Regulation of force and intracellular calcium transients by cyclic AMP generated by forskolin, MDL 17,043 and isoprenaline, and its modulation by muscarinic receptor agents: a novel mechanism for accentuated antagonism

Cardiovascular and metabolic alterations in mice lacking both beta1- and beta2-adrenergic receptors

The activation state of beta-adrenergic receptors (beta-ARs) in vivo is an important determinant of hemodynamic status, cardiac performance, and metabolic rate. In order to achieve homeostasis in vivo, the cellular signals generated by beta-AR activation are integrated with signals from a number of other distinct receptors and signaling pathways. We have utilized genetic knockout models to test directly the role of beta1- and/or beta2-AR expression on these homeostatic control mechanisms. Despite total absence of beta1- and beta2-ARs, the predominant cardiovascular beta-adrenergic subtypes, basal heart rate, blood pressure, and metabolic rate do not differ from wild type controls. However, stimulation of beta-AR function by beta-AR agonists or exercise reveals significant impairments in chronotropic range, vascular reactivity, and metabolic rate. Surprisingly, the blunted chronotropic and metabolic response to exercise seen in beta1/beta2-AR double knockouts fails to impact maximal exercise capacity. Integrating the results from single beta1- and beta2-AR knockouts as well as the beta1-/beta2-AR double knock-out suggest that in the mouse, beta-AR stimulation of cardiac inotropy and chronotropy is mediated almost exclusively by the beta1-AR, whereas vascular relaxation and metabolic rate are controlled by all three beta-ARs (beta1-, beta2-, and beta3-AR). Compensatory alterations in cardiac muscarinic receptor density and vascular beta3-AR responsiveness are also observed in beta1-/beta2-AR double knockouts. In addition to its ability to define beta-AR subtype-specific functions, this genetic approach is also useful in identifying adaptive alterations that serve to maintain critical physiological setpoints such as heart rate, blood pressure, and metabolic rate when cellular signaling mechanisms are perturbed.

The effects of various drugs on the myocardial inotropic response

1. The signal transduction process mediated by cyclic AMP that leads to the characteristic positive inotropic effect (PIE) in association with a positive lusitropic effect (acceleration of rate of twitch relaxation) has been well established. Relationships between accumulation of cyclic AMP, changes in intracellular Ca2+ transients and the PIE differ, however, depending on the mechanism of particular drugs that affect different steps in the metabolism of cyclic AMP. Selective partial agonists of beta 1-adrenoceptors and inhibitors of phosphodiesterase (PDE) III cause the accumulation of less cyclic AMP for a given PIE than does isoproterenol. In addition, in aequorin-microinjected canine ventricular muscle, selective inhibitors of PDE III, OPC 18790 and Org 9731, produced smaller decreases in the responsiveness of myofilaments to Ca2+ ions than isoproterenol, while a partial agonist of beta 1-adrenoceptors, denopamine, elicits a decrease in Ca2+ responsiveness of the same extent as does isoproterenol. 2. Activation of myocardial alpha 1-adrenoceptors, as well as stimulation of receptors for endothelin and angiotensin II, which accelerates hydrolysis of phosphoinositide (PI) to result in production of inositol 1,4,5-trisphosphate (IP3) and diacylglycerol (DAG) are associated with very similar inotropic regulation: (1) the dependence on the species of animals of induction of the PIE; (2) an excellent correlation between the extent of acceleration of hydrolysis of PI and the PIE; (3) isometric contraction curves associated with a negative lusitropic effect; (4) the PIE associated with increases in myofibrillar responsiveness to Ca2+ ions; and (5) the selective inhibition of the PIE by an activator of protein kinase C (PKC), phorbol 12,13-dibutyrate (PDBu), with little effect on the PIE of isoproterenol and Bay k 8644. 3. A novel class of cardiotonic agents, namely, Ca2+ sensitizers such as EMD 53998 and Org 30029, act on the Ca(2+)-binding site of troponin C, increasing the affinity of these sites for Ca2+ ions, or at the actin-myosin interface to facilitate the cycling of cross-bridges. These agents produce a PIE with little change or decrease in Ca2+ transients and may bring about a significant breakthrough in the development of drugs for reversal of myocardial failure in the treatment of congestive heart failure.

