Dorothy E. Vatner

Depressed beta-adrenergic receptor- and endothelium-mediated vasodilation in conscious dogs with heart failure.

Peripheral vasodilator responsiveness was examined in pacing-induced heart failure (HF) in 11 conscious dogs chronically instrumented for measurement of systemic (total peripheral resistance [TPR]) and local (iliac blood flow) vascular resistance. Dose responses to isoproterenol (ISO), acetylcholine (ACh), and nitroglycerin (NTG) were examined in the same dogs before pacing (control) and after 4 to 7 weeks of rapid ventricular pacing, which induced congestive HF, characterized by increased left ventricular end-diastolic pressure (6.7 +/- 0.4 [control] versus 28 +/- 1.5 [HF] mm Hg) and decreased cardiac output (-30 +/- 5%) and left ventricular dP/dt (-53 +/- 3%), as well as ascites and peripheral edema. In the control state, TPR fell by 57 +/- 2% in response to ISO (100 ng/kg), by 61 +/- 3% in response to ACh (3 micrograms/kg), and by 55 +/- 2% in response to NTG (10 micrograms/kg). In HF, smaller decreases (P < .05) in TPR were observed with the same doses of ISO (-50 +/- 2%) and ACh (-49 +/- 2%) but not with NTG (-58 +/- 3%). Depressed responses to systemic ISO and ACh, but not NTG, were observed in HF in the presence of ganglionic blockade and also after local administration of smaller doses of the drugs in the absence of ganglionic blockade, but where systemic effects were not elicited. Inhibition of nitric oxide synthase increased TPR to a greater degree before HF (+154 +/- 28% [control]) than after (+80 +/- 22% [HF]) and eliminated the depressed responses to ACh but not to ISO. beta-Adrenergic receptor density, as determined by 125I-cyanopindolol binding in membrane preparations from mesenteric vessels was significantly decreased after HF (130 +/- 3 [control] versus 100 +/- 8 [HF] fmol/mg, P < .05) without any change in affinity. Thus, peripheral vascular beta-adrenergic receptor downregulation occurs in HF, independent of altered endothelium-mediated peripheral vasodilation.

BETA -ADRENOCEPTOR DESENSITIZATION DURING THE DEVELOPMENT OF CANINE PACING-INDUCED HEART FAILURE

1. The goal of this review is to emphasize four major points regarding the development of catecholamine desensitization in heart failure (HF).

NADP improves the efficiency of cholera toxin gatalyzed ADP-ribosylation in liver and heart membranes

Guanine nucleotide binding proteins (G-proteins) can be identified by their ability to be ADP-ribosylated using [32P]NAD as the substrate and bacterial toxins as catalysts. This labelling, when performed in liver and sarcolemma membrane preparations, can be complicated by competing enzymes which degrade NAD, making it unavailable to participate in the desired reaction. The addition of NADP in reaction mixtures markedly slows the degradation of NAD, but does not compete with NAD in cholera toxin labelling of stimulatory G-protein. The efficiency of cholera toxin labelling is improved to the extent that saturation curves may be constructed, allowing the quantitation of ADP-ribosylation sites in membranes.

Inotropic response to norepinephrine is augmented early and maintained late in conscious dogs with perinephritic hypertension.

