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European Heart Journal 1992 13(8):1074-1079;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Plasma endogenous opioid levels in acute myocardial infarction patients, with and without pain

P. BERNARDI*,, F. FONTANA*, E. M. PICH{dagger}, S. SPAMPINATO{dagger} and M. CANOSSA{dagger}

*Istituto di Patologia, Speciale Medica e Metodologia Clinica, Università degli Studi di Bologna Italy
{dagger}Istituto di Fisiologia Umana, Università degli Studi di Modena Italy
{ddagger}Dipartimento di Farmacologia, Università degli Studi di Bologna Italy

Received 18 July 1991; revised 13 February 1992; .

Correspondence Prof. Pasquale Bernardi, Istituto di Patologia Speciale Medica e Metologia Clinica, Ospedale S. Orsola. Via Massarenti, 9, 40138 Bologna, Italy.

Abstract

Plasma levels of ß-endorphin, met-enkephalin and dynorphin were assessed in acute myocardial infarction (A MI) patients, with and without pain (group I: no pain, N = 12; group II: severe pain, N = 16). Plasma opioid peptide concentration was measured on admission to hospital (between 1 and 3 h after the myocardial infarction onset), at 7, 12, 24 h and at 2, 3 and 4 days. A transient increase in plasma ß-endorphin levels was found in AMI patients with severe pain, the levels normalizing within 12–18 h when pain had ceased. No changes in ß-endorphin concentration were observed in AMI patients without pain. Compared with healthy subjects, low levels of met-enkephalin were found in both groups of AMI patients throughout the study. Low levels of dynorphin were observed in patients with no pain while in the other patients initial low levels of dynorphin normalized when pain ceased. Blood pressure, heart rate and central venous pressure values were normal and did not correlate with plasma opioid levels. The results suggest that endogenous opioids do not affect pain in the early phase of myocardial infarction. The rise in ß-endorphin concentration observed in patients with severe pain seems to be induced by pain stress.

Key Words: Endogenous opioids • ß-endorphin • met-enkephalin • dynorphin • myocardial infarction • chest pain


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