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NEUROLOGY 1991;41:1107
© 1991 American Academy of Neurology

Beta-receptor sensitivity in autonomic failure

S. M. Baser, MD, R. T. Brown, MD, M. T. Curras, MD, C. E. Baucom, BS, D. R. Hooper, BS; and and R. J. Polinsky, MD

Clinical Neuropharmacology Section, Clinical Neuroscience Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD.

We examined the cardiovascular, plasma norepinephrine (NE), and plasma renin (PRA) responses to isoproterenol infusion in patients with autonomic failure and in normal subjects. Slopes of the blood pressure response/dose relationships were more negative in patients with multiple system atrophy and pure autonomic failure (PAF) than in normal subjects, consistent with impaired baroreflex modulation. A shift to the left in patients with PAF suggests ß-adrenergic receptor supersensitivity. In normal subjects, the increase in plasma NE and PRA was proportional to the log of the plasma isoproterenol level. Isoproterenol infusion did not increase plasma NE or PRA in either patient group despite a reduction in mean blood pressure. Reflexive cardiovascular and renal mechanisms appear to play a role in eliciting the plasma NE and PRA responses to isoproterenol infusion in normal subjects.

Address correspondence and reprint requests to Dr. Ronald J. Polinsky, Bldg. 10, Room 5N262, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892.

Received June 26, 1990. Accepted for publication in final form December 10, 1990.






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