Myocardial force-frequency defect in mitral regurgitation heart failure is reversed by forskolin

BACKGROUND

Postoperative ejection phase parameters and patient survival rates for mitral valve replacement surgery are considerably lower than for similar aortic valve surgery. While chordal transection probably is the major contributor to the lowered values, there is also evidence for decreased preoperative myocardial contractile reserve in mitral regurgitation patients. This study characterizes abnormalities in the force-frequency relation that may underlie impaired function of myocardium isolated from mitral regurgitation patients with New York Heart Association class II-III heart failure.

METHODS AND RESULTS

Left ventricular epicardial myocardium was obtained by surgical biopsy during mitral valve replacement surgery in patients with mitral regurgitation heart failure (left ventricular ejection fraction, 0.64 +/- 0.05) and during coronary artery bypass surgery in patients with normal ventricular function. The steady-state twitch tension versus frequency relation was measured in myocardial strip preparations (37 degree C, 12 to 228 min-1) in the absence and presence of forskolin. Relative to normal function, peak isometric twitch tension in mitral regurgitation is depressed by 50% (P < .02) and 74% (P < .003) at contraction frequencies of 60 min-1 and 168 min-1, respectively. The slope of the tension-frequency curve is blunted and its peak is shifted to a lower frequency (mitral regurgitation: 134 min-1; normal function: 173 min-1; P < .02). The myosin heavy chain concentration did not differ between mitral regurgitation and normal function strips (53 +/- 4 versus 54 +/- 4 nmol/g blotted wt). Forskolin (0.5 mumol/L) completely reversed the tension depression, blunting, and the lowered peak frequency in the mitral regurgitation preparations.

CONCLUSIONS

Preoperatively, myocardial tension generation in mitral regurgitation patients is severely depressed, and the force-frequency curve is blunted and has a negative slope in the exercise range of heart rates. The reversal of these defects by forskolin suggests that abnormal excitation-contraction coupling may underlie the decreased contractile reserve in mitral regurgitation patients.

Alterations in contractile properties and Ca2+ transients by beta-and muscarinic receptor stimulation in ferret myocardium

1. To clarify the mechanism which regulates the time course of twitch tension when beta- and muscarinic receptors are stimulated, intracellular Ca2+ transients, Ca2+ sensitivity of the contractile element and the cross-bridge cycling rate (CCR) were measured in ferret ventricular muscles. 2. Isoprenaline (Iso; 0.1 microM) increased peaks of Ca2+ transients measured with aequorin and tension, and abbreviated the time courses of both signals. Addition of acetylcholine (ACh; 0.01-1 microM) to the Iso-treated preparation dose dependently decreased the peaks of both signals and restored the time course of Ca2+ transients. However, the time course of tension was not recovered by the addition of ACh, and the relaxation time in particular, was further shortened by ACh. Carbachol (1 microM) applied to the Iso-treated preparation yielded similar results. 3. [Ca2+]i and tension at a quasi-steady level of tetanic contraction, which was produced by ryanodine (5 microM) and repetitive stimulation, were measured and Ca2+ sensitivity of the contractile element was estimated. Iso (0.1 microM) decreased the Ca2+ sensitivity and the addition of ACh (1 microM) completely recovered it to the control level. 4. In order to measure CCR, the perturbation analysis method was applied to steady-state tension of tetanic contraction. The CCR was not altered even when the tetanic tension level was decreased to 50% by decreasing [Ca2+]o. Iso (0.1 microM) slightly decreased the tetanic tension level and increased the CCR from 2.73 to 3.25 Hz. The effect of Iso was observed when the Iso-decreased tension was recovered by an increase in [Ca2+]i. The addition of ACh (1 microM) recovered the CCR which was increased by Iso, to the control level. Atropine (10 microM) blocked the effect of ACh, and carbachol (1 microM) restored the CCR increased by Iso to the control level. 5. The time course of Ca2+ transients, Ca2+ sensitivity and CCR were antagonistically regulated by beta- and muscarinic receptor stimulation, but the time course of tension did not parallel the changes in these parameters. Therefore, these results suggest that the time course of tension, particularly the relaxation time, is not determined by the time course of Ca2+ transients, Ca2+ sensitivity and the CCR, and that other factors might be involved in the regulation of the time course of tension when beta- and muscarinic receptors are stimulated.