Search PubMed⌕ Search

Biomedical subjects

J Puel

Publications and source records attributed to J Puel.

At least 109 records · Page 6Linked to original sources
PubMed1996

Multicenter evaluating of a commercially available PCR assay for diagnosing enterovirus infection in a panel of cerebrospinal fluid specimens.

Thirteen laboratories participated in blind tests of a panel of 20 coded cerebrospinal fluid specimens (7 uninfected samples, 3 samples infected with 1 50% tissue culture infective dose [TCID50]/0.1 ml [nonenterovirus strains], and 10 samples infected with 10, 1, or 0.1 TCID50/0.1 ml [three different enterovirus serotypes]) on the Amplicor enterovirus PCR assay (Roche Diagnostic Systems). The panel was also evaluated by in-house PCR (two nested-PCR and three one-step PCR assay) or tissue culture (eight laboratories). The viral load was shown to influence greatly the sensitivity of the assay. The average sensitivity of the Amplicor test ranged from 67 to 98% for viral titers of 1 to 10 TCID50/0.1 ml, respectively; titers of 0.1 TCID50/0.1 ml resulted in a sensitivity of only 16%. The overall specificity of the Amplicor test was 98%. The Amplicor assay compared favorably to the five in-house PCR tests (no significant difference in either sensitivity or specificity) and was much more sensitive than tissue culture (P < 0.001), even for high viral loads. It was easy to perform, rapid (about 6 h), well-standardized, and appeared to be suitable for the diagnosis of enterovirus meningitis on a routine basis in laboratories trained in molecular biology techniques.

Base Sequence↗
PubMed1996

Ligands of the antiestrogen-binding site are able to inhibit virion production of human immunodeficiency virus 1-infected lymphocytes.

Since the discovery of human immunodeficiency retrovirus, the drug arsenal against retrovirus has rapidly increased. Concomitantly, new challenges in the therapy of acquired immune deficiency syndrome have arisen, including drug toxicities, drug resistance, and the development of various cancers as effective therapies prolong survival. Tamoxifen, a nonsteroidal antiestrogen with a low incidence of side effects, is widely used in cancer therapy; it is known to exert pleiotropic activities by binding essentially to the estrogen receptor and other unidentified proteins. In the present work, quantification of the p24 core protein of human immunodeficiency virus 1 produced by infected lymphocytes shows an inhibitory effect of tamoxifen on virion production. Moreover, we assume that this effect is not mediated by the estrogen receptor because antiestrogen ligands interacting with the antiestrogen-binding site exhibit efficacy related to their affinity for this site, although specific antiestrogens of the estrogen receptor are ineffective.

Antiviral Agents↗
PubMed1996

[Prophylactic cesarean section and HIV seropositive patients].

OBJECTIVES: HIV infection among children is essentially related to perinatal transmission. It seems the contamination occurs late in the pregnancy or during the labor. The benefits of cesarean section in HIV-infected women has to be examined. STUDY DESIGN: A retrospective survey of all deliveries of 292 HIV-infected women, of the newborns and of the impact of different ways of delivery on transmission risks. 164 women had a pregnancy lasting more than 28 weeks, 27 underwent a cesarean section. RESULTS: 22.2% of patients who underwent a cesarean section contaminated their child, 25.2% among vaginal deliveries. No significant association was found between HIV transmission and delivery mode. CONCLUSION: We outline the necessary elements for the conduct of a conclusive efficacy trial of operative versus vaginal delivery.

Cesarean Section↗
PubMed1996

[Value of the study of latent atrial vulnerability in unexplained ischemic cerebrovascular accident of young subjects].

This study searched for abnormalities of the atrial electrophysiological substrate in young subjects with unexplained ischaemic cerebrovascular accidents. Thirty-seven patients (18 to 45 years) underwent programmed atrial stimulation at 2 sites in the right atrium after an unexplained ischaemic cerebrovascular accident. Seventeen of them underwent repeat study at 6 months. The following parameters were analysed: indices of atrioventricular conduction and sinus node automaticity; indices related to atrial hyperexcitability: effective refractory period; adaptation of the refractory periods to heart rate, intraatrial conduction and the index of latent vulnerability; the inducibility test by the extrastimulus technique. The following results were obtained: 54% of patients had an inducible atrial arrhythmia; the effective refractory periods and index of latent vulnerability were lower (204 +/- 21 ms and 2.25 +/- 0.7) in the inducible patients than in the non-inducible patients (232 +/- 28 ms and 3.4 +/- 1.1) (p < 0.001 and p < 0.002 respectively); 76% of patients had latent atrial vulnerability indicating and underlying arrhythmogenic substrate; this substrate was still present 6 months later in 80% of these cases; in patients with an abnormality of the interatrial septum, there was an abnormality of the electrophysiological investigation in 85% of cases compared with 65% in those with normal transoesophageal echocardiography. These results confirm the presence of an arrhythmogenic substrate similar to that of patients with paroxysmal atrial fibrillation in over two thirds of cases. Programmed atrial stimulation is a reproducible technique. The relationship between latent atrial vulnerability and abnormalities of the interatrial septum requires confirmation in a series with a larger numbers of patients.

