Gabrusenko S A, Naumov V G, Krasnikova T L, Kupriianenko T I, Gadzhiev A B, Mazaev A V, Mukharliamov N M
Kardiologiia. 1990 Jul;30(7):67-72.
Twenty eight males with dilated cardiomyopathy, 5 males with coronary heart disease concurrent with postinfarction cardiosclerosis, 4 males and 2 females with rheumatic heart disease were examined. The findings suggest desensitization of the cellular beta-adrenoreceptor complex in patients with circulatory failure, which appeared as lower beta-adrenoreceptor density with cardiac decompensation progression and impaired transmission of a hormonal signal in the cell, particularly in patients with dilated cardiomyopathy. Digoxin therapy let to an increase in beta-adrenoreceptor density with its initial decrease and to adenylate cyclase activity enhancement. The absence of a positive ++clinico-hemodynamic effect and time course of plasma catecholamine levels in some patients with severe circulatory failure during digoxin use, as well as no changes in the values of the beta-adrenoreceptor adenylate cyclase complex indicate that the abnormalities in beta-adrenergic regulation play an important role in the pathogenesis of refractoriness at the cellular level. Retention of forskolin's stimulant effect allows one to expect a significant positive therapeutic response to be shown with the usage of drugs whose load point is a catalytic subunit of adenylate cyclase.
对28例扩张型心肌病男性患者、5例冠心病并发心肌梗死后心肌硬化男性患者、4例男性和2例女性风湿性心脏病患者进行了检查。研究结果表明，循环衰竭患者细胞β-肾上腺素能受体复合物存在脱敏现象，表现为随着心脏失代偿进展β-肾上腺素能受体密度降低，且细胞内激素信号传递受损，尤其是在扩张型心肌病患者中。地高辛治疗可使β-肾上腺素能受体密度在最初降低后升高，并增强腺苷酸环化酶活性。在一些严重循环衰竭患者使用地高辛期间，缺乏明显的临床血液动力学效应以及血浆儿茶酚胺水平的时间进程，同时β-肾上腺素能受体腺苷酸环化酶复合物的值没有变化，这表明β-肾上腺素能调节异常在细胞水平难治性发病机制中起重要作用。福司可林刺激作用的持续存在使人预期，使用以腺苷酸环化酶催化亚基为作用靶点的药物会显示出显著的阳性治疗反应。
