The negative functional and metabolic effects of muscarinic stimulation are enhanced by beta-adrenergic activation in control and hypertrophic dog hearts in vivo.
The aim of the current study was to determine if the effects of muscarinic stimulation on left ventricular function and metabolism are greater during beta-adrenergic activation, whether a cyclic GMP-mediated mechanism is responsible, and if this is altered by left ventricular hypertrophy (LVH) induced by aortic valve stenosis. Acetylcholine (Ach) (5 micrograms/kg/min) and/or isoproterenol (Iso) (0.1 micrograms/kg/min) was infused into a branch of the left anterior descending (LAD) artery in 8 control and 8 LVH open-chest anesthetized dogs. LVH increased heart weight, heart-to-body weight ratio and systolic left ventricular pressure. LVH reduced muscarinic receptor density (fmol/mg protein) (control: 149.2+/-18.6; LVH: 77.8+/-8.6), but not affinity. Alone, Ach had no effect on regional force, work or metabolism. Iso increased peak force (g) (control: baseline-7.4+/-0.4; Iso-12.4+/-2.2; LVH: baseline-6.7+/-0.8; Iso-16.3+/-2.7, regional work (g mm/min)) (control: baseline-1250+/-186; Iso-1813+/-409; LVH: baseline-927+/-235; Iso-1244+/-222), and O2 consumption (ml O2/min/100 g) (control: baseline-3.3+/-0.2; Iso-8.1+/-2.0; LVH: baseline-4.8+/-1.0; Iso-8.3+/-1.1). During Iso, Ach reduced segment shortening (control: Iso-14.5+/-1.2; Iso+Ach-10.5+/-1.8; LVH: Iso-10.4+/-1.5; Iso+Ach-7.6+/-1.3) and peak force (control: Iso+Ach-7.7+/-1.0; LVH: Iso+Ach-10.5+/-1.4). Ach also reduced work (control: Iso+Ach-875+/-217; LVH: Iso+Ach-776+/-180) and O2 consumption (control: Iso+Ach-3.4+/-0.7; LVH: Iso+Ach-3.6+/-0.6) in the presence of Iso. Cyclic GMP was higher in the LVH animals during all treatments and was elevated from baseline by Ach in both groups. Neither Iso nor Iso+Ach had a significant effect on cyclic GMP. Thus, the negative functional and metabolic effects of muscarinic stimulation are enhanced during beta-adrenergic activation. This does not, however, appear to be dependent on a cyclic GMP-mediated mechanism. Despite reduced number of muscarinic receptors, this response was not altered by pressure-induced cardiac hypertrophy.