Adolescent↗
PubMed1995

Meta-analysis of randomised trials comparing coronary angioplasty with bypass surgery.

A patient with severe angina will often be eligible for either angioplasty (PTCA) or bypass surgery (CABG). Results from eight published randomised trials have been combined in a collaborative meta-analysis of 3371 patients (1661 CABG, 1710 PTCA) with a mean follow-up of 2.7 years. The total deaths in the CABG and PTCA groups were 73 and 79, respectively, with a relative risk (RR) of 1.08 (95% CI 0.79-1.50). The combined endpoint of cardiac death and non-fatal myocardial infarction occurred in 169 PTCA patients and 154 CABG patients (RR 1.10 [0.89-1.37]). Amongst patients randomised to PTCA 17.8% required additional CABG within a year, while in subsequent years the need for additional CABG was around 2% per annum. The rate of additional non-randomised interventions (PTCA and/or CABG) in the first year of follow-up was 33.7% and 3.3% in patients randomised to PTCA and CABG, respectively. The prevalence of angina after one year was considerably higher in the PTCA group (RR 1.56 [1.30-1.88]) but at 3 years this difference had attenuated (RR 1.22 [0.99-1.54]). Overall there was substantial similarity in outcome across the trials. Separate analyses for the 732 single-vessel and 2639 multivessel disease patients were largely compatible, though the rates of mortality, additional intervention, and prevalent angina were slightly lower in single vessel disease. The combined evidence comparing PTCA with CABG shows no difference in prognosis between these two initial revascularisation strategies. However, the treatments differ markedly in the subsequent requirement for additional revascularisation procedures and in the relief of angina. These results will influence the choice of revascularisation procedure in future patients with angina.

Angina Pectoris↗
PubMed1995

Study of LDL and acetylated LDL endocytosis by mononuclear cells in HIV infection.

Activated lymphocytes have a high level of low density lipoprotein (LDL) uptake as compared to resting lymphocytes, whereas scavenger receptors for acetylated LDL (Ac-LDL) are expressed on limited number of immune cells, i.e., monocytes/macrophages. The endocytosis of LDL and Ac-LDL by mononuclear cells was studied during in vitro and in vivo HIV infection, in order to use LDL and Ac-LDL as carriers of antiviral and/or immunomodulatory drugs towards lymphocytes and monocytes. The uptake of LDL and Ac-LDL was analyzed by cytofluorimetry. LDL endocytosis in PHA/IL2-activated lymphocytes was higher than in resting lymphocytes. In vitro HIV infection of PHA/IL2-activated lymphocytes did not alter the high LDL endocytosis in lymphocytes. CD4+ and CD8+ cells. In a group of 12 symptomatic patients there was no alteration of LDL endocytosis in lymphocytes, CD4 and CD8 lymphocytes. In another group of 23 individuals, the Ac-LDL endocytosis mediated by CD14+ monocytes was unaltered in asymptomatic patients (n = 6) and in some symptomatic patients (n = 6, CD14+ cells > 100/mm3). On the contrary, in other symptomatic patients (n = 11, CD14+ cells < 100/mm3), the number of Ac-LDL+ CD14+ cells decreased, whereas their efficiency of Ac-LDL endocytosis increased as compared to those of other HIV+ patients. In conclusion, the use of lipoproteins as carriers to increase the drug delivery to CD4+ lymphocytes and to CD14+ monocytes can be envisaged, since: (i) the LDL endocytosis was not impaired in CD4 lymphocytes of HIV+ patients, and (ii) the Ac-LDL uptake by monocytes was altered only in some patients of stage IV.

Antigens, CD↗
PubMed1995

Treatment of chronic hepatitis C with recombinant interferon alpha in kidney transplant recipients.

