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Circulation. 1999;100:2210-2212

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(Circulation. 1999;100:2210.)
© 1999 American Heart Association, Inc.


Brief Rapid Communications

Opposing Effects of ß1- and ß2-Adrenergic Receptors on Cardiac Myocyte Apoptosis

Role of a Pertussis Toxin–Sensitive G Protein

Catherine Communal, PhD; Krishna Singh, PhD; Douglas B. Sawyer, MD, PhD; Wilson S. Colucci, MD

From the Myocardial Biology Unit and Cardiovascular Division, Boston University Medical Center, Boston Veterans Affairs Medical Center and Boston University School of Medicine, Boston, Mass.

Correspondence to Wilson S. Colucci, MD, Boston University Medical Center, 88 E Newton St, Boston, MA 02118. E-mail wilson.colucci{at}bmc.org


*    Abstract
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Background—ß-Adrenergic receptor (ß-AR) stimulation increases apoptosis in adult rat cardiac (ventricular) myocytes (ARVMs) via activation of adenylyl cyclase. ß2-ARs may couple to a Gi-mediated signaling pathway that can oppose the actions of adenylyl cyclase.

Methods and Results—In ARVMs, ß-AR stimulation for 24 hours increased the number of apoptotic cells as measured by flow cytometry. ß-AR–stimulated apoptosis was abolished by the ß1-AR–selective antagonist CGP 20712A (P<0.05 versus ß-AR stimulation alone) but was potentiated by the ß2-AR–selective antagonist ICI 118,551 (P<0.05 versus ß-AR stimulation alone). The muscarinic agonist carbachol also prevented ß-AR–stimulated apoptosis (P<0.05 versus ß-AR stimulation alone), whereas pertussis toxin potentiated the apoptotic action of ß-AR stimulation (P<0.05 versus ß-AR stimulation alone) and prevented the antiapoptotic action of carbachol.

Conclusions—In ARVMs, stimulation of ß1-ARs increases apoptosis via a cAMP-dependent mechanism, whereas stimulation of ß2-ARs inhibits apoptosis via a Gi-coupled pathway. These findings have implications for the pathophysiology and treatment of myocardial failure.


Key Words: apoptosis • receptors, adrenergic, beta • myocytes • adenylyl cyclase • proteins


*    Introduction
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We previously demonstrated that exposing adult rat ventricular myocytes (ARVMs) to norepinephrine (NE) for 24 hours increases the number of apoptotic cells.1 This effect is inhibited by the nonselective ß-adrenergic receptor (ß-AR) antagonist propranolol, mimicked by the adenylyl cyclase stimulator forskolin, and attenuated by an inhibitor of protein kinase A, indicating that NE stimulates apoptosis via a ß-AR–mediated increase in cAMP.1 Likewise, Iwai-Kanai et al2 showed that ß-AR stimulation increases apoptosis in neonatal rat cardiac myocytes by a mechanism that is dependent on the cAMP–protein kinase A pathway.

Both ß1- and ß2-ARs are expressed in cardiac myocytes and mediate an increase in contractility via Gs-dependent coupling to adenylyl cyclase.3 However, ß2-ARs can also couple to signaling pathways independent of cAMP or Gs and, in particular, to a pertussis toxin (PTX)–sensitive pathway mediated by Gi.4 5 6 We tested the hypotheses that (1) ß1- and ß2-AR subtypes exert opposing effects on apoptosis in cardiac myocytes and (2) ß2-AR activation attenuates ß1-AR–stimulated apoptosis via Gi. Accordingly, ARVMs were exposed to NE or isoproterenol in the presence of ß1- or ß2-AR–selective antagonists. Apoptosis was measured by flow cytometry and confirmed by terminal deoxynucleotidyl transferase (TdT)–mediated nick end-labeling (TUNEL).1 Carbachol and PTX were used to stimulate or inhibit Gi, respectively.


