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Cardiology Unit, Department of Medicine, and Department of Neurobiology and Anatomy, University of Rochester Medical Center, Rochester, New York 14642
Right heart failure (RHF) is
characterized by chamber-specific reductions of myocardial
norepinephrine (NE) reuptake,
-receptor density, and profiles of
cardiac sympathetic nerve ending neurotransmitters. To study the
functional linkage between NE uptake and the pre- and postsynaptic
changes, we administered desipramine (225 mg/day), a NE uptake
inhibitor, to dogs with RHF produced by tricuspid avulsion and
progressive pulmonary constriction or sham-operated dogs for 6 wk.
Animals receiving no desipramine were studied as controls. We measured
myocardial NE uptake activity using [3H]NE,
-receptor
density by [125I]iodocyanopindolol, inotropic responses
to dobutamine, and noradrenergic terminal neurotransmitter profiles
by glyoxylic acid-induced histofluorescence for
catecholamines, and immunocytochemical staining for tyrosine hydroxylase and neuropeptide Y. Desipramine decreased myocardial NE
uptake activity and had no effect on the resting hemodynamics in both
RHF and sham animals but decreased myocardial
-adrenoceptor density
and
-adrenergic inotropic responses in both ventricles of the RHF
animals. However, desipramine treatment prevented the reduction of
sympathetic neurotransmitter profiles in the failing heart. Our results
indicate that NE uptake inhibition facilitates the reduction of
myocardial
-adrenoceptor density and
-adrenergic subsensitivity
in RHF, probably by increasing interstitial NE concentrations, but
protects the cardiac noradrenergic nerve endings from damage, probably
via blockade of NE-derived neurotoxic metabolites into the nerve endings.
congestive heart failure; neuronal norepinephrine uptake; tyrosine hydroxylase; neuropeptide Y
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