Circulating noradrenaline leads to release of neuropeptide Y from cardiac sympathetic nerve terminals via activation of β‐adrenergic receptors

Abstract Cardiac disease is marked by sympathoexcitation and elevated levels of noradrenaline (NA) and cotransmitter neuropeptide Y (NPY). Increased NPY levels are associated with a greater risk of ventricular arrhythmias and mortality. Nonetheless, the factors that cause NPY release remain poorly understood. We hypothesized that circulating catecholamines might lead to NPY release from myocardial sympathetic nerve terminals via a β‐receptor‐mediated mechanism that enhances sympathoexcitation. Ventricular interstitial NA and NPY levels were measured in six Yorkshire pigs after i.v . administration of NA (1 mg) and before and after propranolol infusion (1 mg/kg). Real‐time interstitial NPY levels were measured using ventricular capacitive immunoprobes (CIs) affixed with NPY antibodies and quantified as the change in CI input current ( I NPY ) upon binding of NPY. Interstitial NA was measured with adjacent fast‐scan cyclic voltammetry probes ( I NA ). A left ventricular pressure catheter and continuous ECGs were used for haemodynamic recordings, and an epicardial 56‐electrode sock was used for measurements of activation recovery interval, a surrogate of action potential duration. Upon administration of NA, heart rate and left ventricular pressure increased, and activation recovery interval shortened. Notably, NA significantly increased interstitial myocardial NPY levels. After propranolol, changes in heart rate and activation recovery interval were largely mitigated. The I NA increased to a similar extent post‐propranolol vs . pre‐propranolol, but changes in I NPY were significantly reduced post‐propranolol. Coronary sinus plasma analyses confirmed fast‐scan cyclic voltammetry and CI findings. Hence, this study demonstrates that circulating NA induces NPY release from ventricular sympathetic nerve terminals, the mechanism for which is mediated via β‐adrenergic receptors and can be blocked by the non‐selective β‐blocker, propranolol. image Key points Cardiovascular disease is characterized by sympathovagal imbalance, with increased plasma noradrenaline (NA) and neuropeptide Y (NPY) concentrations. Increased NPY levels are associated with increased ventricular arrhythmias and mortality in heart failure. Limited data are available on the specific factors that cause NPY release. In this study, fast‐scan cyclic voltammetry and capacitive immunoprobes were used to allow for real‐time in vivo measurements of interstitial myocardial neurotransmitters and neuropeptides, respectively. Using an in vivo porcine model with cardiac fast‐scan cyclic voltammetry and capacitive immunoprobes, it was shown that systemic NA can increase ventricular interstitial NPY levels, suggesting that NA induces NPY release from postganglionic sympathetic nerves. The release of NPY was blocked by administration of the non‐selective β‐blocker propranolol, suggesting that release of NPY is dependent on activation of β‐adrenergic receptors by NA.