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European Heart Journal 1994 15(Supplement D):7-13; doi:10.1093/eurheartj/15.suppl_D.7
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Myocardial Cyclic AMP and Norepinephrine Content in Human Heart Failure

V. Regitz-Zagrosek, R. Hertrampf*, C. Steffen*, A. Hildebrandt* and E. Fleck

Freie Universität Berlin, Universitätsklinikum Rudolf Virchow and Deutsches Herzzentrum Berlin, Innere Medizin—Kardiologie/Angiologie Berlin, Germany

Correspondence: PD Dr Vera Regitz-Zagrosek, German Heart Institute Berlin, Dept of Internal Medicine/Cardiology, Augustenburger Platz 1, 13 353 Berlin, Germany

Impaired production of myocardial cyclic adenosine monophosphate (cAMP) is thought to contribute to contractile dysfunction in end stage heart failure, but myocardial cAMP content has not yet been evaluated in heart failure patients in comparison with controls. We therefore measured the myocardial content of cAMP by radioimmunossay in endomyocardial biopsies from patients in different stages of heart failure and in controls and correlated it with biochemical and functional parameters. The myocardial content of norepinephrine was determined by HPLC in the same biopsies in order to assess if the myocardium studied was affected by heart failure. Myocardial cAMP (in fmoLµg–1 non-collagen protein) in 20 patients with heart failure (LVEF: 27 ± 8%, cAMP: 5.8 ± 2.0) was unchanged in comparison with eight controls (LVEF: 64 ± 4.7%, cAMP, 4.9 ± 2.1). In contrast, myocardial norepinephrine (in pg.µg–1 non-collagen protein) in the same biopsies was significantly reduced in heart failure (4.0 ±3.0) in comparison with the same controls (11.5 ±3.0, P <0.0002). Plasma cAMP in 20 heart failure patients (22.0 ± 4.2 pmoLl–1) was not different from controls (22.0± 7.8), whereas plasma norepinephrine was increased (heart failure: 460 ±257pg.ml–1, controls 182 ± 49, P < 0.001).

Myocardial cAMP levels are indistinguishable from controls in human heart failure and therefore do not contribute to a further characterization of the cardiac adrenergic system in these patients. This is most likely due to the impossibility of obtaining biopsies with truly unstimulated adenylyl cyclase activity.

Key Words: Human heart failure • myocardial cAMP • myocardial norepinephrine

* Present address: Bundes institut für Arzneimittel und Medizinprodukte, SeestraBe, 13353 Berlin, Germany.


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