Chronic hepatitis C is a common cause of viral liver disease in kidney transplant (KT) recipients. To assess the efficacy and safety of therapy with interferon alpha we conducted a prospective study where 14 cadaveric KT recipients with chronic hepatitis C received recombinant interferon alpha-2b (IFNa) 3 million units three times weekly (scheduled) for 6 months (group A). 14 KT recipients with chronic hepatitis C were not treated and served as controls for the study period (group B). All the patients in both groups had had stable renal function for at least one year. All patients in both groups had a positive HCV viremia at the beginning of the study. Patients of group A were treated for 142 +/- 34.8 days (range 65-168); elevated serum aminotransferase (ALT) levels decreased rapidly and significantly from 100.3 +/- 48.9 to 37.7 +/- 13.9 IU/L (P = 0.001); 10 patients (77%) were "responders," whereas the others experienced a decrease in ALT values but without reaching the normal ranges. With a mean follow-up of twelve months after discontinuation of IFNa therapy, 8 responders--i.e., 80%--relapsed within 1-20 weeks. Only 4 patients had no detectable HCV viremia at the end of the IFNa; two of them already have abnormal values of ALT. Moreover HCV viremia was present in all patients one month after the cessation of IFNa treatment. Side effects of IFNa (fatigue, anorexia, weight loss) were frequent, and 3 patients decided to drop out of the treatment. The hematological tolerance was good although there was a significant decrease in hemoglobin (11.9 +/- 1.7 vs. 13.4 +/- 1.7 g/dl; P = 0.0044). In group B, serum ALT levels did not significantly decrease (84.2 +/- 47.6 vs. 105.2 +/- 68.8 IU/L). At the end of the study period serum ALT levels were significantly lower in group A than in group B (37.7 +/- 13.9 vs. 84.2 +/- 47.6 IU/L, P = 0.013). The major concern in group A was the occurrence of 5 renal failures. Kidney transplant biopsies showed edema, no significant tubulitis, scarcely scattered interstitial inflammatory cellular infiltration, and mesangial thickening. Four patients received methylprednisolone pulses but renal function improved in only two cases. We were not able to discover predictive factors of renal failure. We conclude that IFNa therapy is effective in controlling disease activity--i.e., reducing amino-transferase levels in KT patients with chronic hepatitis C, although relapse and detection of HCV RNA after the cessation of treatment were observed, respectively, in 80% and 100% of patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1995

Myocardial protection with calcium-channel blockers during ischaemia and reperfusion by PTCA.

The effects of calcium channel blockers on acute myocardial ischaemia have been evaluated over the past two decades. A number of experimental studies have demonstrated that calcium antagonists protect the myocardium when administered before or during PTCA. Intracoronary verapamil prior to the second inflation attenuates the severity of ischaemic ST-segment changes and anginal pain. Heart rate and blood pressure are not influenced by verapamil or placebo. Similarly, there are multiple clinical and biological data suggesting that intracoronary nifedipine, diltiazem or bepridil, and intracoronary or intravenous nicardipine might result in a reduced incidence of myocardial ischaemia during PTCA. The beneficial effect of these drugs can be explained by a direct cardioprotective effect or by an enhanced collateral flow and haemodynamic improvement. During early reperfusion in acute myocardial infarction (AMI) administration of calcium channel blockers or agents that inhibit calcium release from the sarcoplasmic reticulum can protect hearts from stunning and can decrease the no-reflow phenomenon. The most recent explanation relates this observation to decreased sensitivity of the myofibrils to calcium. Further clinical and experimental studies are necessary to clarify the protective role in reperfusion injury. To summarize, therefore, administration of calcium channel blockers can decrease ischaemia during elective PTCA and can reduce reperfusion injury during early PTCA in AMI.

Angioplasty, Balloon, Coronary↗
PubMed1995

Preliminary results of treatment of chronic hepatitis C with recombinant interferon alpha in renal transplant patients.

