Altered adrenergic receptor density in myocardial hibernation in humans : A possible mechanism of depressed myocardial function
Alterations in adrenergic receptor densities can potentially contribute to myocardial dysfunction. Their relevance to myocardial hibernation in humans is unknown. Accordingly, 22 transmural myocardial biopsies were obtained in 11 patients with ischemic ventricular dysfunction during bypass surgery,...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2000-11, Vol.102 (21), p.2599-2606 |
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| creator | SHAN, Kesavan BICK, Roger J ZOGHBI, William A POINDEXTER, Brian J NAGUEH, Sherif F SHIMONI, Sarah VERANI, Mario S KENG, Felix REARDON, Michael J LETSOU, George V HOWELL, Jimmy F |
| description | Alterations in adrenergic receptor densities can potentially contribute to myocardial dysfunction. Their relevance to myocardial hibernation in humans is unknown.
Accordingly, 22 transmural myocardial biopsies were obtained in 11 patients with ischemic ventricular dysfunction during bypass surgery, guided by transesophageal echocardiography. Patients underwent dobutamine echocardiography (DE) and rest scintigraphic studies before revascularization and DE at 3 to 4 months. alpha- and ss-receptor density (ARD and BRD) and extent of fibrosis were quantified from the myocardial biopsies. Of the 22 segments, 16 had abnormal rest function and 6 were normal. Severely hypokinetic or akinetic segments showed a 2.4-fold increase in ARD with a concomitant 50% decrease in BRD compared with normal segments. An increase in ARD, a decrease in BRD to a lesser extent, and thus an increase in ARD/BRD ratio were seen in dysfunctional segments with contractile reserve compared with normal segments and were most pronounced in those without contractile reserve (P: |
| doi_str_mv | 10.1161/01.CIR.102.21.2599 |
| format | Article |
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Accordingly, 22 transmural myocardial biopsies were obtained in 11 patients with ischemic ventricular dysfunction during bypass surgery, guided by transesophageal echocardiography. Patients underwent dobutamine echocardiography (DE) and rest scintigraphic studies before revascularization and DE at 3 to 4 months. alpha- and ss-receptor density (ARD and BRD) and extent of fibrosis were quantified from the myocardial biopsies. Of the 22 segments, 16 had abnormal rest function and 6 were normal. Severely hypokinetic or akinetic segments showed a 2.4-fold increase in ARD with a concomitant 50% decrease in BRD compared with normal segments. An increase in ARD, a decrease in BRD to a lesser extent, and thus an increase in ARD/BRD ratio were seen in dysfunctional segments with contractile reserve compared with normal segments and were most pronounced in those without contractile reserve (P:<0.001). Similar findings were observed if recovery of function or scintigraphic uptake was analyzed as a marker for viability. No significant relation between either ARD or BRD and percent myocardial fibrosis was noted (r=0.37 and -0.39, respectively).
Thus, graded and reciprocal changes in alpha- and ss-adrenergic receptor densities occur in viable, hibernating myocardium and may account in part for the observed depression in resting myocardial function and preserved contractile reserve in this entity.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.102.21.2599</identifier><identifier>PMID: 11085963</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Biological and medical sciences ; Biopsy ; Cardiology. Vascular system ; Coronary Artery Bypass ; Coronary heart disease ; Dobutamine ; Echocardiography ; Female ; Fibrosis - pathology ; Heart ; Heart - diagnostic imaging ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Contraction - drug effects ; Myocardial Stunning - metabolism ; Myocardial Stunning - pathology ; Myocardium - metabolism ; Myocardium - pathology ; Radiography ; Radionuclide Imaging ; Receptors, Adrenergic, alpha - metabolism ; Receptors, Adrenergic, beta - metabolism ; Recovery of Function ; Ventricular Dysfunction, Left - diagnosis ; Ventricular Dysfunction, Left - etiology ; Ventricular Dysfunction, Left - surgery</subject><ispartof>Circulation (New York, N.Y.), 2000-11, Vol.102 (21), p.2599-2606</ispartof><rights>2001 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Nov 21, 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c348t-572800b0b0a7e3bd3e55f7e964ed74f223ad747015d6a4414c79e998950144963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=810545$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11085963$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SHAN, Kesavan</creatorcontrib><creatorcontrib>BICK, Roger J</creatorcontrib><creatorcontrib>ZOGHBI, William A</creatorcontrib><creatorcontrib>POINDEXTER, Brian J</creatorcontrib><creatorcontrib>NAGUEH, Sherif F</creatorcontrib><creatorcontrib>SHIMONI, Sarah</creatorcontrib><creatorcontrib>VERANI, Mario S</creatorcontrib><creatorcontrib>KENG, Felix</creatorcontrib><creatorcontrib>REARDON, Michael J</creatorcontrib><creatorcontrib>LETSOU, George V</creatorcontrib><creatorcontrib>HOWELL, Jimmy F</creatorcontrib><title>Altered adrenergic receptor density in myocardial hibernation in humans : A possible mechanism of depressed myocardial function</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Alterations in adrenergic receptor densities can potentially contribute to myocardial dysfunction. Their relevance to myocardial hibernation in humans is unknown.
