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Heart rate and plasma catecholamines were determined in 16 patients with alcoholic fatty liver and 14 patients with alcoholic cirrhosis of the liver. The measurements were performed at rest and after exercise on the bicycle ergometer, on average 11 days after admission to hospital. In comparison with a control group, the mean heart rate of the patient group was significantly increased at rest and under graduated loading. Significantly increased plasma catecholamine concentrations under resting conditions were observed in both groups of patients, the increase being more pronounced in the cirrhotics (increased with progressive liver damage, significant differences being found between the control group and each of the two groups of patients). During exercise under a load of 50 or 100 watts, the increases in adrenaline, noradrenaline and dopamine concentrations were greatest in patients with alcoholic cirrhosis. With reference to the initial values, however, the increases in concentration were identical in all three groups. In the patients, metabolism of the catecholamines remained unchanged after an average of 11 days abstinence from alcohol; they showed a significantly diminished elimination of vanillylmandelic acid in the urine and, compared with the greatly elevated plasma catecholamine levels, they showed only a moderate increase in the excretion of catecholamines. The results reported here support the assumption that changes in catecholamine metabolism compatible with an increased sympathetic activity are present in chronic alcoholics without advanced liver damage.

Catecholamines in the Plasma and Urine of Patients with Alcoholic Liver Damage under Resting and Exercise Conditions