EFFECTS OF CHRONIC BETA-ADRENERGIC-BLOCKADE ON THE LEFT-VENTRICULAR AND CARDIOCYTE ABNORMALITIES OF CHRONIC CANINE MITRAL REGURGITATION

被引:139
作者
TSUTSUI, H
SPINALE, FG
NAGATSU, M
SCHMID, PG
ISHIHARA, K
DEFREYTE, G
COOPER, G
CARABELLO, BA
机构
[1] MED UNIV S CAROLINA, GAZES CARDIAC RES INST, DEPT MED, DIV CARDIOL, CHARLESTON, SC 29425 USA
[2] MED UNIV S CAROLINA, DEPT SURG, DIV CARDIOTHORAC, CHARLESTON, SC 29425 USA
[3] RALPH H JOHNSON DEPT VET AFFAIRS MED CTR, CHARLESTON, SC 29403 USA
[4] UNIV IOWA, VET AFFAIRS MED CTR, DEPT INTERNAL MED, IOWA CITY, IA 52246 USA
关键词
MITRAL VALVE INSUFFICIENCY; ADRENERGIC BETA RECEPTOR BLOCKADERS; VENTRICULAR FUNCTION; LEFT HEART FAILURE; CONGESTIVE HYPERTROPHY;
D O I
10.1172/JCI117277
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
The mechanism by which beta blockade improves left ventricular dysfunction in various cardiomyopathies has been ascribed to improved contractile function of the myocardium or to improved beta-adrenergic responsiveness. In this study we tested two hypotheses: (a) that chronic beta blockade would improve the left ventricular dysfunction which develops in mitral regurgitation, and (b) that an important mechanism of this effect would be improved innate contractile function of the myocardium. Two groups of six dogs with chronic severe mitral regurgitation were studied. After 3 mo both groups had developed similar and significant left ventricular dysfunction. One group was then gradually beta-blocked while the second group continued to be observed without further intervention. In the group that remained unblocked, contractile function remained depressed. However, in the group that received chronic beta blockade, contractile function improved substantially. The contractility of cardiocytes isolated from the unblocked hearts and then studied in the absence of beta receptor stimulation was extremely depressed. However, contractility of cardiocytes isolated from the beta-blocked ventricles was virtually normal. Consistent with these data, myofibrillar density was much higher, 55 +/- 4% in the beta-blocked group vs. 39 +/- 2% (P < 0.01) in the unblocked group; thus, there were more contractile elements to generate force in the beta-blocked group. We conclude that chronic beta blockade improves left ventricular function in chronic experimental mitral regurgitation. This improvement was associated with an improvement in the innate contractile function of isolated cardiocytes, which in turn is associated with an increase in the number of contractile elements.
引用
收藏
页码:2639 / 2648
页数:10
相关论文
共 64 条
  • [1] LONG-TERM (2-YEAR) BENEFICIAL-EFFECTS OF BETA-ADRENERGIC-BLOCKADE WITH BUCINDOLOL IN PATIENTS WITH IDIOPATHIC DILATED CARDIOMYOPATHY
    ANDERSON, JL
    GILBERT, EM
    OCONNELL, JB
    RENLUND, D
    YANOWITZ, F
    MURRAY, M
    ROSKELLEY, M
    MEALEY, P
    VOLKMAN, K
    DEITCHMAN, D
    BRISTOW, M
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 17 (06) : 1373 - 1381
  • [2] STANDARDIZATION OF END-SYSTOLIC PRESSURE-VOLUME RELATION IN THE DOG
    BELCHER, P
    BOERBOOM, LE
    OLINGER, GN
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY, 1985, 249 (03): : H547 - H553
  • [3] REGIONAL MYOCYTE SIZE IN NORMOTENSIVE AND SPONTANEOUSLY HYPERTENSIVE RATS
    BISHOP, SP
    OPARIL, S
    REYNOLDS, RH
    DRUMMOND, JL
    [J]. HYPERTENSION, 1979, 1 (04) : 378 - 383
  • [4] BRISTOW MR, 1989, MOL PHARMACOL, V35, P295
  • [5] DECREASED CATECHOLAMINE SENSITIVITY AND BETA-ADRENERGIC-RECEPTOR DENSITY IN FAILING HUMAN HEARTS
    BRISTOW, MR
    GINSBURG, R
    MINOBE, W
    CUBICCIOTTI, RS
    SAGEMAN, WS
    LURIE, K
    BILLINGHAM, ME
    HARRISON, DC
    STINSON, EB
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1982, 307 (04) : 205 - 211
  • [6] LEFT-VENTRICULAR FUNCTION IN EXPERIMENTAL VOLUME OVERLOAD HYPERTROPHY
    CARABELLO, BA
    NAKANO, K
    CORIN, W
    BIEDERMAN, R
    SPANN, JF
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY, 1989, 256 (04): : H974 - H981
  • [7] LEFT-VENTRICULAR HYPERTROPHY DUE TO VOLUME OVERLOAD VERSUS PRESSURE OVERLOAD
    CARABELLO, BA
    ZILE, MR
    TANAKA, R
    COOPER, G
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY, 1992, 263 (04): : H1137 - H1144
  • [8] CORONARY BLOOD-FLOW IN DOGS WITH CONTRACTILE DYSFUNCTION DUE TO EXPERIMENTAL VOLUME OVERLOAD
    CARABELLO, BA
    NAKANO, K
    ISHIHARA, K
    KANAZAWA, S
    BIEDERMAN, RWW
    SPANN, JF
    [J]. CIRCULATION, 1991, 83 (03) : 1063 - 1075
  • [9] MECHANISM OF DECREASED FORWARD STROKE VOLUME IN CHILDREN AND SWINE WITH VENTRICULAR SEPTAL-DEFECT AND FAILURE TO THRIVE
    CORIN, WJ
    SWINDLE, MM
    SPANN, JF
    NAKANO, K
    FRANKIS, M
    BIEDERMAN, RWW
    SMITH, A
    TAYLOR, A
    CARABELLO, BA
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1988, 82 (02) : 544 - 551
  • [10] LEFT-VENTRICULAR PASSIVE DIASTOLIC PROPERTIES IN CHRONIC MITRAL REGURGITATION
    CORIN, WJ
    MURAKAMI, T
    MONRAD, ES
    HESS, OM
    KRAYENBUEHL, HP
    [J]. CIRCULATION, 1991, 83 (03) : 797 - 807