Regulation of the catecholamine beta-adrenergic system in ventricular remodeling of hypertension

Peng Yingxin1, Shan Jiang, Qi Xiaoyong

  • 1Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Japanese Heart Journal
|April 20, 2004
PubMed

Insights

Hypertension

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Hypertension is associated with structural changes in the heart.
  • Hormonal systems are implicated in hypertension-related cardiac remodeling.
  • The role of the catecholamine beta-adrenergic system in this process requires further investigation.

Purpose of the Study:

  • To investigate the changes in the circulating catecholamine beta-adrenergic system during left ventricular remodeling in hypertensive patients.
  • To correlate these changes with different patterns of left ventricular remodeling.

Main Methods:

  • Echocardiography was used to classify hypertensive patients into four groups based on left ventricular morphology and mass.
  • Plasma levels of norepinephrine (NE) and epinephrine (E) were measured.
  • Lymphocyte beta-adrenoceptor (beta-AR) density and intralymphocyte cyclic AMP (cAMP) content were assessed.

Main Results:

  • Hypertensive patients showed significantly increased plasma NE and E levels compared to controls.
  • Lymphocyte beta-AR density and cAMP content were elevated in normal morphology, concentric remodeling, and concentric hypertrophy groups, but decreased in the eccentric hypertrophy group.
  • Plasma catecholamine levels were highest in the normal morphology group and decreased progressively in other remodeling groups.

Conclusions:

  • The catecholamine beta-adrenergic system is closely linked to left ventricular remodeling in hypertension.
  • Catecholamine levels increase progressively during remodeling.
  • Beta-adrenoceptor density and cAMP content initially increase and then decrease with advancing remodeling stages.

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Antihypertensive Drugs: Action of β1 Blockers01:17

Antihypertensive Drugs: Action of β1 Blockers

β1-receptors are primarily located in the heart and kidneys. In cardiac myocytes, these receptors interact with neurotransmitters released by the sympathetic nervous system during heightened activity or danger. As a result, β1-receptors get activated, initiating a series of biochemical processes. Excessive activation of beta receptors due to chronic stress can abnormally increase heart rate and contractility, resulting in high blood pressure or hypertension. To counteract this, β1-blockers...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Hormonal Regulation of Blood Pressure01:17

Hormonal Regulation of Blood Pressure

Endocrinal or hormonal intervention in the cardiovascular system is predominantly exerted by the catecholamines - epinephrine and norepinephrine, as well as a slew of hormones that interact with renal function to modulate blood volume.
Epinephrine and Norepinephrine
The adrenal medulla releases epinephrine and norepinephrine, catecholamines that enhance and extend the sympathetic or "fight or flight" physiological response. These hormones escalate heart rate and the force of contraction while...
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors01:30

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors

Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...