We studied the inotropic responses to intravenous infusions of norepinephrine in nine conscious chronically instrumented dogs before and early (2-4 weeks) in the development of perinephritic hypertension; seven conscious dogs were studied later (approximately 14 weeks), during a more stable phase of hypertension. perinephritic hypertension was associated with a 24% increase in left ventricular (LV) mass during developing hypertension; no further increase was seen during the stable hypertension phase. LV end-systolic stress was increased early (p less than 0.01) but was normalized later. The LV end-systolic stress-volume relation demonstrated an enhanced contractile response to norepinephrine during developing hypertension, which returned toward control later in the course of stable hypertension. The LV dP/dt responses to norepinephrine (0.4 microgram/kg/min) were significantly greater during developing hypertension (7,509 +/- 337 mm Hg/sec, p less than 0.05) compared with the control period (4,737 +/- 286 mm Hg/sec) and returned toward the control value during stable hypertension (5,168 +/- 465 mm Hg/sec). The enhanced inotropic responses to norepinephrine in developing hypertension were preserved in the presence of ganglionic blockade, suggesting that the augmentation was not mediated via reflex mechanisms. These physiological responses were associated with an increase in beta-adrenergic receptor density, but no significant change in basal or maximal adenylate cyclase stimulation occurred during developing hypertension. Thus, in contrast to prior studies in anesthetized animals, the inotropic response to beta-adrenergic stimulation is not depressed in conscious dogs but is enhanced selectively during the development of hypertension and maintained during stable hypertension.

Mechanisms of alpha 1-adrenergic vascular desensitization in conscious dogs.

To investigate the mechanisms of alpha 1-adrenergic vascular desensitization, osmotic minipumps containing either saline (n = 9) or amidephrine mesylate (AMD) (n = 9), a selective alpha 1-adrenergic receptor agonist, were implanted subcutaneously in dogs with chronically implanted arterial and right atrial pressure catheters and aortic flow probes. After chronic alpha 1-adrenergic receptor stimulation, significant physiological desensitization to acute AMD challenges was observed, i.e., pressor and vasoconstrictor responses to the alpha 1-adrenergic agonist were significantly depressed (p < 0.01) compared with responses in the same dogs studied in the conscious state before pump implantation. However, physiological desensitization to acute challenges of the neurotransmitter norepinephrine (NE) (0.1 micrograms/kg per minute) in the presence of beta-adrenergic receptor blockade was not observed for either mean arterial pressure (MAP) (30 +/- 7 versus 28 +/- 5 mm Hg) or total peripheral resistance (TPR) (29.8 +/- 4.9 versus 28.9 +/- 7.3 mm Hg/l per minute). In the presence of beta-adrenergic receptor plus ganglionic blockade after AMD pump implantation, physiological desensitization to NE was unmasked since the control responses to NE (0.1 micrograms/kg per minute) before the AMD pumps were now greater (p < 0.01) than after chronic AMD administration for both MAP (66 +/- 5 versus 32 +/- 2 mm Hg) and TPR (42.6 +/- 10.3 versus 23.9 +/- 4.4 mm Hg/l per minute). In the presence of beta-adrenergic receptor, ganglionic, plus NE-uptake blockade after AMD pump implantation, desensitization was even more apparent, since NE (0.1 micrograms/kg per minute) induced even greater differences in MAP (33 +/- 5 versus 109 +/- 6 mm Hg) and TPR (28.1 +/- 1.8 versus 111.8 +/- 14.7 mm Hg/l per minute). The maximal force of contraction induced by NE in the presence or absence of endothelium was significantly decreased (p < 0.05) in vitro in mesenteric artery rings from AMD pump dogs compared with saline control dogs. Furthermore, alpha 1-adrenergic receptor density, as determined by [3H]prazosin binding in membrane preparations from vessels in the mesentery, was decreased (8.2 +/- 1.0 versus 18.4 +/- 1.4 fmol/mg protein, p < 0.001) without any change in Kd in the AMD pump dogs compared with the saline pump dogs.(ABSTRACT TRUNCATED AT 400 WORDS)

Characterization of subfractions from purified sarcolemma of canine left ventricle

