Myocardial turnover of endogenous opioids and calcitonin-gene-related peptide in the human heart and the effects of spinal cord stimulation on pacing-induced angina pectoris

Cardiology. 1998 Mar;89(3):170-7. doi: 10.1159/000006783.


Earlier studies have shown that spinal cord stimulation (SCS) has antianginal and anti-ischemic effects in severe coronary artery disease. In the present study, 14 patients were subjected to right-sided atrial catheterization and atrial pacing. The patients were paced to angina during a control session and during spinal cord stimulation. Myocardial extraction of beta-endorphin (BE) during control pacing (8 +/- 22%) changed to release at the maximum pacing rate during treatment (-21 +/- 47%, a negative value representing release). Furthermore, the results indicate local myocardial turnover of leuenkephalin, BE and calcitonin-gene-related peptide. In addition, it is implied that SCS may induce myocardial release of BE which could explain the beneficial effects in myocardial ischemia.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angina Pectoris / etiology
  • Angina Pectoris / metabolism*
  • Angina Pectoris / rehabilitation
  • Calcitonin Gene-Related Peptide / metabolism*
  • Cardiac Catheterization
  • Cardiac Pacing, Artificial / adverse effects*
  • Electric Stimulation Therapy
  • Electrodes, Implanted
  • Enkephalin, Leucine / metabolism*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / etiology
  • Myocardial Ischemia / metabolism
  • Myocardium / metabolism*
  • Radioimmunoassay
  • Spinal Cord / physiology*
  • beta-Endorphin / metabolism*


  • Enkephalin, Leucine
  • beta-Endorphin
  • Calcitonin Gene-Related Peptide