Beta-adrenoceptor--G-protein--adenylyl cyclase system in cardiac disease: a new insight into desensitization

High-impact loading training induces bone hyperresorption activity in young elite female gymnasts

The aim of this study was to investigate the effect of intensive exercise on bone turnover (as reflected by bone resorption) in young elite female gymnasts. Forty-five healthy girls including 24 gymnasts (11.9+/-2 yr) and 21 controls (12.3+/-1.4 yr) were studied. Body weight, height, bone age and body composition were measured. Bone mineral density (BMD) was assessed at the whole body, lumbar vertebrae, hip and radius by means of DXA. Volumetric density (BMAD) was calculated. Bone velocity (SOS) and attenuation (BUA) were measured by QUS at the calcaneus. Urinary androstenedione (delta4), dehydroepiandrosterone sulfate (DHEA-S), and CrossLaps (CTx) were measured. BMD and BMAD were significantly greater in the gymnasts at all sites except whole body. SOS was found significantly higher. Delta4 values were significantly lower in the gymnasts. The distribution of the subjects according to Tanner stages was not different between groups. CTx levels were significantly higher in the gymnasts (989.08+/-154.63 microg/mmol Cr.) vs controls (580.25+/-123.99 microg/mmol Cr., p=0.02). CTx values decreased from Tanner stage 1 to stage 4 in each group, the gymnasts' levels always being higher than those of the controls. In conclusion, gymnastics seems to stimulate bone resorption activity in highly-trained young females. The coexistence of bone hyperresorption and higher BMD in gymnasts suggests increased bone turnover resulting in increased bone density in these subjects.

Monitoring of beta-receptor sensitivity in cardiac surgery

OBJECTIVE

To determine the repeatability of the hemodynamic response to repeated isoproterenol challenge doses to validate the standardized isoproterenol sensitivity test as an index of cardiovascular beta-receptor function.

DESIGN

Prospective, single-blind, nonrandomized clinical trial.

SETTING

University department of cardiothoracic anesthesia.

PARTICIPANTS

Twenty middle-aged men scheduled for primary elective coronary artery bypass surgery, 10 of whom had been treated with cardioselective beta1-antagonists for more than 3 months.

INTERVENTIONS

After induction of anesthesia and baseline hemodynamic evaluation, cardiac beta-receptor sensitivity was estimated from the chronotropic/inotropic responses to four intravenous 4-microg isoproterenol bolus doses.

MEASUREMENTS AND MAIN RESULTS

Baseline cardiovascular function and pharmacodynamic response to the four isoproterenol challenge doses were monitored with catheters in the radial and pulmonary arteries (thermodilution). Heart rate was continuously recorded and calculated from the electrocardiogram. Baseline hemodynamic status and response to the first 4 microg of isoproterenol were similar in the 10 patients treated with beta1-antagonists and the rest of the patients. In all 20 patients, heart rate response to the three subsequent isoproterenol challenge doses decreased progressively by 28%.

CONCLUSION

The standardized isoproterenol sensitivity test is unreliable for clinical monitoring of cardiac beta-adrenoceptor function.

Cardiac beta-adrenoceptors, G-proteins and adenylate cyclase regulation during myocardial hypertrophy

The role of the beta-adrenoceptor-G-protein-adenylate cyclase system in the pathogenesis of cardiac hypertrophy was studied. We have used a minipig model of pressure-overload cardiac hypertrophy secondary to aortic banding. Four groups of five animals were used: minipigs made hypertrophic were evaluated 2 months (CH2 group) and 9 months (CH9 group) later and compared to controls (C2 and C9 groups, respectively). A decrease in beta-adrenergic receptor density and an increase in antagonist affinity were shown in left ventricular membranes of hypertrophied animals compared with controls. In both groups, CH2 and CH9, an increase in EC50 for isoproterenol-stimulated adenylate cyclase activity, an increase in forskolin-stimulated adenylate cyclase activity and a diminished inhibition by carbachol of isoproterenol-stimulated adenylate cyclase were observed. In contrast, fluoride-stimulated adenylate cyclase activity was markedly increased only in the end stage of hypertrophy. alpha s-cholera toxin-catalysed ADP-ribosylation is increased in early hypertrophy and then decreases with late hypertrophy and a similar pattern is observed with alpha o pertussis toxin-catalysed ADP-ribosylation, whereas alpha i-ADP-ribosylation remains unchanged. Tissue content of Gs-, Gi- and Go-proteins, as assessed by specific antibodies, was found unchanged in CH9 and CH2 groups when compared with that in C9 and C2 control groups, respectively. Modifications in Gs functional activity in later hypertrophic stages, expressed as alterations in cholera toxin ADP-ribosylation and adenylate cyclase fluoride responsiveness, may be important in the pathogenesis of decompensation from compensated hypertrophy to cardiac failure.