Chronic hepatitis C is a common cause of viral liver disease in kidney transplant recipients. To assess the efficacy and the safety of therapy with interferon alpha (IFN alpha) in such a population we conducted a prospective study where 16 kidney transplant recipients with chronic hepatitis C received recombinant IFN alpha 3 million units three times weekly scheduled for 24 consecutive weeks. All the patients had stable renal function for at least 1 year (mean serum creatinine 125.4 +/- 41 mumol/l). Fifteen patients had a positive HCV viraemia at the beginning of the study. In 15 patients serum alanine aminotransferase (ALT) levels decreased rapidly and normalized (48 +/- 44 vs 98.5 +/- 46 IU/l; P = 0.0044). ALT remained in the normal range as long as IFN alpha was continued. Serum levels of gamma glutamyl transpeptidase decreased from 129.75 +/- 111.2 to 88 +/- 85 IU/l; P = 0.012). After discontinuation of IFN alpha therapy seven responders relapsed within 1-9 weeks. HCV viraemia assessed 1 month after the end of IFN alpha therapy remained positive in all the patients who scored positive at the beginning, i.e. 15. Side effects of IFN alpha (fatigue, anorexia, weight loss) were frequent leading to four patients dropping out of the study. The haematological tolerance was moderate. The major concern was the increase in serum creatinine (162.5 +/- 57.6 vs 125.4 +/- 41 mumol/l; P < 0.05). In fact only six patients experienced renal failure occurring 45-168 days after the beginning of IFN alpha. Kidney transplant biopsies showed oedema, scarce scattered interstitial inflammatory cellular infiltration and moderate mesangial hypertrophy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Analysis of envelope sequence variants suggests multiple mechanisms of mother-to-child transmission of human immunodeficiency virus type 1.

In order to elucidate the molecular mechanisms involved in human immunodeficiency virus type 1 (HIV-1) mother-to-child transmission, we have analyzed the genetic variation within the V3 hypervariable domain and flanking regions of the HIV-1 envelope gene in four mother-child transmission pairs. Phylogenetic analysis and amino acid sequence comparison were performed on cell-associated viral sequences derived from maternal samples collected at different time points during pregnancy, after delivery, and from child samples collected from the time of birth until the child was approximately 1 year of age. Heterogeneous sequence populations were observed to be present in all maternal samples collected during pregnancy and postdelivery. In three newborns, viral sequence populations obtained within 2 weeks after birth revealed a high level of V3 sequence variability. In contrast, V3 sequences obtained from the fourth child (diagnosed at the age of 1 month) displayed a more restricted heterogeneity. The phylogenetic analysis performed for each mother-child sequence set suggested that several mechanisms may potentially be involved in HIV-1 vertical transmission. For one pair, child sequences were homogeneous and clustered in a single branch within the phylogenetic tree, consistent with selective transmission of a single maternal variant. For the other three pairs, the child sequences were more heterogeneous and clustered in several separate branches within the tree. In these cases, it appeared likely that more than one maternal variant was responsible for infection of the child. In conclusion, no single mechanism can account for mother-to-child HIV-1 transmission; both the selective transmission of a single maternal variant and multiple transmission events may occur.

Adult↗
PubMed1995

[Myocardial infarction in non-menopausal women. Coronary lesions and prognosis].

Between 1977 and 1990, 64 premenopausal women, under 50 years of age (42 +/- 5.6 years), were admitted for typical acute myocardial infarction with pathological Q waves. Twenty one patients had attempted myocardial revascularisation either by intravenous thrombolysis or primary angioplasty (n = 3). All patients underwent coronary angiography with selective left ventriculography during their hospital admission. This group of 64 women was characterised by the association of coronary risk factors (2.8 per patient): smoking (89%), hyperlipidaemia (67%), diabetes (45%) and oral contraception (35%). Coronary angiography showed single vessel occlusion in 86% of patients receiving oral contraception, multiple vessel disease in 36.5% and single or double vessel disease in 31.7% of the other patients. There were 3 deaths during the hospital period (4.6%), 12 cases of left ventricular failure, 2 ventricular aneurysms, 2 operated ischaemic mitral regurgitations and 9 recurrences of pain treated by angioplasty. During follow-up (36.5 +/- 4 months), 22 patients were readmitted to hospital and there were 3 further deaths, 12 cases of persistent cardiac failure, 10 cases of latent ventricular dysfunction and 9 ischaemic reoccurrences treated by angioplasty or surgery. The results in this group of patients suffering from myocardial infarction at an unusually early age for women showed that although the mortality was similar to that observed in men of the same age (9%) there was a very high morbidity and a high risk of cardiac failure. The prognosis of myocardial infarction in women, though better than 10 years ago, should improve with immediate revascularisation, the correction of cardiovascular risk factors and the rapid application of all techniques of modern cardiology.

Adult↗
PubMed1995

[Coronary artery disease in octogenarians: contribution of coronary angiography and evaluation of therapeutic possibilities].

