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Gary P. Zaloga, MD; Bart Chernow, MD; Russ Zajtchuk, MD; Robert Chin, MD; Thomas G. Rainey, MD; C. Raymond Lake, MD, PhD

Arch Intern Med. 1984;144(6):1149-1152.

Abstract
• While performing thyroid function tests, we noticed that protirelin (TRH) raised BP, and, therefore, we investigated the effect of diagnostic dosages of protirelin (500 µg) on plasma catecholamine levels and cardiovascular function in eight patients one day before, one day after, and four weeks following heart surgery. Mean arterial pressure (MAP), heart rate (HR), plasma norepinephrine (NE), epinephrine (EPI), dopamine (DA), thyroid hormone (triiodothyronine [T₃], thyroxine), and thyrotropin (TSH) levels were measured before and after the intravenous injection of protirelin. Protirelin increased MAP transiently from 88 ± 2 to 103 ± 3 mm Hg (before surgery), 86±4 to 102±4 mm Hg (one day after surgery), and 86±4 to 104±5 mm Hg (four weeks after surgery). There were no notable changes in HR or plasma NE, EPI, or DA levels. The T₃ and TSH response to protirelin was normal on all three study days. Protirelin raised MAP by an effect on systemic vascular resistance (SVR) rather than an increase in cardiac output. We conclude the following: (1) diagnostic dosages of protirelin transiently elevate MAP and SVR by a noncatecholamine mechanism, (2) clinicians who perform protirelin tests should be aware of protirelin's transient pressor effects.

(Arch Intern Med 1984;144:1149-1152)

Author Affiliations
From the Departments of Internal Medicine (Drs Zaloga and Chin) and Critical Care Medicine (Drs Chernow and Rainey), Naval Hospital, Bethesda; the Department of Thoracic Surgery, Walter Reed Army Medical Center, Washington, DC (Dr Zajtchuk); and the Departments of Medicine (Drs Chernow and Rainey), Psychiatry (Dr Lake), Pharmacology (Dr Lake), and Thoracic Surgery (Dr Zajtchuk), Uniformed Services University of the Health Services, Bethesda, Md.

Footnotes
Accepted for publication Sept 20, 1983.

The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Navy or Army Departments, of the Naval or Army Services at large, or of the Department of Defense.

Reprint requests to Box 129, Naval Hospital, Bethesda, MD 20814 (Dr Chernow).

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