ed.),  Beta-Adrenergic Responses: Therapeutic Implications in Cardiovascular Disease , UCLA Forum in Medical Sciences, Berkeley, Calif: University of California Press, to be published.