Articles |
From the 1. Medizinische Klinik der Technischen Universität München.
Correspondence to Dr Martin Ungerer, 1. Medizinische Klinik der Technischen Universität München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675 München, Germany.
| Abstract |
|---|
|
|
|---|
Key Words: ischemia norepinephrine rat heart uptake1 carrier
| Introduction |
|---|
|
|
|---|
- and
ß-adrenergic receptors, a significant increase in receptor
density has been described during early myocardial
ischemia.7 8 It is possible that other membrane
proteins involved in sympathoadrenergic signal transduction might also
be regulated during cardiac ischemia. To elucidate the changes in cardiac norepinephrine elimination under ischemic conditions, we studied the uptake1 carrier protein during experimental ischemia in isolated perfused rat hearts. The density and affinity of this protein were measured by radioligand binding. The transport capacity was determined by measuring the clearance of [3H]norepinephrine following ischemia and during reperfusion.
| Materials and Methods |
|---|
|
|
|---|
Determination of Norepinephrine
Samples from the effluents were taken in 1-minute periods
throughout the experiments or within the first 5 minutes of reperfusion
after stop-flow ischemia. This time interval has been
proved sufficient to recover the norepinephrine overflow
during ischemia.3 Norepinephrine was
determined in the effluent as previously described.11
Briefly, after a two-step solvent extraction and concentration of
the samples, the separation of catecholamines was performed
with a reversed-phase high-performance liquid
chromatography system. Quantitative analysis
was achieved by electrochemical detection. The limit of detection of
norepinephrine was 0.1 nmol/L and the recovery was
98%.
Preparation of Cardiac Membranes
For preparation of membranes, whole hearts were cut to pieces
with a scalpel, resuspended in ice-cold lysis buffer (5 mmol/L
Tris-HCl, pH 7.4, and 2 mmol/L EDTA), and homogenized for
30 seconds in an ultraturrax tissue mincer. The homogenate
was centrifuged at 1000g for 15 minutes to remove
cell debris and nuclei, and the supernatant was centrifuged
twice at 100 000g for 30 minutes. The resulting membrane
pellet was resuspended in a buffer containing 50 mmol/L Tris-HCl (pH
7.5), 100 mmol/L NaCl, and 5 mmol/L KCl and used for
radioligand binding. Protein concentration was determined
according to Bradford.12
Radioligand Binding
Incubation of membranes with [3H]mazindol (NEN-Du
Pont) in concentrations ranging from 0.5 to 25 nmol/L was carried out
in 50 mmol/L Tris-HCl (pH 7.5), 100 mmol/L NaCl, and 5 mmol/L KCl, with
or without 10 µmol/L desipramine to define nonspecific binding, for
20 minutes at 22°C in a volume of 200 µL. On average, 280 µg of
protein per tube was used. Mazindol is known to inhibit uptake of
dopamine also, but it binds to the dopamine carrier with an affinity
10-fold lower than for the uptake1
carrier.13 14 15 In tissues rich in
norepinephrine uptake, such as cerebral cortex, binding of
[3H]mazindol seems to correspond exclusively to
norepinephrine uptake.13 Moreover, comparing
the saturation binding of [3H]desipramine to that of
[3H]mazindol, we found very similar Bmax
values. The nonspecific binding of [3H]desipramine,
however, accounted for more than 40% of the total binding; therefore,
this radioligand could not be used for our experiments. We
also tested the effect of specific dopamine uptake inhibition by
GBR-12909, which displays almost 100-fold selectivity for dopamine
versus norepinephrine uptake.14 15 In cellular
models of cloned, overexpressed carriers,14 15 20 nmol/L
GBR-12909 inhibits radioligand binding to dopamine carriers
almost completely, whereas it does not affect
norepinephrine uptake1.14 15 In
cardiac membranes, 20 nmol/L GBR-12909 did not alter
[3H]mazindol binding (131±7 fmol/mg protein versus
125±4 fmol/mg in control hearts). However, 100 nmol/L GBR-12909
inhibited binding of [3H]mazindol by 10% (to 110±9
fmol/mg protein), and 500 nmol/L GBR-12909 inhibited binding by 50%
(to 65±7 fmol/mg protein). These findings indicate the dependence of
cardiac [3H]mazindol binding on
norepinephrine uptake1 carriers.
