PubMed Health⌕ Search

Biomedical subjects

A Fleckenstein

Publications and source records attributed to A Fleckenstein.

At least 73 records · Page 4Linked to original sources

Disturbed myocardial calcium metabolism: a possible pathogenetic factor in the hereditary cardiomyopathy of the Syrian hamster.

In the BIO 8262 inbred strain of cardiomyopathic Syrian hamsters, a latent disturbance of their myocardial calcium metabolism could be evidenced. Whereas the myocardial calcium content of untreated young cardiomyopathic hamsters with prenecrotic hearts did not differ from that of healthy control animals, it was distinctly elevated 6 hours after injection of isoproterenol (1 mg/kg body weight s.c.) in cardiomyopathic animals remaining unchanged in healthy controls. However, the same dose of isoproterenol induced elevated myocardial 45Ca uptake in both strains, although that of the cardiomyopathic hearts was distinctly greater. Later, during the stage of spontaneous progressive necrotization of the hearts, a spontaneously increased myocardial uptake of 45Ca and calcium content became manifest. By combined treatment with isoproterenol and verapamil, a substance which is known to decrease the calcium conductivity of myocardial cell membranes without blocking beta-adrenergic receptors, the isoproterenol-stimulated 45Ca uptake by prenecrotic cardiomyopathic hearts as well as the increase of their calcium content could be inhibited. Long-term treatment with verapamil alone beginning during the prenecrotic phase of the cardiac condition, was fully effective in preventing myocardial overload as well as necrotization. These findings demonstrate that overload with calcium of cardiomyopathic cells of the hamsters can be influenced beneficially. Therefore, the disturbed myocardial calcium metabolism in the hereditary cardiomyopathy of the Syrian hamster is considered a decisive pathogenetic factor.

Age Factors↗

Key role of Ca in the production of noncoronarogenic myocardial necroses.

Skeletal and heart muscle fibers undergo severe functional and structural alterations, resulting in necrotization as soon as extracellular Ca ions penetrate excessively into the sarcoplasm, so that the capacities of the Ca binding or extrusion processes become insufficient. In mechanically injured skeletal muscle fibers, this necrotization process begins in the neighborhood of the membrane lesion where a large Ca inward transport takes place. Accordingly, elimination of Ca from the Ringer solution or an outward electric current which blocks the influx of extracellular Ca prevents the onset of necrotization, whereas additional Ca or an inward electric current which augments the influx of Ca potentiates the course of degradation. The crucial reaction in the production of necroses in skeletal and heart muscle fibers is a high energy phosphate deficiency which results (a) from excessive activation of Ca-dependent intracellular ATPases, and (b) from Ca-induced mitochondrial destruction. This applies especially to myocardial fiber damage caused by large doses of beta-adrenergic catecholamines such as isoproterenol. The number and size of the isoproterenol-induced cardiac lesions are obviously determined by the extent and, particularly, by the duration of the Ca-mediated high energy phosphate penury. Substances which sensitize the myocardium to catecholamine-induced necrotization (9-alpha-fluorocortisol, dihydrotachysterol, NaH2PO4) act by potentiating intracellular Ca overload and high energy phosphate breakdown. Conversely, verapamil D 600, and other Ca-antagonistic compounds protect the structural integrity of the heart muscle fibers by restricting transmembrane Ca influx and, consequently, ATP and creatine phosphate exhaustion.

Adenosine Triphosphate↗

Prevention of myocardial Ca overload and necrotization by Mg and K salts or acidosis.

The crucial point in the pathogenesis of isoproterenol-induced myocardial necrotization is an abundant intracellular Ca accumulation leading to high energy phosphate exhaustion. Accordingly, in the early stage of the isoproterenol-induced necrotization process, the onset of ATP and creatine phosphate breakdown strictly parallels the acute Ca gain. In this type of necrosis, the Mg losses from the myocardium appear as a concomitant phenomenon. The hearts can be protected against the deleterious Ca overload and necrotization by increasing the plasma concentration of Mg, K, or H ions in order to counterbalance Ca according to the ration (see article). On the other hand, if Mg, K, or H ion concentrations are too low, isoproterenol-induced Ca uptake and myocardial lesions are potentiated.

Adenosine Triphosphate↗