*    Methods
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Myocytes
ARVMs were isolated from the hearts of adult (200 to 220 g) male Sprague-Dawley rats,1 plated at a nonconfluent density of 30 to 50 cells/mm2 on 100-mm plastic culture dishes (Fisher) or 40x22-mm glass coverslips (Fisher) precoated with laminin (1 µg/cm2, Becton-Dickinson), and maintained in ACCT medium (DMEM; BSA, 2 mg/mL; L-carnitine, 2 mmol/L; creatine, 5 mmol/L; taurine, 5 mmol/L; penicillin, 100 IU/mL; streptomycin, 100 µg/mL) for 16 hours before drug treatments.

Drug Treatments
Myocytes were treated with isoproterenol (10 µmol/L) or a combination of NE (10 µmol/L) and prazosin (PZ; 0.1 µmol/L, 30 minutes before NE) for 24 hours. All dishes were supplemented with ascorbic acid (0.1 mmol/L). The ß1-AR–selective antagonist CGP 20712A (0.3 µmol/L, RBI) or the ß2-AR–selective antagonist ICI 118,551 (0.1 µmol/L, RBI) was added 30 minutes before NE. Carbachol (30 µmol/L, Sigma) or PTX (1 µg/mL, Sigma) was added 30 minutes or 3 hours, respectively, before NE.

Flow Cytometry
Myocyte apoptosis was assessed primarily by flow cytometry as described and validated.1 Apoptotic cells stained with propidium iodide exhibit a reduced DNA content peak in the hypodiploid region indicative of apoptosis.7

TUNEL Staining
TUNEL staining was performed on cells plated on glass coverslips with a Boehringer Mannheim in situ death detection kit.1 The percentage of TUNEL-positive myocytes (relative to total myocytes) was determined by counting 400 to 500 cells in 20 randomly chosen fields per coverslip on each of 3 coverslips for each experiment.

Cellular cAMP Content
ARVMs ({approx}2x105) were homogenized at 4°C in buffer (Tris-HCl, 50 mmol/L; MgCl2, 10 mmol/L; EDTA, 1 mmol/L; and PMSF, 5 µmol/L; pH 7.4), and cAMP was measured by radioimmunoassay (Dupont-NEN).

Statistics
All data are presented as mean±SEM. Differences among multiple conditions were determined by 1-way ANOVA with a post hoc Tukey’s test. Differences were considered significant if the null hypothesis could be rejected at the 0.05 level.


*    Results
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ß-AR–Stimulated Apoptosis Is Mediated via ß1-ARs
Under control conditions, {approx}6% to 7% of cells are apoptotic, as indicated by a hypodiploid DNA content.1 7

As we previously reported,1 treatment with NE/PZ for 24 hours increased the number of apoptotic myocytes by 1.72±0.08-fold (Figure 1ADown). Pretreatment with the ß1-AR–selective antagonist CGP 20712A5 alone had no effect on the number of apoptotic cells, but it inhibited the apoptotic action of NE/PZ. Conversely, pretreatment with the ß2-AR–selective antagonist ICI 118,5515 alone had no effect on the number of apoptotic cells, but it potentiated the apoptotic action of NE/PZ. Likewise, treatment with the nonselective ß-AR agonist isoproterenol increased the number of apoptotic myocytes by 1.81±0.08-fold (Figure 1BDown). As with NE/PZ, this effect was inhibited by CGP 20712A and potentiated by ICI 118,551.