Termination of the Binding Assay
The reaction was terminated by filtration through GF/B filters
and washing with ice-cold incubation buffer. Filter radioactivity
was determined by liquid scintillation counting. Uptake1
carrier density and affinity were determined from Scatchard plots of
the counting data. Fig 1
shows a typical binding
experiment. The binding was fully saturable and showed a linear
dependence on the amount of membrane protein used. Specific binding
depended on the presence of sodium ions and was not detectable in the
absence of sodium. Optimum binding was achieved at a concentration of
100 mmol/L NaCl. Specific binding was completely inhibited by
saturating concentrations of desipramine, norepinephrine,
or nisoxetine, as described in the literature.16 The
coefficient of variation between repeated measurements in the same
heart was less than 5% in all cases.
|
RNA Preparation
Tissues for RNA preparation were taken from
ventricular myocardium and the hippocampal
brain of three different rats, from three explanted human hearts
(ventricular myocardium of patients with
dilated cardiomyopathy), and from the peritumorous
area of a tissue section removed at the operation of a human brain
glioblastoma. RNA was prepared from the frozen tissues according to the
protocol of Chomczynski and Sacchi,17 as modified
according to our previous publication.18 The amount of RNA
in the samples was determined by UV absorption.
Reverse Transcription and PCR
The RNA of each heart was reverse transcribed with mouse
multiple lymphoma virus reverse transcriptase (BRL) into cDNA. Sense
and antisense oligonucleotide primer pairs were
synthesized to match the cDNA sequences of human uptake1
protein14 and the partial sequence of uptake1
protein as cloned from rat pheochromocytoma PC12 cells.19
The primers were chosen to hybridize to both sequences and were
therefore matched to highly homologous regions: sense primer, base
pairs 230 to 251 of human coding sequence 5'-CAA TGT TTG GCG TTT CCC
CTA TC-3'; antisense primer, base pairs 732 to 711 of human coding
sequence 5'-CGA CGA CCA TCA GAC AGA GCA-3'. We also amplified the cDNAs
for human and rat GAPDH as internal standards, as
described.18 Forty cycles of PCR were carried out, and the
products were analyzed on an agarose gel. They were then
cut out, purified, and sequenced with an automated sequencer.
[3H]Norepinephrine Uptake
The measurement of cardiac norepinephrine clearance
was carried out as described.20 Briefly, a bolus of
[3H]norepinephrine (1 mL, 3 µCi, 100 pmol
norepinephrine, NEN-Du Pont) was injected into the
perfusion system. Proportional distribution of the radioactivity to the
hearts (n=6) and blank channels (n=2) was provided by a mixing chamber
and a multichannel peristaltic pump. The effluent was sampled
successively at 2-minute intervals before and after the administration
of [3H]norepinephrine. Blank channels were
additional channels that were perfused freely. Sampling of the
radioactivity outflow from these channels was used to control the
comparability of the experiments and constituted total
[3H]norepinephrine subjected to each heart. A
500-µL portion of each sample was mixed with 4 mL of a liquid
scintillation cocktail (Zinsser) and immediately counted in a
ß-counter. Radioactivity decreased to nearly background levels
within 5 minutes after addition of
[3H]norepinephrine. The amount of
[3H]norepinephrine that was extracted by the
hearts (uptake) is expressed as percentage of total
[3H]norepinephrine administered.
Statistics
Results for norepinephrine release are expressed as
mean with standard error of the mean (SEM). [3H]Mazindol
Bmax data are also given as mean±SEM. For
uptake1 carrier affinities, we calculated 95% confidence
intervals on the basis of pD2 values.
[3H]Norepinephrine extraction data are given
as mean with standard deviation (SD). For each experimental condition,
six hearts were subjected to a specific intervention, whereas six other
hearts were perfused normally for the same time period, without any
intervention. Results of time-matched groups were compared by
one-way analysis of variance and tested by Scheffé's
test. A value of P<.05 was regarded as significant.
| Results |
|---|
|
|
|---|
Binding of the Uptake1 Carrier
After stimulation-evoked release of norepinephrine
during normal perfusion (six stimulations within 60 minutes), cardiac
uptake1 carrier density increased to 165% of control
values (P<.001, Fig 2
). Within 40 minutes of
reperfusion, we observed a normalization of the carrier densities,
which had been elevated directly after electrical field stimulation
(Fig 2
). Carrier affinities (Kd) were not
affected under any experimental condition (Table
).
