WIXLIB

PATHOPHYSIOLOGY OF HEART DISEASE

DEVELOPMENTS IN CARDIOVASCULAR MEDICINEMorganroth, loel, Moore, E.N., eds.: Sudden cardiac death and congestive heart failure: Diagnosis andtreatment. 1983. ISBN 0-89838-580-6.Perry, H.M., ed.: Lifelong management of hypertension. ISBN 0-89838-582-2.laffe, E.A., ed.: Biology of endothelial cells. ISBN 0-89838-587-3.Surawicz, B., Reddy, C.P., Prystowsky, E.N., eds.: Tachycardias. 1984. ISBN 0-89838-588-1.Spencer, M.P., ed.: Cardiac doppler diagnosis. ISBN 0-89838-591-1.Villareal, H.V., Sambhi, M.P., eds.: Topics in pathophysiology of hypertension. ISBN 0-89838-595-4.Messerli, F.H., ed.: Cardiovascular disease in the elderly. 1984. ISBN 0-89838-596-2.Simoons, M.L., Reiber, 1.H.C., eds.: Nuclear imaging in clinical cardiology. ISBN 0-89838-599-7.Ter Keurs, H.E.D.l., Schipperheym, 1.1., eds.: Cardiac left ventricular hypertrophy. ISBN0-89838-612-8.Sperelakis, N., ed.: Physiology and pathophysiology of the heart. ISBN 0-89838-615-2.Messerli, F.H., ed.: Kidney in essential hypertension. 1983. ISBN 0-89838-616-0.Sambhi, M.P., ed.: Fundamental fault in hypertension. ISBN 0-89838-638-1.Marchesi, D., ed.: Ambulatory monitoring: Cardiovascular system and allied applications. ISBN0-89838-642-X.Kupper, W., Macalpin, R.N., Bleifeld, W., eds.: Coronary tone in ischemic heart disease. ISBN0-89838-646-2.Sperelakis, N., Caulfield, 1.B., eds.: Calcium antagonists: Mechanisms of action on cardiac muscle andvascular smooth muscle. ISBN 0-89838-655-1.Godfraind, T., Herman, A.S., Wellens, D., eds.: Entry blockers in cardiovascular and cerebraldysfunctions. ISBN 0-89838-658-6.Morganroth, 1., Moore, E.N., eds.: Interventions in the acute phase of myocardial infarction. ISBN0-89838-659-4.Abel, F.L., Newman, W.H., eds.: Functional aspects of the normal, hypertrophied, and failing heart.ISBN 0-89838-665-9.Sideman, S., and Beyar, R., eds.: Simulation and imaging of the cardiac system. ISBN 0-89838-687-X.van de Wall, E., Lie, K.I., eds.: Recent views on hypertrophic cardiomyopathy. ISBN 0-89838-694-2.Beamish, R.E., Singal, P.K., Dhalla, N.S., eds.: Stress and heart disease. ISBN 089838-709-4.Beamish, R.E., Panagia, V., Dhalla, N.S., eds.: Pathogenesis of stress-induced heart disease. ISBN0-89838-710-8.Morganroth, 1., Moore, E.N., eds., Cardiac arrhythmias: New therapeutic drugs and devices.ISBN 0-89838-716-7.Mathes, P., ed.: Secondary prevention in coronary artery disease and myocardial infarction.ISBN 0-89838-736-1.Stone, H. Lowell, Weglicki, W.B., eds., Pathology of cardiovascular injury. ISBN 0-89838-743-4.Meyer, 1., Erbel, R., Rupprecht, H.J., eds., Improvement of myocardial perfusion. ISBN 0-89838-748-5.Reiber, J.H.C., Serruys, P.W., Slager, C.J.: Quantitative coronary and left ventricular cineangiography.ISBN 0-89838-760-4.Fagard, R.H., Bekaert, I.E., eds., Sports cardiology. ISBN 0-89838-782-5.Reiber, J.H.C., Serruys, P.W., eds., State of the art in quantitative coronary arteriography. ISBN0-89838-804-X.Roelandt, J., ed.: Color doppler flow imaging. ISBN 0-89838-806-6.van de Wall, E.E., ed.: Noninvasive imaging of cardiac metabolism. ISBN 0-89838-812-0.Liebman, 1., Plonsey, R., Rudy, Y., eds., Pediatric and fundamental electrocardiography. ISBN0-89838-815-5.Higler, H., Hombach, V., eds., Invasive cardiovascular therapy. ISBN 0-89838-818-X.Serruys, P.W., Meester, G.T., eds., Coronary angioplasty: a controlled model for ischemia. ISBN0-89838-819-8.Tooke, J.E., Smaje, L.H., eds.: Clinical investigation of the microcirculation. ISBN0-89838-833-3.van Dam, Th., van Oosterom, A., eds.: Electrocardiographic body surface mapping. ISBN0-89838-834-1.Spencer, M.P., ed.: Ultrasonic diagnosis of cerebrovascular disease. ISBN 0-89838-836-8.Legato, M.J., ed.: The stressed heart. ISBN 0-89838-849-X.Safar, M.E., ed.: Arterial and venous systems in essential hypertension. ISBN 0-89838-857-0.Roelandt, J., ed.: Digital techniques in echocardiography. ISBN 0-89838-861-9.This book is a volume in the series, "Advances in Myocardiology" (N.S. Dhalla, Series Editor). "Advances in Myocardiology" is a subseries within "Developments in Cardiovascular Medicine".