Three membrane fractions were studied from canine myocardial left ventricle (LV); crude, light vesicle, and enriched sarcolemma. The percent of the total yield of membrane protein was 99.3 +/- 0.2% for the crude fraction, 0.4 +/- 0.1% for the light vesicle fraction, and 0.3 +/- 0.03% for the purified fraction. Sodium, potassium-ATPase activity in the purified fraction (100 +/- 10.8 mumol Pi/h/mg) was five fold more concentrated than in the light vesicle fraction (18.5 +/- 1.85 mumol Pi/h/mg), and nineteen fold more than in the crude fraction (5.29 +/- 0.57 mumol Pi/h/mg). beta-Adrenergic receptors were 8-fold enriched in the purified fraction (1006 +/- 219 vs 132 +/- 13 fmol/mg in the crude fraction) and 4-fold enriched in the light vesicle fraction (497 +/- 152 fmol/mg). Adenylate cyclase activity was enriched by only 13 to 17-fold in the purified fraction, and only 2 to 4-fold in the light vesicle fraction. The percent of the total beta-adrenergic receptors per gram wet weight was 94 +/- 20% for the crude fraction, 2.1 +/- 0.4% for the light vesicle fraction, and 3.8 +/- 0.7% for the purified fraction. When alamethicin was used to uncover latent enzyme activity, beta-adrenergic receptor density was not affected, but Na+,K(+)-ATPase and adenylate cyclase activity were enhanced in each membrane fraction studied. The surprising finding was that Na+,K(+)-ATPase activity was enriched to the same extent as the beta-adrenergic receptor density in the light vesicle fraction. One potential explanation is that the light vesicle fraction is located in a specialized region of the plasma membrane.

Abnormalities in β-Adrenergic Signal Transduction with Myocardial Decompensation and Failure

The progression of changes in β-adrenergic receptor signalling was studied over several time points during the development of pacing-induced heart failure in long-term instrumented, conscious dogs. Animals were paced at 240 beats per minute for one month and data were averaged at 1 day, 1 week, and 3–4 weeks after pacing. The rate of change in left ventricular pressure (LV dP/dt) was decreased at 1 day, LV end-diastolic pressure and heart rate were increased at 1 week, but heart failure occurred only after 3–4 weeks of pacing. Circulating levels of norepinephrine were elevated after 1 day of pacing, and tissue levels of norepinephrine were reduced only after 3–4 weeks of pacing. High-affinity β-adrenergic receptors and adenylyl cyclase activity decreased after one day of pacing. β1-adrenergic receptor density decreased after one week of pacing. Gs functional activity was not reduced, but Giα2 rose after 3–4 weeks of pacing. Thus, β-adrenergic receptor signal transduction is significantly altered early, i. e., 1 day after the initiation of rapid ventricular pacing, prior to the development of heart failure. Changes occurring at 1 day after rapid ventricular pacing include increases in plasma catecholamines, uncoupling of the β-adrenergic receptor from adenylyl cyclase, and a decrease in adenylyl cyclase activity. After more prolonged pacing there is a decrease in β1-adrenergic receptors, decreases in myocardial tissue catecholamines, and increases in Giα2. Therefore, physiological changes in β-adrenergic receptor function during the initial development of heart failure appear to be mediated by different mechanisms than those changes that occur later as heart failure becomes manifest.

Initial Changes in β-Adrenergic Receptor Function during Development of Rapid Ventricular Pacing-Induced Heart Failure

Current knowledge of the pathogenesis of myocardial failure is derived mainly from studies of chronic or end-stage failing hearts. However, the mechanisms responsible for early changes in contractile function prior to the onset of severe congestive heart failure and the accompanying complications such as fibrosis might be more important, especially for creating therapeutic strategies to reverse the process of heart failure. The canine model of rapid pacing-induced heart failure is ideal for these studies because there is a progressive impairment in cardiac function, with initial cardiac dysfunction prior to development of a large dilated heart and severe congestive heart failure [1–6]. Since this occurs in the absence of significant hypertrophy or fibrosis, it makes the interpretation of data less complicated. This model of pacing-induced failure is also characterized by decreased responsiveness to β-adrenergic receptor stimulation, as seen with chronic human heart failure [7–8]. Furthermore, this action can be observed early in the cardiac dysfunction stage. Therefore, the goal of this chapter is to review data from our laboratory concerning the early changes in the β-adrenergic-receptor-G-protein-adenylyl-cyclase signal transduction system induced by rapid ventricular pacing prior to the onset of heart failure [1–3].