An increasing number of octogenarians is being referred for coronary angiography with a view to myocardial revascularisation. Based on a retrospective study of 168 octogenarians undergoing coronary angiography between January 1987 and December 1992, the authors reviewed the indications, the risks and therapeutic decisions taken in those patients with significant coronary artery disease. The population studied had acute myocardial ischaemia in 88.7% of cases, a low incidence of previous myocardial infarction and severe extracardiac pathology. Significant coronary lesions were observed in 90% of patients (151) with multiple vessel diseases in 57.8% of cases. The mortality attributed to coronary angioplasty was 0.59% (1 case) and the morbidity was 4.7%. The number of disease vessels did not influence the decision as 75.5% of single vessel, 75% of double vessel and 77.3% of triple vessel disease patients were referred for coronary surgery or angioplasty. Of the patients undergoing a revascularisation procedure (n = 108), those referred for surgery (n = 22) had more severe coronary disease than those referred for angioplasty (p < 0.05). The hospital mortality was high about 8%, irrespective of the therapeutic decision. The 3 year actuarial survival was 70% in the group undergoing myocardial revascularisation (whether by angioplasty or coronary surgery) and 53.6% in subjects treated medically. These results show that coronary angiography in a selected elderly population is possible although the mortality and morbidity should not be underestimated. A high proportion of these patients (72%) is referred for myocardial revascularisation.

Aged↗
PubMed1995

[Atrial insertion of accessory pathways in permanent reciprocating junctional tachycardia].

Permanent reciprocating junctional tachycardia (PRJT) is an uncommon type of Tachycardia, usually associated with a retrogradely conducting accessory pathway situated near to the ostium of the coronary sinus. This study reports the localisation of the site of atrial insertion of the accessory pathway, confirmed by the efficacy of intracardiac catheter ablation. Five patients (4 men), aged 14 to 45, experienced PRTJT at rates of 120 to 150/mn over a period of 2 to 15 years. 4 patients were normal, expected in 2 patients in whom they were 16 and 20%. One of these suffered a thromboembolic complication after pharmacological interruption of the tachycardia. The presence of an accessory pathway with decremential retrograde conduction was confirmed in all cases. Catheter ablation was successful in the medio-septal (2 cases), posteroseptal (1 case), lateral (1 case) and anteroseptal (1 case) regions. Six to 30 applications of 20 to 30 watts of radiofrequency energy were used in the 5 cases. In one case (right lateral accessory pathway), a fulguration procedure was necessary with a cathodic shock of 160 Joules. The AV conduction was preserved and retrograde conduction was normalised in all cases. All patients remained asymptomatic for a period of 10 to 43 months without antiarrhythmic therapy. The ejection fractions of the two patients with left ventricular dysfunction returned to normal. The authors conclude that the accessory pathways of PRJT may be situated in different regions of the right atrium. The efficacy of catheter ablation was 100 % in this form of tachycardia.

Adolescent↗
PubMed1994

[Prognosis of silent myocardial ischemia].

Asymptomatic or silent myocardial ischemia (SI) is frequent in coronary heart disease and its prognostic value is controversial. The aim of our study is to compare coronary atherosclerosis, left ventricular function and clinical out come of 110 patients with S.I. (A group) and 210 patients with stable angina (B group). The 320 patients were submitted: to symptom limited exercise stress-test with permanent electrocardiographic control by a Case 12-15 digitalized system with ST segment depression interpretation. A test was considered positive for ischemia if there was ST depression of > 1 mv in magnitude from baseline, persisting for 0.08 sec or exercise angina and ischemia: to selective coronarography by Seldinger technic, with left ventricular cineangiography in 2 incidences. A significant coronary stenosis was defined as > 50% reduction of luminal diameter; to medical treatment with betablockers (87.5% of patients), calcium inhibitors (12.5%), aspirin (90%) and nitrates; to regular medical surveillance. During the follow-up (42.4 +/- 5 months in mean) the number of deaths, myocardial infarctions, heart failure, unstable angina and revascularizations were analyzed. Patients of A group with S.I. had a high percentage of risks factors (diabetes mellitus 55%, nicotinism 85%, dyslipidemia 22.5%) and history of previous myocardial infarction in 33% of cases. There are not significant differences between severity and extension of coronary disease, or ventricular dysfunction in patients of A group or B. The percentages of deaths (2.10 versus 3%), acute myocardial infarctions (9.5 versus 8.5%), heart failures (2.72 versus 3%), surgical indications (14.7 versus 15.7%) are not significantly different between the 2 groups. In A group, 34% of patients were treated by angioplasty versus 40% of patients in group B (p < 0.02). S.I. has a bad prognostic and the clinical out come of coronary heart disease is not dependent of presence of angina during exercise testing and daily activities.

