(Circulation. 1997;96:592-598.)
© 1997 American Heart Association, Inc.
Articles |
From the Division of Cardiology, University of Cincinnati (Ohio) Medical Center.
Background Many of the cardiovascular manifestations of thyroid hormone excess resemble those produced by sympathoadrenal stimulation. The objective of this study was to determine the effects of thyroid hormone excess on myocardial ß-adrenergic expression and responsiveness to infused agonists in the primate heart.
Methods and Results The responses of left
ventricular isovolumic contraction (dP/dtmax)
and relaxation (
) during graded dobutamine infusion were
studied both before and after 4 weeks of thyroid hormone administration
in 8 chronically instrumented baboons. At matched (atrially paced)
heart rates, thyroid hormone significantly increased resting
dP/dtmax (3073±1034 versus 2318±829 mm Hg/s,
P<.05) and decreased
(24.0±5.5 versus 28.2±5.4 ms,
P<.05). The change from baseline for dP/dtmax
and
in response to ß1-adrenergic stimulation was
significant at each dobutamine dose (2.5 to 10
µg·kg-1·min-1),
but when expressed as a percent change, it was similar before versus
after thyroid hormone. Similar changes were found when
ß2-adrenergic stimulation was produced by terbutaline
infusion in three additional baboons. ß-Adrenergic receptor (ßAR)
expression was higher in five thyroxine-treated than in five control
baboons (37.4±1.2 versus 15.7±3.2 fmol/mg, P<.001), and
this was due to a greater increase in the ß2AR (5.9±1.5
to 20.6±1.2 fmol/mg, P<.001) than the ß1AR
(9.7±1.7 to 16.8±0.1 fmol/mg, P<.01) subtype.
Conclusions In the primate heart, thyroid hormone produces positive inotropic and lusitropic effects in the resting state and upregulates both ß1AR and ß2AR, with the ß2AR increase predominating. At equivalent rates, however, thyroid hormone excess does not appear to enhance the sensitivity of left ventricular contractility and relaxation to either ß1- or ß2-adrenergic stimulation.
Key Words: thyroid receptors, adrenergic, beta contractility
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