The Beta-Adrenergic Receptor in Heart Failure

1983 ◽  
Vol 18 (11) ◽  
pp. 103-125 ◽  
Author(s):  
James A. Heinsimer ◽  
Robert J. Lefkowitz
1993 ◽  
Vol 73 (6) ◽  
pp. 1013-1023 ◽  
Author(s):  
K Kiuchi ◽  
N Sato ◽  
R P Shannon ◽  
D E Vatner ◽  
K Morgan ◽  
...  

2000 ◽  
Vol 1 ◽  
pp. 6-8
Author(s):  
JC Mohan

It is uncommon for clinical trials to be prematurely terminated because of formidable evidence in favour ofa particular agent or strategy and rare for such trials to be reported in lay press. This is what has precisely happened with regard to beta-adrenoceptor blocking therapy in patients with congestive heart failure twice once in 1996 and again in March, 2000. The drug in question has been carvedilol (a beta-adrenergic receptor blocking agent) and the trials were Carvedilol US Heart Failure Study and GOPERNICUS (Carvedilol Prospective Randomised Cumulative Outcome Study). The therapy in patients of congestive heart failure has shown a remarkable change over a period of last three decades ever since it was shown by a Swedish team that in some patients with heart failure, beta-blocking agents can cause symptomatic improvement in refractory heart failure. The current theme is no longer symptomatic relief which is variable butsurvival benefits and less need for cardiac transplantation and recurrent hospitalization.Saga of beta-blocker therapy taught us how mechanistic approach and experimental data do not always provide the correct answer to a complex pathophysiological syndrome.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Uribe ◽  
D Andersson

Abstract Background Beta-adrenergic receptor signaling is widely recognized as a fundamental component in the pathogenesis of chronic heart failure. However, the mechanisms behind beta-adrenergic receptor-mediated remodeling in cardiomyocytes and the myocardium are not fully understood. Oxidative stress has been proposed as a central pathophysiological mediator in cardiovascular disease and heart failure. The triggers and sources of oxidative stress in heart failure remain unclear. In this study we use mice with mitochondria-targeted overexpression of the antioxidant enzyme catalase (mCAT) to link beta-adrenergic receptor-mediated stress to mitochondrial reactive oxidative species (ROS) and the progression of heart failure. Hypothesis Mitochondrial ROS, induced by beta-adrenergic receptor-activation, is a mediator in the progression of the heart failure phenotype. Methods mCAT and wild type mice (n=10) were administered the non-selective beta-adrenergic agonist Isoprotenerol (Iso; 50mg/kg/day) through subcutaneous osmotic pumps for 3 weeks. Hearts were taken for biochemistry (western blotting, qPCR). Cardiomyocytes were isolated and loaded with Fluo-3 AM to study intracellular Ca2+ transients and fractional shortening using confocal line scan microscopy. All experiments were performed in accordance with the Stockholm ethical committee for animal research. Results and conclusions The WT mice displayed an increased heart/body weight ratio following chronic Iso administration. In contrast, mCAT mice displayed resistance to Iso-induced cardiac hypertrophy (p<0.05). Furthermore, chronic Iso exposure in WT mice induced increased ROS-dependent post-translational protein modifications, impaired cardiomyocyte Ca2+ handling and reduced contractility in isolated cardiomyocytes (p<0.05). Cardiomyocytes from mCAT mice did not display the deleterious effects of chronic Iso exposure on cardiomyocyte Ca2+ and contractility. Our study demonstrates that beta-adrenergic receptor stimulation-induced remodeling of the heart, which is similar to what is seen in heart failure, can be prevented by overexpressing catalase in the mitochondria. This indicates an important role of mitochondrial ROS in the link between adrenergic signaling and the development of cardiomyopathy and heart failure. Acknowledgement/Funding Hjärtlungfonden


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