[Regulation of myocardium beta-adrenoreceptor pathway in ventricular remodeling of heart failure patients]

Abstract

Objective: To study the role of myocardium beta-adrenoreceptor pathway in ventricular remodeling of heart failure patients.

Methods: Beta-adrenergic receptor density (Bmax) and the content of cAMP were measured in the papillae of left ventricle and blood lymphocyte of 20 patients with heart failure (CHF) (NYHA classification II to III). Bmax was investigated by 3H-dihydroalpneolol as ligand, cAMP by competitive immunoassay, and left ventricle mass index (LVMI) by echocardiogram.

Results: The Bmax and cAMP in failing myocardium were significantly negatively were correlated with LVMI (r = -0.77, P < 0.01 and r = -0.46, P < 0.05 respectively). The Bmax of myocardium and blood lymphocyte in CHF patients with NYHA III (63 +/- 12 fmol/mgpro and 514 +/- 115 fmol/10(7) cell), was significantly lower than that of NYHA II patients (94 +/- 20 fmol/mgpro and 702 +/- 138 fmol/10(7) cell, and that in patients with abnormal LVMI (62 +/- 12 fmol/mgpro and 516 +/- 122 fmol/10(7) cell) decreased more significantly than that in normal LVMI patients. Even in normal LVMI patients (92 +/- 21 fmol/ mgpro and 682 +/- 146 fmol/10(7) cell), the Bmax of blood lymphocyte was already decreased (P < 0.01), when comparing with the controls. The intralymphocyte cAMP content was more significantly decreased than that of the controls (P < 0.05).

Conclusions: The Bmax can reflect the severity of ventricle remodeling and the impairment of myocardium. The regulation of myocardium intracellular messenger transduction is earlier than the pathologic structural change of LV remodeling.