Catecholamine data in response to exercise

With exercise adrenaline and noradrenaline plasma concentrations increased in both control and syndrome X groups and the actual plasma levels Immediately post-exercise are shown in Table 6.

Adrenaline response to exercise:

The median values together with the interquartile range for the pre-exercise and immediately post-exercise plasma adrenaline concentrations are given in Table 6A. In the control group, the median plasma adrenaline concentration increased from 82 (31,175) pg/ml at rest, to 295 (100,663) pg/ml immediately post exercise.

In the syndrome X group the median plasma adrenaline concentration increased from 144 (49,249) pg/ml to 288 (65,1457) pg/ml immediately after exercise.

Comparison of the two groups immediately after exercise showed that there was no significant statistical difference between them (Mann-Whitney, P=0.60).

Noradrenaline response to exercise:

The median values together with the interquartile range for the pre-exercise and immediately post-exercise plasma noradrenaline concentrations are given in Table 6A.

In the control group, the median plasma noradrenaline concentration increased from 559 (310,804) pg/ml at rest to 990 (857,1547) pg/ml immediately after exercise. In the syndrome X group the median plasma noradrenaline concentration increased from 500 (262,769) pg/ml at rest toi 430 (994,2448) pg/ml immediately after exercise. Comparison of the two groups immediately after exercise showed that there was a significant statistical difference at a level of P=0.04 (Mann-Whitney).

Thus, at the 95% significance level, the data is compatible with there being a difference between the two immediately post-exercise plasma noradrenaline distributions.

Total catecholamine response to exercise

A bar chart illustrating how the median total (adrenaline + noradrenaline) plasma concentrations for both the control and syndrome X groups vary over the course of the test is shown in Figure 6.

With exercise the total plasma catecholamine concentration increased in both groups. Resting, pre-exercise and immediately post-exercise values are shown in Table 7. The median values together with the interquartile range are given in Table 7A. In the control group, the median total catecholamine concentration increased from 654 (357,953) pg/ml at rest, to1264 (965,2290) pg/ml immediately post-exercise. In the syndrome X group the total catecholamine plasma concentration increased from 744 (407,1029) pg/ml at rest, to 1774 (1129,3857) pg/ml immediately post-exercise. Comparison of the two groups immediately post-exercise showed that there was a highly significant statistical difference (Mann-Whitney, P=0.01).

Figure 6.

Median total plasma catecholamine concentrations (with interquartile range) for the control and syndrome X groups over the course of the test.

Concentration (pg/ml) 4000 3500 3000 2500 2000 1500 1000 500 0 □Control Group □Syndrome X Group P = 0.0 1 *, 1774 P =0.62* 1264 P = 0.9 4 * 654 744 822 906

Pre-exercise Immediately 20 mins Post-Exercise Post-Exercise

Plasma catecholamine concentration changes from pre-exercise to immediately post-exercise (delta values)

A box plot illustrating the median plasma adrenaline and noradrenaline concentration changes from pre-exercise to immediately post-exercise (delta values) is shown in Figure 7. This figure also lists the P values for the Mann-Whitney tests of significance between each of the two distributions at the pre-exercise and immediately post-exercise points.

The increases in the plasma catecholamine concentrations from pre-exercise to immediately post-exercise (delta values) for both the control and syndrome X subjects are shown in Table 8. The median delta values together with the interquartile range for the changes are given in Table BA.

The median pre-exercise to immediately post-exercise change score for adrenaline was 202 (32,476) pg/ml for the control group and 134 (12,1233) pg/ml for the

syndrome X groups. There was no statistical significant difference between the groups. (Mann-Whitney, P=0.60)

The median pre-exercise to immediately post-exercise change score for noradrenaline was 546 (260,901) pg/ml for the control group and 850 (520,1926) pg/ml for the syndrome X group. There was a highly significant statistical difference between the groups (P=0 005) Thus, at the 99% significance level, the data is compatible with there being a difference in delta noradrenaline values between the control and syndrome X groups.

Figure 7.

Median delta values for the plasma adrenaline and noradrenaline concentrations from pre-exercise to immediately post-exercise.

Median delta value (pg/ml)

1000 800 600 400 200 P=0.005* P=0.60* Control Syndrome X

Adrenaline

Noradrenaline

Relation between plasma catecholamine concentration changes from pre­ exercise to immediately post-exercise (delta values) and immediately post­ exercise ST segment depression in syndrome X patients

Adrenaline concentrations versus ST segment depression:

A graph illustrating the increase in the plasma adrenaline concentrations from pre­ exercise to immediately post-exercise (delta values) versus ST segment depression immediately post-exercise in syndrome X patients is shown in Figure 8 .

From this scatter plot it is apparent that there is no correlation between the two parameters (The Spearman Rank Correlation Coefficient is - 0.094 which is not significant with a P value >0.2 ).

Figure 8.

Scatterplot of the delta values for the plasma adrenaline concentration from pre-exercise to immediately post-exercise versus ST segment depression for the syndrome X group.

Delta value for concentration (pg/ml) 3000 2500 2000 1500 1000 500 -500 0 0.5 1 1.5 2 2.5 3 3.5 ST segment depression (mm) 4.5

Noradrenaline concentrations versus ST segment depression:

A graph illustrating the increase in the plasma noradrenaline concentrations from pre-exercise to immediately post-exercise (delta values) versus ST segment depression immediately post-exercise is shown in Figure 9.

From this scatter plot it is apparent that that there is no correlation between the two parameters (The Spearman Rank Correlation Coefficient is -0.244 which Is not significant with a P value >0.1).

Figure 9.

Scatterplot of the delta values for the plasma noradrenaline concentration from pre-exercise to immediately post-exercise versus ST segment

depression for the syndrome X group.

Delta value for concentration (pg/ml) 4000 3000 2000 1000 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 ST segment depression (mm)

Percentage increase in the plasma concentration of catecholamines from pre-exercise to immediately post-exercise

The percentage increases in the median plasma catecholamine concentrations from pre-exercise to immediately post-exercise are illustrated in a bar chart in Figure 10. This Figure also lists the P values for the Mann-Whitney tests of significance for the percentage increases in adrenaline and noradrenaline serum concentrations.

The percentage increases in the adrenaline and noradrenaline median plasma

concentrations are given in Table 9. The median percentage increase together with the interquartile range are given in Table 9A .

Plasma adrenaline:

In the control group the median plasma adrenaline percentage increase was 137% (55,498%) and in the syndrome X group was 132% (20,522%)

There was no significant difference between the groups (Mann-Whitney P=0.61). Plasma noradrenaline:

In the control group the median plasma noradrenaline percentage increase was 108% (60,173%) and in the syndrome X group was 191% (109,313%). There was a highly significant statistical difference between the groups (Mann Whitney, P=0 002).

Thus, at the 99% significant level, the data are compatible with there being a difference between the two percentage increases in noradrenaline distributions.

Figure 10.

Median percentage increase in the plasma adrenaline and noradrenaline concentrations from pre-exercise to immediately post-exercise.

Median % increase 250 200 150 100 50 0 P=0.61* Control Syndrome X

Adrenaline

r

Noradrenaline