PATHOPHYSIOLOGY OFHEART DISEASEProceedings of the Symposium held at the EighthAnnual Meeting of the American Section of theInternational Society for Heart Research,July 8-11, 1986, Winnipeg, Canadaedited byNaranjan S. DhallaPawan K. SingalRobert E. BeamishYouville Research Institute, St. Boniface GeneralHospital and University of Manitoba, Department ofPhysiology, Winnipeg, Canada"!lUllMartinus Nijhoff Publishinga member of the Kluwer Academic Publishers GroupBoston/Dordrecht/Lancaster

Distributorsfor North America: Kluwer Academic Publishers, 101 Philip Drive, Assinippi Park,Norwell, MA 02061, USAfor the UK and Ireland: Kluwer Academic Publishers, MTP Press Limited,Falcon House, Queen Square, Lancaster LA1 IRN, UKfor all other countries: Kluwer Academic Publishers Group,Distribution Centre, Post Office Box 322, 3300 AH Dordrecht,The NetherlandsLibrary of Congress Cataloging-in-Publication DataPathophysiology of heart disease.(Developments in cardiovascular medicine. Advancesin myocardiology)1. Heart-Diseases-Congresses. 2. Physiology,Pathological-Congresses. I. Dhalla, Naranjan S.II. Singal, Pawan K. III. Beamish, Robert E.IV. International Society for Heart Research. AmericanSection. Meeting (8th: 1986 : Winnipeg, Man.)V. Series. [DNLM: I. Heart-physiopathology-congresses.2. Heart Diseases-physiopathology-congresses.WG 200 P2965 1986)RC682.9.P2561987616.1 '20786-33115ISBN-13: 978-1-4612-9219-7e-ISBN-13: 978-1-4613-2051-7001: 10.1007/978-1-4613-2051-7Copyright 1987 by Martinus Nijhoff Publishing, BostonSoftcover reprint of the hardcover I st edition 1987AIl rights reserved. No part of this publication may be reproduced, stored in a retrieval system, ortransmitted in any form or by any means, mechanical, photocopying, recording, or otherwise,without the prior written permission of the publisher, Martinus Nijhoff Publishing, 101 Philip Drive,Assinippi Park, Norwell, MA 02061.

This book is dedicated toDr. Howard E. Morgan for hisdistinguished contributions to theunderstanding of bioohemical meohanismsin heart disease.

CONTENTSPrefaceAcknowledgementsA.PRESIDENTIAL ADDRESS1. Role of the Basic Sciences in the Practice of CardiologyA.M. KatzB.xixiii3MYOCARDIAL HYPERTROPHY2. Physiological and Pathological HypertrophyR. Jacob, M. Vogt and H. Rupp3. Potential Role of Catecholamines in the Production of Physiologicaland Pathological HypertrophyM.M. Laks39574. Role of Thyroid Hormone in the Regulation of Cardiac HypertrophyI. Klein and C. Hong735. Oxygen Sources and Sinks in Myocardial HypertrophyK. Rakusan and Z. Turek836. Stretch, A Common Denominator in Muscle Growth937. The Quantity and Rate ot Calcium Uptake in Normal and HypertrophiedHeartsN.R. Alpert, E.M. Blanchard and L.A. Mulieri99H.E. Morgan, E.E. Gordon, B.H.L. Chua, L.A. Russo and X.P. XenophontosC.HYPERTENSION AND HEART FAILURE8. Implications of Atrial Natriuretic Factor (ANF) in the Pathogenesis ofExperimental and Human HypertensionM. Cantin, R. Garcia, J. Gutkowska, G. Thibault, O. Kuchel, P.Larochelle, J. Cusson, P. Hamet, B.L. Schiffrin and J. Genest1159. Plasma Concentration of Atrial Natriuretic Factor in Congestive HeartFailureK. Ogawa, T. Ito, H. Hashimoto and T. Satake13110. Mechanisms of Vasoconstriction in Hypertension and Chronic CongestiveHeart FailureR.J. Cody14311. Possible Adverse Effects of Catecholamines in Congestive Heart Failure:A Rationale for Beta-Blocker TherapyM.J. Sole151

