Catecholamine-induced cardiac hypertrophy uncouples beta-adrenoceptors from slow calcium channels

Cardiac hypertrophy induced by sustained β-adrenoreceptor activation: pathophysiological aspects

Cardiac hypertrophy is promoted by adrenergic over-activation and represents an independent risk factor for cardiovascular morbidity and mortality. The basic knowledge about mechanisms by which sustained adrenergic activation promotes myocardial growth, as well as understanding how structural changes in hypertrophied myocardium could affect myocardial function has been acquired from studies using an animal model of chronic systemic beta-adrenoreceptor agonist administration. Sustained beta-adrenoreceptor activation was shown to enhance the synthesis of myocardial proteins, an effect mediated via stimulation of myocardial growth factors, up-regulation of nuclear proto-oncogenes, induction of cardiac oxidative stress, as well as activation of mitogen-activated protein kinases and phosphatidylinositol 3-kinase. Sustained beta-adrenoreceptor activation contributes to impaired cardiac autonomic regulation as evidenced by blunted parasympathetically-mediated cardiovascular reflexes as well as abnormal storage of myocardial catecholamines. Catecholamine-induced cardiac hypertrophy is associated with reduced contractile responses to adrenergic agonists, an effect attributed to downregulation of myocardial beta-adrenoreceptors, uncoupling of beta-adrenoreceptors and adenylate cyclase, as well as modifications of downstream cAMP-mediated signaling. In compensated cardiac hypertrophy, these changes are associated with preserved or even enhanced basal ventricular systolic function due to increased sarcoplasmic reticulum Ca(2+) content and Ca(2+)-induced sarcoplasmic reticulum Ca(2+) release. The increased availability of Ca(2+) to maintain cardiomyocyte contraction is attributed to prolongation of the action potential due to inhibition of the transient outward potassium current as well as stimulation of the reverse mode of the Na(+)-Ca(2+) exchange. Further progression of cardiac hypertrophy towards heart failure is due to abnormalities in Ca(2+) handling, necrotic myocardial injury, and increased myocardial stiffness due to interstitial fibrosis.

Captopril and norepinephrine-induced hypertrophy and haemodynamics in rats

We wished to determine whether pretreatment with captopril, an angiotension-converting enzyme (ACE) inhibitor, modified the myocardial and haemodynamic consequences of chronic administration of norepinephrine (NE) in rats. Administration of NE (0.15 mg kg(-1) h(-1) by an osmotic minipump implanted subcutaneously for 28 days) resulted in left but not right ventricular hypertrophy. Captopril (250 but not 52 mu g kg(-1) h(1) administered for 28 days) significantly attenuated the development of left ventricular hypertrophy (weight of left ventricle to body weight ratio was 0.46 +/- 0.01 0.57 +/- 0.02, 0.53 +/- 0.02, and 0.51 +/- 0.01 for vehicle, NE, and NE plus low and high dose of captopril, respectively). Chronic administration of NE caused significant increases in systolic arterial blood pressure (BP: 194 +/- 11 vs. 130 +/- 6 mm Hg), systolic left ventricular pressure, heart rate (HR: 458 +/- 13 vs. 389 +/- 15 beats/min) and dP dt(-1)(max) P(-1), an index of myocardial contractility (202 +/- 29 vs. 91 +/- 3 s(-1)). Captopril (250 mu g kg(-1) h(-1) for 28 days) significantly reduced diastolic arterial BP (from 86 +/- 6 to 53 +/- 3 mm Hg). Concomitant administration of this dose of captopril together with NE prevented the NE-induced increase in systolic arterial BP but did not modify the increases in HR or dP dt(-1) max P(-1) (261 +/- 41 and 202 +/- 29 s(-1) in captopril and NE vs. NE-alone groups). Acute administration of NE (0.1-10 mu g kg(-1) intravenously, i.v.) produced less marked increases in cardiac contractility and in arterial BP in rats chronically pretreated with NE or NE plus captopril than in animals receiving vehicle or captopril alone. Chronic administration of NE and/or captopril did not significantly modify the haemodynamic effects of the acute administration of calcium chloride. We conclude that administration of captopril at 250 but not 52 mu g kg(-1) h(-1) for 28 days attenuates NE-induced cardiac hypertrophy and that this effect is associated with a decrease in systolic arterial BP. Captopril did not modify the reduced effects of acutely administered NE in rats treated with NE for a prolonged period.

[3H]forskolin binding to cardiac adenylate cyclase in guinea pigs chronically infused with isoproterenol

Guinea pigs were infused with the beta-adrenoceptor agonist isoproterenol (400 micrograms/kg/hr, 7 days) and cardiac adenylate cyclase was detected using [3H]forskolin. Two populations of [3H]forskolin binding sites were present in heart, the affinities (KD 2 nM and 280 nM) and densities (Bmax 9 and 900 fmol/mg protein) of which were unchanged by isoproterenol infusion compared with vehicle (1 mM HCl). The autoradiographic localisation of [3H]forskolin binding was also unchanged. The G protein activators NaF 10 mM and 5'-guanylylimidodiphosphate (Gpp(NH)p) 10 microM increased [3H]forskolin binding in heart from vehicle-treated animals by 100% and 80% respectively. NaF-stimulated binding was unchanged in isoproterenol-treated animals, however, Gpp(NH)p-stimulated binding was reduced by 35% which may indicate an increased influence of Gi.