a- and b-Adrenergic Pathways Differentially Regulate Cell Type–Specific Apoptosis in Rat Cardiac Myocytes

Background—The apoptosis of cardiac myocytes may play a role in the development of heart failure. Norepinephrine is one of the factors activated in heart failure and can induce myocardial cell apoptosis in culture. However, it is unknown if aand b-adrenergic pathways coordinately or differentially regulate apoptosis and if this apoptotic pathway uses common or cell type–specific apoptotic signals. Methods and Results—We stimulated cultured neonatal rat cardiac myocytes with an a1-adrenergic agonist (PE, phenylephrine), a b-adrenergic agonist (isoproterenol [Iso]) or a membrane-permeable cAMP analogue (8-Br-cAMP) in serum-free conditions for 48 hours. Iso and 8-Br-cAMP markedly increased the number of TUNEL-positive cells (%TUNEL-positive nuclei .40%) compared with saline stimulation (,10%). DNA fragmentation was also confirmed by ladder formation in agarose gels. Apoptotic myocytes were characterized by cell shrinkage and nuclear condensation, consistent with morphological features of apoptosis. The Iso-induced apoptosis was almost completely inhibited by the protein kinase A–specific inhibitor KT5720. In contrast, PE inhibited 8-Br-cAMP–induced myocardial cell apoptosis. The apoptosis-inhibitory effect by PE was negated by the a1-adrenergic receptor antagonist prazosin and the MEK-1–specific inhibitor PD098059. Interestingly, although 8-Br-cAMP markedly induced apoptosis in cardiac myocytes, it completely blocked serum depletion–induced apoptosis in PC12 cells, a rat pheochromocytoma cell line. Conclusions—These findings indicate that aand b-adrenergic pathways differentially regulate myocardial cell apoptosis. The results also suggest that a cAMP– protein kinase A pathway is necessary and sufficient for b-adrenergic agonist–induced apoptosis and that this apoptotic pathway is not functional in other cell types, for example, PC12 cells. (Circulation. 1999;100:305-311.)