|
|
After stop-flow ischemia, we detected a gradual increase in
the density (Bmax) of uptake1 carrier
sites with progression of the ischemic periods (Fig 3
). After 80 minutes of stop-flow ischemia,
the number of binding sites reached 160% of that of the control hearts
and was also elevated after 6 hours of low-flow ischemia
(all values, P<.005 versus control values). Addition of 20
nmol/L GBR-12909, a dopamine uptake inhibitor, to binding
assays did not affect the upregulation of [3H]mazindol
binding sites after 60 minutes of stop-flow ischemia. In
the presence of GBR-12909, uptake1 carrier site density was
210±12 fmol/mg in ischemic hearts and 128±10 fmol/mg in
normoxic hearts, whereas in the absence of GBR-12909, the density was
190±5 fmol/mg after stop-flow ischemia and 125±4 fmol/mg
in control hearts. This finding indicated that
norepinephrine uptake1 carriers are
specifically upregulated during cardiac ischemia. To study the
stability of uptake1 carrier upregulation over time, we
induced 40 minutes of stop-flow ischemia and thereafter
perfused the hearts at normal flow (Fig 4
). It turned
out that uptake1 carrier density remained elevated within
20 minutes of reperfusion and returned to baseline values after 40
minutes of reperfusion (Fig 4
). Thus, the period of carrier
upregulation was comparable to that after electrical field stimulation.
The respective carrier affinities (Kd) did not
vary significantly between the experimental groups (Table
).
|
|
[3H]Norepinephrine Uptake
The cardiac elimination of norepinephrine was
investigated by measuring the clearance of
[3H]norepinephrine, which was given as a
bolus during reperfusion. In the presence of 10 µmol/L
desipramine, virtually no cardiac uptake of
[3H]norepinephrine occurred (1.5±1% versus
30±4% in control hearts, Fig 5
).
|
Electrical field stimulation resulted in a significant increase
of [3H]norepinephrine clearance (to 41±4%,
Fig 5
). [3H]Norepinephrine clearance was
still elevated 20 minutes after the intervention (40±5%), and it
decreased to baseline values 40 minutes after the stimulation (31±7%,
Fig 5
), paralleling the normalized number of uptake1
carrier sites at that time (Fig 2
).
After 40 minutes of stop-flow ischemia, we found a biphasic
regulation of cardiac norepinephrine uptake during
reperfusion (Fig 6
). In the first minutes of
reperfusion, cardiac norepinephrine clearance was markedly
suppressed (to 5±2% versus 28±3% in control hearts, Fig 6
). After
10 minutes of reperfusion, the levels of norepinephrine
extraction were still below those of the controls (17±3%,
P<.05). After 20 minutes of reperfusion, however,
[3H]norepinephrine extraction significantly
exceeded that of the control hearts (39±5%, Fig 6
), at a time when
uptake1 carrier density was still elevated (Fig 4
).
Norepinephrine clearance reached baseline values after 40
minutes of reperfusion (to 29±5%), paralleling the normalization of
the carrier density at that time (Fig 4
).
|
Uptake1 Carrier mRNA
To determine the mRNA expression of the uptake1
carrier, a reverse transcription/polymerase chain reaction was carried
out, starting from rat and human heart and brain tissues. The mRNA for
GAPDH, a nonregulated housekeeping enzyme, was measured as a control.
Fig 7
shows that PCR products in expected sizes were
obtained from rat and human brain tissues amplified with the respective
primers, which obviously hybridized to both sequences. All PCR
products were obtained as single bands that could easily be
visualized in ethidium bromidecontaining agarose gels. The
products from human and rat brains were purified and
partially sequenced. They were identical to the expected sequences. In
contrast, no specific bands could be amplified from any human or rat
heart tissue (n=3 each), although the control message GAPDH was
present in all cDNAs (Fig 7
).
|
| Discussion |
|---|
|
|
|---|
Until now, it was not known whether changes in uptake1 carrier protein density or affinity during ischemia might contribute to the functional changes of norepinephrine release. The density and affinity of uptake1 carrier proteins can be investigated by studying the binding of tritiated antagonist radioligands to cardiac membranes. Using this assay, we identified a binding site in rat heart membranes to which both desipramine and mazindol bound saturably and with high affinity. Radioligand binding depended on the presence of sodium ions, and it was displaced specifically by uptake1 inhibitors. Previous work has shown that this binding site is directly related to the specific uptake of norepinephrine.13 This assumption was supported by our finding that a specific dopamine-uptake blocker did not affect [3H]mazindol binding to cardiac membranes.
