Beta1-Adrenoreceptor Reactivity of Human Myocardium in Ischemic Heart Disease with Preserved and Reduced Ejection Fraction of Left Ventricular and ITS Relationship with Structural and Functional Parameters of the Heart

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Abstract

The relationship between adrenergic reactivity of isolated myocardium of the human right atrial appendage in coronary heart disease (CHD) with preserved and reduced ejection fraction (EF) of the left ventricle (LV) upon stimulation of β1-adrenergic receptors (β1-AR) with echocardiography (EchoCG) parameters was studied. It has been shown that adrenergic reactivity, assessed by changes in the force of contractions of isolated myocardial strips in response to stimulation of β1-AR, in patients with preserved LVEF has positive dynamics at 20-minute observation. In reduced LVEF, adrenergic reactivity in response to β1-AR stimulation is weakened and does not have positive dynamics. In patients with CHD, myocardial adrenergic reactivity associated with β1-AR is a significant factor in determining intracardiac hemodynamics. This is manifested in the presence of correlations between the mechanical response of isolated myocardium upon stimulation of β1-AR and the results of echocardiography, and such correlations have different directions in patients with preserved and reduced EF. The discovered differences in the correlation of cardiac ultrasound parameters with the inotropic response of isolated myocardial fragments upon stimulation of β1-AR with preserved and reduced EF probably reflect the different severity of cardiac chamber remodeling and the state of general neurohumoral regulation in the conditions of the pathology under consideration.

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About the authors

S. A. Afanasiev

Tomsk National Research Medical Center

Author for correspondence.
Email: Tursky@cardio-tomsk.ru
Russian Federation, Tomsk

D. S. Kondratieva

Tomsk National Research Medical Center

Email: Tursky@cardio-tomsk.ru
Russian Federation, Tomsk

E. F. Muslimova

Tomsk National Research Medical Center

Email: Tursky@cardio-tomsk.ru
Russian Federation, Tomsk

V. A. Korepanov

Tomsk National Research Medical Center

Email: Tursky@cardio-tomsk.ru
Russian Federation, Tomsk

V. V. Zatolokin

Tomsk National Research Medical Center

Email: Tursky@cardio-tomsk.ru
Russian Federation, Tomsk

Sh. D. Akhmedov

Tomsk National Research Medical Center

Email: Tursky@cardio-tomsk.ru
Russian Federation, Tomsk

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2. Fig. 1. Typical view of continuous mechanogram registration of muscle strips from myocardium of the human right atrium auricle reflecting the development of inotropic response during β1-AR agonist exposure (A), as well as single ‘contraction-relaxation’ cycles in patients with preserved (B) and low (C) ejection fraction. 1 - before β1-AR agonist exposure; 2 - 1 min after β1-AR agonist exposure; 3 - 20 min after β1-AR agonist exposure

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3. Fig. 2. Correlations found in patients with preserved PV between the inotropic response of muscle strips 1 (A) and 20 (B) min after β1-AR stimulation with the results of EchoCG examination of their hearts. EF, ejection fraction (%); CSR, end-systolic volume (ml); EDV, end-diastolic volume (ml), peak E, LV early diastolic filling velocity (cm/s); peak A, LV late diastolic filling velocity (cm/s)

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4. Fig. 3. Correlations found in patients with low PV between the inotropic response of muscle strips at 1 (A) and 20 (B) min after β1-AR stimulation with the results of echocardiography (echoCG) studies of their hearts. For designations, see Fig. 2

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