Lymphocyte G proteins reflect response to treatment in congestive heart failure
| Autor: | Rochelle L. Goldsmith, Gerald W. Neuberg, Madeline Yushak, John P. Bilezikian, Norma Medina, Moira McCarty, Milton Packer, Mary Gratch, Evelyn M. Horn, Marrick L. Kukin |
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| Rok vydání: | 1995 |
| Předmět: |
Male
Chronotropic Inotrope medicine.medical_specialty Mean arterial pressure Vasodilator Agents Cardiac index Hemodynamics Vasodilation Norepinephrine Radioligand Assay GTP-Binding Proteins Internal medicine Receptors Adrenergic beta Cyclic AMP Humans Medicine Lymphocytes Aged Heart Failure business.industry Middle Aged medicine.disease Endocrinology medicine.anatomical_structure Heart failure Chronic Disease Cardiology Vascular resistance Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | American Heart Journal. 129:98-106 |
| ISSN: | 0002-8703 |
| Popis: | Congestive heart failure is associated with chronotropic and inotropic hyporesponsiveness to adrenergic stimulation. A decrease in Gs alpha or an increase in Gi alpha is associated with a decrease in adenylyl cyclase activity. The current study assessed G proteins in response to treatment with direct-acting vasodilators and correlated changes in lymphocyte beta-adrenergic receptor components with changes in hemodynamic variables. Twenty-three patients with severe chronic congestive heart failure (New York Heart Association functional classes III and IV) were studied. Patients were grouped as responders (n = 10) or nonresponders (n = 13) on the basis of clinical assessment of functional status from questionnaires. Therapy was associated with an increase in cardiac index, a decrease in mean arterial pressure, and a decrease in systemic vascular resistance in all patients. Left ventricular filling pressure significantly decreased in responders (26 +/- 2 mm to 13 +/- 3 mm, p0.05) but did not change significantly in nonresponders. Similarly, mean right atrial pressure significantly decreased in responders (11 +/- 2 mm Hg to 4 +/- 1 mm Hg, p0.05) but did not change in nonresponders. Plasma norepinephrine increased significantly only in nonresponders (679 +/- 100 pg/ml to 1233 +/- 201 pg/ml, p0.05). Whereas lymphocyte beta-adrenergic receptor density and Gs did not significantly change, Gi increased after treatment only in the nonresponder group (23 +/- 5 to 51 +/- 11 fmol/mg, p0.05). A poor response to direct-acting vasodilators can be distinguished by reactive increases in plasma norepinephrine and lymphocyte Gi in the absence of a decrease in either left- or right-sided filling pressures. |
| Databáze: | OpenAIRE |
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