Inotropic responsiveness of the heart in catecholamine cardiomyopathy

doi:10.1016/0002-8703(81)90378-1

American Heart Journal

Volume 101, Issue 1, January 1981, Pages 17-21

https://doi.org/10.1016/0002-8703(81)90378-1 Get rights and content

Abstract

Inotropic responsiveness to norepinephrine (NE) or Ca²⁺ was studied in 15 rabbits with catecholamine cardiomyopathy (CM) and the results were compared with 11 controls. The former group was prepared by infusing NE (2 μg/min/kg) for 90 minutes, 2 to 3 days prior to study, and injury was confirmed and quantified histologically. Comparison of NE dose-response curves relating percent increase of left ventricular (LV) $dP dt$ max to NE dose in six controls and 10 CM hearts revealed significant depression of CM contractility. Responses to graded infusions of Ca²⁺ were also determined in five controls and in five CM animals. With the increases in serum Ca²⁺ identical in the two groups, the percent increases in $dP dt$ max were less in CM hearts. Further, NE dose-response curves obtained during continuous CaCl₂ infusion were sharply attenuated in CM hearts and initial LV end-diastolic pressure (LVEDP) in the CM hearts was considerably higher than in the controls. It is concluded that inotropic sensitivity to NE is reduced in CM hearts. This cannot be ascribed to altered β-receptors alone, because responsiveness to Ca²⁺ was also reduced. Myocardial damage was indicated by histology and elevated LVEDP. Moreover, the normalized percent data suggest that the remaining viable fibers in the CM hearts were functioning subnormally and thus reduced performance was not due solely to the decreased number of contracting units.

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Left ventricular hypertrophy and hypertensive cardiomyopathy may occur in patients with chronic hypertension from pheochromocytoma. In addition, the long-term elevation of catecholamine levels leads to significant desensitisation of beta-adrenergic receptors.10 Oxidised catecholamines may increase the permeability of the sarcolemmal membrane, leading to calcium influx and intracellular calcium overload, which may can result in acute myocarditis, with diffuse interstitial inflammatory infiltrates and myocardial necrosis.9
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^☆: Supported by research grant HL-20401, and in part by grant HL-08659 and by training grant HL-07272 from the National Institutes of Health.

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Inotropic responsiveness of the heart in catecholamine cardiomyopathy☆

Abstract

Hum Pathol

Norepinephrine stores and contractile force of papillary muscle from the failing human heart

Circulation

Effects of insulin on experimental catecholamine cardiomyopathy

Am J Pathol

Recent advances in studies of cardiac structure and metabolism

Histochemical and electron microscopical studies on the cardiac necroses produced by sympathomimetic agents

Ann NY Acad Sci

Cardiovascular injury induced by sympathetic catecholamines

Progr Cardiovasc Dis

Congestive heart failure. Role of altered myocardial cellular control

N Engl J Med

Effects of insulin on cardiac muscle contraction and responsiveness to norepinephrine

Am J Physiol

Biostatistics