Free adrenaline, noradrenaline and vanilylmandelic acid excretion with 24-hour urine in patients with chronic circulatory failure.

The purpose of this work was to study the excretion of free adrenaline (A), noradrenaline (NA) and vanilylmandelic acid (VMA) in 24-hour urine in patients with chronic circulatory failure. The investigations were carried out in a group of 152 patients (61 women and 91 men) with rheumatic valvular heart disease (61 cases), chronic cor pulmonale syndrome (23), atherosclerotic myocardial degeneration (68). A and NA urinary excretion was normal in cases with grades 1 and 2 of hemodynamic disturbances. In cases with grades 3 and 4 the excretion of catecholamines was significantly raised, especially that of NA. With regression of circulatory failure the excretion of catecholamines decreased even to normal level. Increased VMA excretion was observed only in cases with grade 4 hemodynamic disturbances. The only factor influencing the function of the adrenergic system and excretion of catecholamines was the degree of circulatory failure. Stimulation of adrenergic system in chronic circulatory failure counteracts the effects of hemodynamic disturbances caused by circulatory failure.