Accordingly, 22 transmural myocardial biopsies were obtained in 11 patients with ischemic ventricular dysfunction during bypass surgery, guided by transesophageal echocardiography. Patients underwent dobutamine echocardiography (DE) and rest scintigraphic studies before revascularization and DE at 3 to 4 months. alpha- and ss-receptor density (ARD and BRD) and extent of fibrosis were quantified from the myocardial biopsies. Of the 22 segments, 16 had abnormal rest function and 6 were normal. Severely hypokinetic or akinetic segments showed a 2.4-fold increase in ARD with a concomitant 50% decrease in BRD compared with normal segments. An increase in ARD, a decrease in BRD to a lesser extent, and thus an increase in ARD/BRD ratio were seen in dysfunctional segments with contractile reserve compared with normal segments and were most pronounced in those without contractile reserve (P:<0.001). Similar findings were observed if recovery of function or scintigraphic uptake was analyzed as a marker for viability. No significant relation between either ARD or BRD and percent myocardial fibrosis was noted (r=0.37 and -0.39, respectively).
Thus, graded and reciprocal changes in alpha- and ss-adrenergic receptor densities occur in viable, hibernating myocardium and may account in part for the observed depression in resting myocardial function and preserved contractile reserve in this entity.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Artery Bypass</subject><subject>Coronary heart disease</subject><subject>Dobutamine</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Fibrosis - pathology</subject><subject>Heart</subject><subject>Heart - diagnostic imaging</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Contraction - drug effects</subject><subject>Myocardial Stunning - metabolism</subject><subject>Myocardial Stunning - pathology</subject><subject>Myocardium - metabolism</subject><subject>Myocardium - pathology</subject><subject>Radiography</subject><subject>Radionuclide Imaging</subject><subject>Receptors, Adrenergic, alpha - metabolism</subject><subject>Receptors, Adrenergic, beta - metabolism</subject><subject>Recovery of Function</subject><subject>Ventricular Dysfunction, Left - diagnosis</subject><subject>Ventricular Dysfunction, Left - etiology</subject><subject>Ventricular Dysfunction, Left - surgery</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc2L1TAUxYMozpvRf8CFBIXZtebmo2ncPR5-DAwIouuQpre-DG1ak3bxVv7r5jEPFcnicsnvnMvhEPIKWA3QwDsG9eHuaw2M1xxqrox5QnaguKykEuYp2THGTKUF51fkOueHsjZCq-fkCoC1yjRiR37txxUT9tT1CSOmH8HThB6XdU60x5jDeqIh0uk0e5f64EZ6DB2m6NYwx_PPcZtczPQ93dNlzjl0I9IJ_dHFkCc6D8VlSZhzufGPybBFf3Z4QZ4Nbsz48jJvyPePH74dPlf3Xz7dHfb3lReyXSulectYV57TKLpeoFKDRtNI7LUcOBeuTM1A9Y2TEqTXBo1pjWIgZUl6Q24ffZc0_9wwr3YK2eM4uojzlq3mkmvTtgV88x_4MG8l7pgtB940hilZIP4I-VQiJxzsksLk0skCs-duLANbuikrLzJ77qaIXl-ct27C_q_kUkYB3l4Al70bh-SiD_kP10I5rcRvpC6XJw</recordid><startdate>20001121</startdate><enddate>20001121</enddate><creator>SHAN, Kesavan</creator><creator>BICK, Roger J</creator><creator>ZOGHBI, William A</creator><creator>POINDEXTER, Brian J</creator><creator>NAGUEH, Sherif F</creator><creator>SHIMONI, Sarah</creator><creator>VERANI, Mario S</creator><creator>KENG, Felix</creator><creator>REARDON, Michael J</creator><creator>LETSOU, George V</creator><creator>HOWELL, Jimmy F</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20001121</creationdate><title>Altered adrenergic receptor density in myocardial hibernation in humans : A possible mechanism of depressed myocardial function</title><author>SHAN, Kesavan ; BICK, Roger J ; ZOGHBI, William A ; POINDEXTER, Brian J ; NAGUEH, Sherif F ; SHIMONI, Sarah ; VERANI, Mario S ; KENG, Felix ; REARDON, Michael J ; LETSOU, George V ; HOWELL, Jimmy F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-572800b0b0a7e3bd3e55f7e964ed74f223ad747015d6a4414c79e998950144963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Artery Bypass</topic><topic>Coronary heart disease</topic><topic>Dobutamine</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Fibrosis - pathology</topic><topic>Heart</topic><topic>Heart - diagnostic imaging</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Contraction - drug effects</topic><topic>Myocardial Stunning - metabolism</topic><topic>Myocardial Stunning - pathology</topic><topic>Myocardium - metabolism</topic><topic>Myocardium - pathology</topic><topic>Radiography</topic><topic>Radionuclide Imaging</topic><topic>Receptors, Adrenergic, alpha - metabolism</topic><topic>Receptors, Adrenergic, beta - metabolism</topic><topic>Recovery of Function</topic><topic>Ventricular Dysfunction, Left - diagnosis</topic><topic>Ventricular Dysfunction, Left - etiology</topic><topic>Ventricular Dysfunction, Left - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SHAN, Kesavan</creatorcontrib><creatorcontrib>BICK, Roger J</creatorcontrib><creatorcontrib>ZOGHBI, William A</creatorcontrib><creatorcontrib>POINDEXTER, Brian J</creatorcontrib><creatorcontrib>NAGUEH, Sherif F</creatorcontrib><creatorcontrib>SHIMONI, Sarah</creatorcontrib><creatorcontrib>VERANI, Mario S</creatorcontrib><creatorcontrib>KENG, Felix</creatorcontrib><creatorcontrib>REARDON, Michael J</creatorcontrib><creatorcontrib>LETSOU, George V</creatorcontrib><creatorcontrib>HOWELL, Jimmy F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SHAN, Kesavan</au><au>BICK, Roger J</au><au>ZOGHBI, William A</au><au>POINDEXTER, Brian J</au><au>NAGUEH, Sherif F</au><au>SHIMONI, Sarah</au><au>VERANI, Mario S</au><au>KENG, Felix</au><au>REARDON, Michael J</au><au>LETSOU, George V</au><au>HOWELL, Jimmy F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Altered adrenergic receptor density in myocardial hibernation in humans : A possible mechanism of depressed myocardial function</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2000-11-21</date><risdate>2000</risdate><volume>102</volume><issue>21</issue><spage>2599</spage><epage>2606</epage><pages>2599-2606</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Alterations in adrenergic receptor densities can potentially contribute to myocardial dysfunction. Their relevance to myocardial hibernation in humans is unknown.
Accordingly, 22 transmural myocardial biopsies were obtained in 11 patients with ischemic ventricular dysfunction during bypass surgery, guided by transesophageal echocardiography. Patients underwent dobutamine echocardiography (DE) and rest scintigraphic studies before revascularization and DE at 3 to 4 months. alpha- and ss-receptor density (ARD and BRD) and extent of fibrosis were quantified from the myocardial biopsies. Of the 22 segments, 16 had abnormal rest function and 6 were normal. Severely hypokinetic or akinetic segments showed a 2.4-fold increase in ARD with a concomitant 50% decrease in BRD compared with normal segments. An increase in ARD, a decrease in BRD to a lesser extent, and thus an increase in ARD/BRD ratio were seen in dysfunctional segments with contractile reserve compared with normal segments and were most pronounced in those without contractile reserve (P:<0.001). Similar findings were observed if recovery of function or scintigraphic uptake was analyzed as a marker for viability. No significant relation between either ARD or BRD and percent myocardial fibrosis was noted (r=0.37 and -0.39, respectively).
Thus, graded and reciprocal changes in alpha- and ss-adrenergic receptor densities occur in viable, hibernating myocardium and may account in part for the observed depression in resting myocardial function and preserved contractile reserve in this entity.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>11085963</pmid><doi>10.1161/01.CIR.102.21.2599</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Complete |
| subjects | Aged Biological and medical sciences Biopsy Cardiology. Vascular system Coronary Artery Bypass Coronary heart disease Dobutamine Echocardiography Female Fibrosis - pathology Heart Heart - diagnostic imaging Humans Male Medical sciences Middle Aged Myocardial Contraction - drug effects Myocardial Stunning - metabolism Myocardial Stunning - pathology Myocardium - metabolism Myocardium - pathology Radiography Radionuclide Imaging Receptors, Adrenergic, alpha - metabolism Receptors, Adrenergic, beta - metabolism Recovery of Function Ventricular Dysfunction, Left - diagnosis Ventricular Dysfunction, Left - etiology Ventricular Dysfunction, Left - surgery |
| title | Altered adrenergic receptor density in myocardial hibernation in humans : A possible mechanism of depressed myocardial function |
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