So far, a regulation of the density of carrier proteins has been observed under only a few conditions. Chronic reserpine administration, leading to norepinephrine depletion, reduced the cortical density and transport capacity of uptake1 carrier proteins.5 18 Likewise, treatment with 6-hydroxydopa or clonidine, or surgical denervation, which all reduce norepinephrine release, downregulated uptake1 carrier binding sites in rat brain and heart.6 21 In contrast, chronic monoamine oxidase inhibition5 or administration of amphetamine6 increased the concentration of synaptic norepinephrine and upregulated uptake1 carrier density and transport capacity.
A downregulation of the density of cardiac uptake1 carrier proteins has been described in heart failure,22 23 and this action was accompanied by a decreased norepinephrine uptake, as assessed by in vitro tissue uptake of [3H]norepinephrine22 24 or as measured by the amount of cardiac extraction of norepinephrine.25 A reduced cardiac norepinephrine uptake activity in heart failure has also been documented scintigraphically in vivo.26 It has been assumed that this downregulation may partly explain the elevated synaptic concentrations of norepinephrine in cardiac failure.
We detected a significant upregulation of the density of uptake1 carrier proteins both after cardiac ischemia and after electrical stimulation, resulting in either exocytotic or nonexocytotic norepinephrine release. Our results on the regulation of cardiac uptake1 carrier proteins are in line with observations from other tissues which suggest that elevations of synaptic norepinephrine are accompanied by increased uptake1 carrier densities. For the first time, however, we documented that such a regulation occurred within a very short period of time (40 to 60 minutes) and that the upregulation was fully reversible during reperfusion, both after stop-flow ischemia and after electrical field stimulation.
Corresponding to the pronounced upregulation of uptake1 carrier protein density after electrical field stimulation, we found an increased transport capacity for norepinephrine. Norepinephrine clearance was due to true neuronal uptake1, as indicated by complete blockade of norepinephrine elimination by desipramine. The enhanced transport capacity persisted until 20 minutes after the intervention and declined after 40 minutes, parallel to the normalization of the density of uptake-carrier binding sites. After stop-flow ischemia, the transport capacity for norepinephrine showed fundamentally different characteristics. Initially, cardiac norepinephrine clearance was completely suppressed. In contrast, [3H]norepinephrine extraction significantly exceeded control levels after 20 minutes of reperfusion, when uptake1 carrier density was still increased. Norepinephrine clearance declined to baseline values after 40 minutes, paralleling the normalization of carrier density at that time. The initial suppression of norepinephrine uptake after ischemia can be attributed to the specific disturbance of carrier function in ischemia, because the norepinephrine carrier inverts its net transport direction from inside to outside the neuron, thereby precipitating nonexocytotic norepinephrine release during ischemia. Reversal of the normal transport direction of the carrier is the consequence of a reduced transmembranous sodium gradient in ischemia. Since the sodium gradient slowly recovers during reperfusion,27 it can be concluded that an increased carrier density enables enhanced norepinephrine clearance only in a brief time frame after ischemia.
It was not possible to assess the actual functional consequence of the increased carrier density during ischemia itself because of the inversion of the carrier's transport direction at that time. It seems plausible, however, that upregulation of the carrier also enhances the outward transport of norepinephrine during ischemia.
The question may be raised which mechanism underlies the upregulation of the norepinephrine carrier in ischemia. Both field stimulation and ischemia induced a significant release of norepinephrine and an upregulation of the cardiac density of uptake1 carrier proteins. Therefore, it is difficult to decide whether this upregulation in ischemia is primarily caused by ischemia itself or whether it is secondary to the increased synaptic concentration of norepinephrine. Generally, the mechanism by which transport proteins are regulated has not yet been clarified. For postsynaptic ß-adrenergic receptors, an upregulation during ischemia seems to be accompanied by an increased externalization of receptor proteins.7 The same might happen to carrier proteins during ischemia. It is well known that a rapid loss of energy-rich phosphates occurs in the isolated rat heart during early ischemia.28 29 Consequently, all cellular processes that depend on these phosphates are compromised in ischemia. Cellular mechanisms and enzymes that normally degrade carrier proteins might be hampered, resulting in a higher net surface density of these proteins. A recent publication suggests that the degree of phosphorylation of the norepinephrine transporter regulates its uptake capacity.30 Alternatively, an alteration of ion gradients across the presynaptic membrane might not only influence the transport direction of the carrier but also serve as a stimulus for an enhanced surface expression of carrier proteins.
