Adrenal gland‐released vasostatin‐I is a myocardial depressant factor

Author:

Schneider Francis123ORCID,Castelain Vincent1,Herbrecht Jean‐Etienne1,Hellé Sophie23,Metz‐Boutigue Marie‐Hélène23

Affiliation:

1. Service de Médecine Intensive‐Réanimation Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg France

2. Inserm UMR 1121, Faculté de Chirurgie Dentaire, Hôpital Civil, 1 Place de l'Hôpital Strasbourg France

3. Fédération de Médecine Translationnelle de Strasbourg, Faculté de Médecine, Rue Kirchleger, 67000 Strasbourg France

Abstract

Pheochromocytoma crisis is an exceptional consequence of the release of storage vesicles of the adrenal medulla. It is complicated by fulminant adrenergic myocarditis. It offers a unique opportunity to detect inotropic negative factors from neuroendocrine origin. Our objectives were (a) to describe a pheochromocytoma crisis, (b) to investigate in vivo myocardial depressant activities for the N‐terminal 1‐76 Chromogranin A‐derived peptide, vasostatin‐I (VS‐I). A patient with a pheochromocytoma crisis was treated, including extracorporeal membrane oxygenation, until mass resection. Plasma concentrations of VS‐I were time‐dependently assessed with a specific immunoassay; correlations with invasive cardiovascular parameters were investigated. Increased VS‐I concentrations were observed over 7 days until tumour resection. VS‐I concentrations correlated positively with Chromogranin A levels, negatively with cardiac output and left ventricular stroke work index, but not with heart rate. This case illustrates the pharmacokinetics of VS‐I in a pheochromocytoma crisis. It highlights myocardial depressant activity for this peptide at high concentrations.

Publisher

Wiley

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