Aged↗
PubMed1994

[Electrocardiographic evaluation of anti-ischemic effect of verapamil during angioplasty].

The anti-ischemic and cardioprotective effects of various angina drugs have been evaluated during angioplasty. This special situation of transitory regional ischemia was used to test verapami given by intra-coronary injection in 15 patients undergoing balloon dilatation of the left anterior descending artery, suffering from stable angina and with normal left ventricular kinetics. Each patient serving as his own control, parameters indicating oxygen consumption and clinical and electrocardiographic (ST segment changes) markers were measured during two successive inflations. Continuous monitoring of comparative variations between a first inflation without treatment and a second inflation after intra-coronary administration of 1 mg of verapamil revealed, following 60 seconds of ischemia, the absence of any change in heart rate, a moderate fall in mean blood pressure (101.7 as against 96.8 mmHg, p = 0.033) and a notable 60% reduction in the amplitude of maximal ST depression (5.07 +/- 3.08 mm as against 2.07 +/- 1.44 mm, p = 0.0002). These results confirm the anti-ischemic properties of verapamil, the action of which is based upon an indirect peripheral vasodilator model but also on a probable direct cardioprotective effect on anoxic myocardial regions.

Adult↗
PubMed1993

Experimental study of transplacental passage of alpha interferon by two assay techniques.

Two methods of assaying alpha interferon (IFN-alpha) were compared during an experiment aimed at determining whether IFN-alpha crosses the human placenta. Human placentas, collected after delivery following a normal pregnancy to term, were catheterized on both sides: fetal and maternal. The IFN-alpha was introduced in known amounts in the maternal circulation and was assayed in the efferent fetal fluid. The following two detection methods were used: radioimmunoassay by competition with [125I]IFN-alpha and assay with a biological system in which IFN-alpha protected Madin-Darby bovine kidney cells from destruction by vesicular stomatitis virus. The results obtained by the two methods were in perfect agreement for the efferent fetal fluid samples. They showed the absence of placental transfer of IFN-alpha. The biological method was found to be more sensitive than radioimmunoassay for low IFN-alpha titers (< 10 IU/ml) but was less reproducible, probably owing to the use of twofold dilutions. The specificities of the two methods were similar and their practicalities were equivalent; the biological method, however, was less costly. The study illustrates the complementarity of the two methods, which were based on different principles. The agreement obtained between the two methods provides a clear confirmation of the experimental results.

Adult↗
PubMed1993

[Beta-adrenergic receptivity and left ventricular hypertrophy caused by pressure overload in man].

The effect of left ventricular chronic pressure overload on right atrial (RA) and left ventricular (LV) myocardial beta-adrenoceptor (beta-AR) density and subtypes ([I125] cyanopindolol binding), adenylate cyclase activity (AC) and ADP-pertussis toxin ribosylated proteins was investigated in 13 patients with aortic stenosis (AO) and compared with the results obtained in 10 patients with mitral stenosis (MI) taken as controls. None of the patients included had any impairement of systolic function or increased plasma catecholamine levels. The total number of beta-AR in RA (62 +/- 6 vs 77 +/- 12 fmoles/mg prot) and LV (39 +/- 7 vs 32 +/- 2 fmoles/mg prot) was similar in AO and in MI. The percentage of beta 1-AR was significantly lower in LV from AO (35 +/- 11 vs 73 +/- 5% in MI) but identical in RA (79 +/- 5 vs 73 +/- 8%). The basal activity of AC was similar in membranes from patients with AO (19 +/- 4 and 22 +/- 5 pmol.mg-1 prot in RA and LV) and in controls (21 +/- 6 and 27 +/- 3 pmol.mg-1 prot in RA and LV). Isoprenaline-induced stimulation of AC was significantly lower in LV membranes from patients with AO (7 +/- 6 vs 45 +/- 6% in MI) but remained identical in RA membranes (51 +/- 18 vs 36 +/- 18% in MI). The quantification of ADP-pertussis toxin ribosylated proteins indicated a lower substrate concentration in myocardial membranes from patients with AO when compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenylyl Cyclases↗