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-Adrenergic Responses and Troponin I Phosphorylation: Anesthesia Interactions
1 Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA, USA; Department of Cardiology, Freeman Hospital, Newcastle, United Kingdom; Clinical Medical Sciences, University of Newcastle upon Tyne, Newcastle, United Kingdom
2 Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA, USA
3 Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
* To whom correspondence should be addressed. E-mail: guy.macgowan{at}nuth.nhs.uk.
The mechanisms by which
-adrenergic stimulation of the heart in-vivo can cause contractile dysfunction are not well understood. We hypothesized that
-adrenergic mediated contractile dysfunction is mediated through protein kinase C phosphorylation of troponin I, which in in-vitro experiments has been shown to reduce actomyosin MgATPase activity. We studied pressure-volume loops in transgenic mice expressing mutant troponin I lacking protein kinase C phosphorylation sites, and hypothesized altered responses to phenylephrine. As anesthesia agents can produce markedly different effects on contractility, we studied 2 agents: avertin and
-chloralose-urethane. With
-chloralose-urethane, at baseline, there were no contractile abnormalities in the troponin I mutants. Phenylephrine produced a 50% reduction in end-systolic elastance in wild type controls, though a 9% increase in troponin I mutants (P<0.05). Avertin was associated with reduced contractility compared to
-chloralose-urethane. Avertin anesthesia, at baseline, produced a reduction in end-systolic elastance by 31% in the troponin I mutants compared to wild type (P<0.05), and this resulted in further marked systolic and diastolic dysfunction with phenylephrine in the troponin I mutants. Dobutamine produced no significant difference in the contractile phenotype of the transgenic mice with either anesthetic regimen. In conclusion, these data (
-chloralose-urethane) demonstrate that
-adrenergic mediated force reduction is mediated through troponin I protein kinase C phosphorylation.
-Adrenergic responses are not mediated through this pathway. Altering the myofilament force-calcium relationship may result in in-vivo increased sensitivity to negative inotropy. Thus, choice of a negative inotropic anesthetic agent (avertin) with phenylephrine can lead to profound contractile dysfunction.
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