To examine whether any de novo synthesis of carriers interferes with the observed regulation of their surface density, we also intended to clarify the possible contribution of translation to this process. However, we could not detect any specific mRNA for uptake1 carrier proteins in any of the human or rat hearts investigated. Therefore, we assume that all mRNAs for uptake1 carrier proteins are synthesized and translated in the neural cell soma, which is a considerable distance from the heart, ie, in the stellate ganglion, and that these proteins are then transported to the cardiac nerve ending via axonal transport. Given the short time course of uptake1 carrier protein upregulation during ischemia, it seems highly improbable that an mRNA regulation can be involved in this mechanism.
In conclusion, the overflow of norepinephrine in myocardial ischemia and exocytotic release of norepinephrine are accompanied by a transiently increased density and transport capacity of uptake1 carrier proteins. The mechanism of uptake1 regulation and its consequences for the disturbances of sympathetic neurotransmission in conjunction with and following ischemia remain to be determined.
| Acknowledgments |
|---|
Received October 23, 1995; accepted February 15, 1996.
| References |
|---|
|
|
|---|
2. Schömig A. Catecholamines in myocardial ischemia: systemic and cardiac release. Circulation. 1990;82(suppl II):II-13-II-22.
3.
Schömig A, Dart AM, Dietz R, Mayer E,
Kübler W. Release of endogenous
catecholamines in the ischemic
myocardium of the rat, part A: locally mediated
release. Circ Res. 1984;55:689-701.
4.
Schömig A, Kurz T, Richardt G, Schömig
E. Neuronal sodium homeostasis and axoplasmic amine
concentration determine calcium-independent
noradrenaline release in normoxic and ischemic rat
heart. Circ Res. 1988;63:214-226.
5.
Lee CM, Javitch JA, Snyder SH. Recognition
sites for norepinephrine uptake: regulation by
neurotransmitter. Science. 1983;220:626-629.
6. Swann AC, Duman R, Hewitt L. Desipramine binding: relationship to central and sympathetic noradrenergic activity. J Neurochem. 1985;44:611-615. [Medline] [Order article via Infotrieve]
7.
Maisel AS, Motulsky HJ, Insel PA.
Externalization of beta-adrenergic receptors promoted by myocardial
ischemia. Science. 1985;230:183-186.
8. Kurz T, Yamada KA, DaTorre SD, Corr PB. Alpha1-adrenergic system and arrhythmias in ischaemic heart disease. Eur Heart J. 1991;12(suppl F):88-98.
9. Langendorff O. Untersuchungen am überlebenden Säugethierherzen. Arch Ges Physiol. 1895;61:291-332.
10. Ungerer M, Stocker M, Richardt G. A1-adenosine receptors and muscarinic cholinoceptors in myocardial ischemia. Naunyn Schmiedebergs Arch Pharmacol. 1996;353:1-9.
11.
Seyfarth M, Feng Y, Hagl S, Sebening F, Richardt G,
Schömig A. Effect of myocardial ischemia on
stimulation-evoked noradrenaline release: modulated
neurotransmission in rat, guinea pig, and human cardiac tissue.
Circ Res. 1993;73:496-502.
12. Bradford MM. A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem. 1976;72:248-254. [Medline] [Order article via Infotrieve]
13. Javitch JA, Blaustein RO, Snyder SH. [3H]Mazindol binding associated with neuronal dopamine and norepinephrine uptake sites. Mol Pharmacol. 1984;26:35-44. [Abstract]
14. Pacholczyk T, Blakely RD, Amara SG. Expression cloning of a cocaine- and antidepressant-sensitive human noradrenaline transporter. Nature. 1991;350:350-354. [Medline] [Order article via Infotrieve]
15.
Shimada S, Kitayama S, Lin CL, Patel A, Nathakumar E,
Gregor P, Kuhar M, Uhl G. Cloning and expression of a
cocaine-sensitive dopamine transporter complementary DNA.
Science. 1991;254:576-578.
16. Lee CM, Javitch JA, Snyder SH. Characterization of [3H]desipramine binding associated with neuronal norepinephrine uptake sites in rat brain membranes. J Neurosci. 1982;2:1515-1525. [Abstract]
17. Chomczynski P, Sacchi N. Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem. 1987;162:156-159. [Medline] [Order article via Infotrieve]
18.
Ungerer M, Böhm M, Elce JS, Erdmann E, Lohse
MJ. Altered expression of ß-adrenergic receptor kinase and
ß1-adrenergic receptors in the failing human
heart. Circulation. 1993;87:454-463.
19.
