Steinfath M, Geertz B, Schmitz W, Scholz H, Haverich A, Breil I, Hanrath P, Reupcke C, Sigmund M, Lo H B
Abteilung Allgemeine Pharmakologie, Universitäts-Krankenhaus Eppendorf, Universität Hamburg, Federal Republic of Germany.
Naunyn Schmiedebergs Arch Pharmacol. 1991 Feb;343(2):217-20. doi: 10.1007/BF00168613.
Cardiac beta-adrenoceptor density and beta 1- and beta 2-subtype distribution were examined in human left ventricular myocardium from transplant donors serving as controls and from patients with mitral valve stenosis, aortic valve stenosis, idiopathic dilated cardiomyopathy, and ischaemic cardiomyopathy respectively. The total beta-adrenoceptor density was similar in transplant donors and patients with moderate heart failure (NYHA II-III) due to mitral valve stenosis, but was markedly reduced in all forms of severe heart failure (NYHA III-IV) studied. A reduction of both beta 1- and beta 2-adrenoceptors was found in patients with severe heart failure due to mitral valve stenosis or ischaemic cardiomyopathy. In contrast, a selective down-regulation of beta 1-adrenoceptors with unchanged beta 2-adrenoceptors and hence a relative increase in the latter was observed in idiopathic dilated cardiomyopathy and aortic valve stenosis. It is concluded that the extent of total beta-adrenoceptor down-regulation is related to the degree of heart failure. Selective loss of beta 1-adrenoceptors is not specific for idiopathic dilated cardiomyopathy but also occurs in aortic valve stenosis. Changes in beta 1- and beta 2-subtype distribution are rather related to the aetiology than to the clinical degree of heart failure.
分别在作为对照的心脏移植供体以及患有二尖瓣狭窄、主动脉瓣狭窄、特发性扩张型心肌病和缺血性心肌病的患者的左心室心肌中检测心脏β-肾上腺素能受体密度以及β1和β2亚型分布。心脏移植供体和因二尖瓣狭窄导致中度心力衰竭（纽约心脏协会II-III级）的患者的总β-肾上腺素能受体密度相似，但在所研究的所有重度心力衰竭（纽约心脏协会III-IV级）形式中均显著降低。在因二尖瓣狭窄或缺血性心肌病导致重度心力衰竭的患者中发现β1和β2肾上腺素能受体均减少。相比之下，在特发性扩张型心肌病和主动脉瓣狭窄中观察到β1肾上腺素能受体选择性下调，而β2肾上腺素能受体不变，因此后者相对增加。得出的结论是，总β-肾上腺素能受体下调的程度与心力衰竭的程度相关。β1肾上腺素能受体的选择性丧失并非特发性扩张型心肌病所特有，在主动脉瓣狭窄中也会出现。β1和β2亚型分布的变化更多地与病因有关，而非与心力衰竭的临床程度有关。