viiiD.HEART DISEASE IN DIABETES12. Cardiao Dysfunotion in the Diabetio HeartJ.H. MoNeill, R.V.S.V. Vadlamudi and B.B. Rodrigues13. The Assooiation of Membrane Alterations with Heart Dysfunotion DuringExperimental Diabetes MellitusG.N. Pieroe and N.S. Dhalla14. Abnormalities in Contraotile Proteins in Myooardium from ChronioDiabetio AnimalsJ. Soheuer, P.S. Pollaok and A. Malhotra15. Energy Metabolism in Diabetio HeartN. Haugaard, M.E. Hess, A. Torbati and O.L. Tulp16. Myooardial Substrate Utilization in Aoute and Chronio, and in Latent andSevere DiabetesJ.J. Spitzer, C. Dobresou, C.H. Lang and K.H. MoDonough17. Triaoylglyoerol Lipase Aotivities and Rates of Endogenous Lipolysis inMyooardial Cells from Diabetio Rat HeartsD.L. Severson, K.A. Kenno, T.S. Larsen and I. Ramirez18. Involvement of Cateoholamines in the Development of DiabetioCardiomyopathyP.K. Ganguly, K.S. Dhalla, R.E. Beamish, I.R. Innes and N.S. DhallaE.165177185199209223237CARDIOMYOPATHIES19. Ultrastruotural Abnormalities in Different Types of Cardiomyopathies25120. Alooholio Cardiomyopathy: Studies of Protein MetabolismS.S. Sohreiber, M. Oratz, M.A. Rothsohild and C.D. Evans26921. Pathophysiology of Anthraoyoline-Induced CardiomyopathyC.W. Tomlinson, J.H. MoNeil1 and D.V. Godin285V.J. Ferrans, F.R. Rodriguez, Y. Tomita and K. Saito22. Effeots of a Chronio Adriamyoin Treatment of Rats on Myooardial LipidHistoohemistryP.K. Singal, S.R. Bawa, R. Darbari, R. Kaur, C.M.R. Deally and R. Bawa29723. The Hypothyroid State in Cardiomyopathic Hamsters311G. Jasmin, L. Prosohek, G. Brisson and N.S. DhallaF.CARDIAC FUNCTION IN SHOCK24. Myooardial Failure and Exoitation-Contraotion Unooupling During theCourse of Canine Endotoxin and Hemorrhagio ShookM.L. Hess, J.A. Thompson and R.C. Kukreja32525. Heart Funotion and Metabolism in Shook During Sepsis and EndotoxemiaR.E. Shepherd, A.H. Burns. P.M.C. DeBlieux, C.H. Lang and K.H. MoDonough335

ix26. Role of Leukotrienes in the Pathogenesis of Shook and TraumaA.M. Lefer35727. Intrinsic Cardiodynamic Response to Thermal InjuryH.Il. Adams367

PREFACEIt is indeed ironical that in the absence of a completeknowledge of Pathophysiology, clinical cardiologists are leftwith no choice but to do the best they can to help the patientwith the armamentarium of drugs at their disposal. But nothingcould be further from truth than to treat the diagnosed end pointof a disease process without a full understanding of its pathophysiology.This point was eloquently made by Dr. Arnold Katz inhis Presidential Address (Chapter 1) at the 8th Annual Meeting ofthe American Section of the International Society for HeartResearch held in Winnipeg, Canada, July 8-11, 1986.This volumerepresents a part of the scientific proceedings of this Meeting.From a reading of this treatise it will become evident thatdiscoveries of newer scientific facts as well as a betterunderstanding of pathophysiology are continuously influencing/improving our therapeutic approaches in modern medicine.In thisbook, latest biochemical, physiological and pharmacologicalfindings on different experimental models such as Myocaridalhypertrophy, Hypertension and heart failure, Diabetes, Cardiomyopathies and Cardiac function in shock are described byinternationally recognised experts.Hopefully informationpresented here will provide another building block to the edificeof Science of Cardiology which we all are trying to create.