Ramachandran B, Houben K, Rozenberg YY, Haigh JH,
Varpetian A, Howard BD. Differential expression of transporters
for norepinephrine and glutamate in wild type, variant, and
WNT-1expressing PC 12 cells. J Biol
Chem. 1993;268:23891-23897.
20. Richardt G, Lumpp U, Haass M, Schömig A. Propranolol inhibits nonexocytotic noradrenaline release in myocardial ischemia. Naunyn Schmiedebergs Arch Pharmacol. 1990;341:50-55. [Medline] [Order article via Infotrieve]
21. Raisman R, Sette M, Pimoule C, Briley M, Langer SZ. High-affinity [3H]desipramine binding in the peripheral and central nervous system: a specific site associated with the neuronal uptake of noradrenaline. Eur J Pharmacol. 1982;78:345-351. [Medline] [Order article via Infotrieve]
22. Liang CS, Fan THM, Sullebarger JT, Sakamoto S. Decreased adrenergic neuronal uptake activity in experimental right heart failure. J Clin Invest. 1989;84:1267-1275.
23. Böhm M, LaRosee K, Schwinger RHG, Erdmann E. Evidence for reduction of norepinephrine uptake sites in the failing human heart. J Am Coll Cardiol. 1995;25:146-153. [Abstract]
24. Beau SL, Saffitz JE. Transmural heterogeneity of norepinephrine uptake in failing human hearts. J Am Coll Cardiol. 1994;23:579-585. [Abstract]
25.
Rose CP, Burgess JH, Cousineau D.
Reduced aortocoronary sinus extraction of
epinephrine in patients with left ventricular
failure secondary to long-term chronic pressure or volume
overload. Circulation. 1983;68:241-244.
26. Merlet P, Dubois-Rande JL, Adnot S, Bourguignon MH, Benvenuti C, Loisance D, Valette H, Castaigne A, Syrota A. Myocardial ß-adrenergic desensitization and neuronal norepinephrine uptake function in idiopathic dilated cardiomyopathy. J Cardiovasc Pharmacol. 1992;19:10-16. [Medline] [Order article via Infotrieve]
27. Fiolet JWT, Baartscheer A, Schumacher CA, Coronel R, ter Welle HF. The change of free energy of ATP hydrolysis during global ischemia and anoxia in the rat heart: its possible role in the regulation of transsarcolemmal sodium and potassium gradients. J Mol Cell Cardiol. 1984;16:1023-1036. [Medline] [Order article via Infotrieve]
28. Neely JR, Rovetto MJ, Whitner JT, Morgan HE. Effects of ischemia on function and metabolism of the isolated working rat heart. Am J Physiol. 1973;225:651-658.
29. Richardt G, Blessing R, Schömig A. Cardiac noradrenaline release accelerates adenosine formation in the ischemic rat heart: role of neuronal noradrenaline carrier and adrenergic receptors. J Mol Cell Cardiol. 1994;26:1321-1328. [Medline] [Order article via Infotrieve]
30. Bönisch H, Lingen B, Brüss M, Presek P. Activation of protein kinase C causes downregulation of the activity of the neuronal noradrenaline transporter. Naunyn Schmiedebergs Arch Pharmacol. 1995;334:R136. Abstract.
This article has been cited by other articles:
![]() |
K. Leineweber, I. Heinroth-Hoffmann, K. Ponicke, G. Abraham, B. Osten, and O.-E. Brodde Cardiac {beta}-Adrenoceptor Desensitization Due to Increased {beta}-Adrenoceptor Kinase Activity in Chronic Uremia J. Am. Soc. Nephrol., January 1, 2002; 13(1): 117 - 124. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Bohm, M. Castellano, M. Flesch, C. Maack, M. Moll, M. Paul, F. Schiffer, and O. Zolk Chamber-Specific Alterations of Norepinephrine Uptake Sites in Cardiac Hypertrophy Hypertension, November 1, 1998; 32(5): 831 - 837. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Ungerer, F. Hartmann, M. Karoglan, A. Chlistalla, S. Ziegler, G. Richardt, M. Overbeck, H. Meisner, A. Schomig, and M. Schwaiger Regional In Vivo and In Vitro Characterization of Autonomic Innervation in Cardiomyopathic Human Heart Circulation, January 20, 1998; 97(2): 174 - 180. [Abstract] [Full Text] [PDF] |
||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Circulation Research Home | Subscriptions | Archives | Feedback | Authors | Help | AHA Journals Home | Search Copyright © 1996 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. |