Chello M, Mastroroberto P, Romano R, Cirillo F, Marchese A R
Coron Artery Dis. 1995 Dec;6(12):957-63.
To evaluate whether coronary artery bypass grafting (CABG) in patients with congestive heart failure (CHF) modifies beta-adrenergic receptor dysfunction, we measured lymphocytic beta-adrenergic receptor density and function, and plasma catecholamine levels in patients with congestive ischaemic disease scheduled for CABG.
Assays were performed on 20 patients with CHF at admission and 6 months following CABG; 20 age-matched healthy subjects served as the control group.
Preoperative lymphocyte beta-adrenergic receptor density was significantly reduced in patients with CHF compared with the control group. Similarly, basal adenylyl cyclase as well isoproterenol- and NaF-stimulated adenylyl cyclase activity was significantly reduced in lymphocytic membranes of patients with CHF compared with controls. Conversely, no difference was found in forskolin-stimulated adenylyl cyclase activity between the two groups of patients. Preoperatively, plasma levels of both noradrenaline and adrenaline were significantly higher in patients with CHF compared with the control group. CABG was associated with clinical and haemodynamic improvement in all patients. Lymphocyte beta-adrenergic receptor density and function were also improved. Basal beta-adrenergic receptor density improved from 39.2 +/- 1.7 to 46 +/- 1.5 fmol/mg protein. Basal adenylyl cyclase activity increased from 33.1 +/- 2.6 40 +/- 2.4 pmol/mg protein per min; a significant increase in activity stimulated by isoproterenol (from 41.5 +/- 3.1 to 61 +/- 3.8 pmol/mg protein per min) and by NaF (from 71.8 +/- 2.7 to 85.3 +/- 3.5 pmol/mg protein per min) was also observed. Although postoperative plasma catecholamine levels tended to decrease, the difference compared with preoperative values was not significant.
The results of our study indicate that CABG in patients with CHF is accompanied by the restoration of an almost normal functional state of the lymphocytic beta-adrenergic receptor system.
为评估充血性心力衰竭（CHF）患者行冠状动脉旁路移植术（CABG）是否能改善β-肾上腺素能受体功能障碍，我们测定了计划行CABG的充血性缺血性疾病患者的淋巴细胞β-肾上腺素能受体密度和功能以及血浆儿茶酚胺水平。
对20例CHF患者入院时及CABG术后6个月进行检测；20例年龄匹配的健康受试者作为对照组。
与对照组相比，CHF患者术前淋巴细胞β-肾上腺素能受体密度显著降低。同样，与对照组相比，CHF患者淋巴细胞膜中基础腺苷酸环化酶以及异丙肾上腺素和氟化钠刺激的腺苷酸环化酶活性显著降低。相反，两组患者中福斯可林刺激的腺苷酸环化酶活性没有差异。术前，CHF患者血浆去甲肾上腺素和肾上腺素水平均显著高于对照组。CABG使所有患者的临床和血流动力学得到改善。淋巴细胞β-肾上腺素能受体密度和功能也得到改善。基础β-肾上腺素能受体密度从39.2±1.7增加到46±1.5 fmol/mg蛋白质。基础腺苷酸环化酶活性从33.1±2.6增加到40±2.4 pmol/mg蛋白质每分钟；异丙肾上腺素（从41.5±3.1增加到61±3.8 pmol/mg蛋白质每分钟）和氟化钠（从71.8±2.7增加到85.3±3.5 pmol/mg蛋白质每分钟）刺激的活性也显著增加。虽然术后血浆儿茶酚胺水平有下降趋势，但与术前值相比差异不显著。
我们的研究结果表明，CHF患者行CABG后，淋巴细胞β-肾上腺素能受体系统的功能状态几乎恢复正常。
