Dg. Ririe et al., TRIIODOTHYRONINE INCREASES CONTRACTILITY INDEPENDENT OF BETA-ADRENERGIC RECEPTORS OR STIMULATION OF CYCLIC-3',5'-ADRENOSINE MONOPHOSPHATE, Anesthesiology, 82(4), 1995, pp. 1004-1012
Background: Triiodothyronine regulates cardiac contractility; however,
the mechanisms by which it produces its acute contractile effects rem
ains unknown. We compared the acute effects of thyroid hormones (triio
dothyronine [T-3] and thyroxine [T-4]) and of isoproterenol on the con
tractility of isolated rat hearts. In addition, we sought to determine
whether the acute inotropic effects of thyroid hormones were mediated
by beta-adrenergic receptors or by increased production of cyclic 3',
5'-adenosine monophosphate (cAMP). Methods: A Langendorff heart prepar
ation harvested from euthyroid male Sprague-Dawley rats was used. Drug
s were administered through an aortic perfusion catheter. A pressure t
ransduced left-ventricular balloon catheter measured pressure and hear
t rate changes. Changes in the maximum positive rate of change in pres
sure (dP/dT) and maximum negative dP/dT were determined. Responses to
varying doses of T-3, T-4, and isoproterenol were assessed in the pres
ence and absence of beta-adrenergic receptor blockade with propranolol
. cAMP production, measured by radioimmunoassay, was determined in myo
cardial cell suspensions after incubation with T-3 or isoproterenol. R
esults: T-3 0.74 nmol rapidly and significantly increased maximum dP/d
T by 335 +/- 38 mmHg/s within 30 s after bolus injection; however, con
tractility was unchanged after as much as 12.9 nmol T-4. The maximal i
ncrease in dP/dT after 0.8 nmol isoproterenol was comparable to that p
roduced by T-3. However, the cardiotonic actions of isoproterenol were
significantly slower to develop (peaking at 60 vs. 15 s) and lasted l
onger than those of T-3. Pretreatment with propranolol 1 mu mol dimini
shed the contractile effects of isoproterenol but had no effect on tho
se of T-3. Concentrations of isoproterenol that increase contractility
also significantly increased cAMP production in isolated rat myocardi
al cells. However, T-3 failed to increase cAMP production. Conclusions
: These results demonstrate that the acute inotropic effects of T-3 ar
e not shared by T-4 and appear unrelated to beta-adrenergic receptor m
echanisms or to generation of cAMP. Thus, T-3 acutely stimulates cardi
ac contraction by mechanisms that differ from those of the more common
ly used beta-adrenergic receptor agonists and phosphodiesterase inhibi
tors. Further studies are needed to identify the mechanisms underlying
the acute contractile effects of T-3 and to determine whether T-3 wil
l prove useful for increasing ventricular function in patients.