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Figure 1. Opposing effects of ß1- or ß2-AR–selective antagonists on ß-AR–stimulated apoptosis in ARVMs. Apoptosis was measured as percentage of cells with hypodiploid DNA by flow cytometry.1 7 Under control conditions, {approx}6% to 7% of cells were apoptotic. A, ß-AR stimulation with combination of 10 µmol/L NE and 0.1 µmol/L PZ (NE/PZ) increased percentage of apoptotic cells (P<0.04; n=6 experiments, each performed in triplicate). Pretreatment with ß1-AR–selective antagonist CGP 20712A (CGP; 0.3 µmol/L) abolished apoptotic action of ß-AR stimulation. Conversely, pretreatment with ß2-AR–selective antagonist ICI 118,551 (ICI; 0.1 µmol) potentiated apoptotic action of ß-AR stimulation (*P<0.05 vs NE/PZ; n=3 to 6 experiments, each performed in triplicate). B, Treatment with isoproterenol (ISO) increased number of apoptotic myocytes (P<0.05; n=3). Pretreatment with CGP inhibited and pretreatment with ICI potentiated apoptotic action of ISO (#P<0.05 vs ISO; n=3 experiments, each performed in triplicate).

Gi Attenuates ß-AR–Stimulated Apoptosis
Pretreatment with PTX had no effect on the number of apoptotic myocytes, but it potentiated the apoptotic action of NE/PZ as measured by flow cytometry (Figure 2ADown). Likewise, PTX pretreatment increased the number of TUNEL-positive cells after NE/PZ (2.68±0.16-fold) compared with NE alone (1.70±0.14-fold; P<0.05 versus NE/PZ+PTX; n=3).



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Figure 2. Role of Gi in ß-AR–stimulated apoptosis. A, Pretreatment with PTX (3 hours; 1 µg/mL)4 potentiated apoptotic action of ß-AR stimulation with NE/PZ. B, Pretreatment with carbachol (CARB; 30 µmol/L) inhibited apoptotic action of ß-AR stimulation with NE/PZ. Antiapoptotic action of CARB was abolished by pretreatment with PTX. *P<0.05 vs NE/PZ; n=3 experiments, each performed in triplicate.

Carbachol Protects From ß-AR–Stimulated Apoptosis via Gi
Pretreatment with carbachol alone had no effect on the number of apoptotic cells, but it abolished the apoptotic action of NE/PZ (Figure 2BUp). Pretreatment with PTX abolished the protective effect of carbachol for NE-stimulated apoptosis.

Myocyte cAMP Content
cAMP content averaged 12.44±1.24 pmol/mg protein in control cells and increased to 37.4±4.9 pmol/mg protein (P<0.05 versus control) with NE/PZ. Pretreatment with PTX had no effect on basal cAMP (11.1±1.2 pmol/mg protein) or that stimulated by NE/PZ (29.1±3.8 pmol/mg protein).


*    Discussion
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*Discussion
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The major new findings of this study are that (1) ß1- and ß2-ARs mediate opposing effects of NE on apoptosis in cardiac myocytes (stimulation by ß1-ARs, inhibition by ß2-ARs) and (2) activation of a PTX-sensitive G protein (presumably Gi) by either ß2-ARs or carbachol inhibits ß-AR–stimulated apoptosis.

Opposing Effects of ß1-ARs and ß2-ARs on Apoptosis
Both ß1- and ß2-ARs can stimulate adenylyl cyclase by coupling to Gs. Recently, it has been appreciated that ß2- but not ß1-ARs can also couple to non–adenylyl cyclase pathways via Gi.4 The Gi-mediated action may oppose the effect mediated by Gs and in some cases may be the predominant ß2-AR effect. Xiao and Lakatta3 showed that inhibition of Gi potentiated the ability of ß2-AR stimulation to increase contractility, intracellular calcium, and calcium current in ARVMs. The coupling of ß2-ARs to Gi may be regulated by a Gs-mediated, protein kinase A–dependent phosphorylation of the ß2-ARs that favors coupling to Gi.4

Although NE and isoproterenol stimulate both ß1- and ß2-ARs in ARVMs, the net effect is to increase apoptosis. Because ß1-ARs account for {approx}80% of ß-ARs in ARVMs,8 the predominance of the ß1-AR effect on apoptosis may reflect the stoichiometry of the subtypes. ß1-AR–stimulated cAMP might also inhibit non–cAMP-dependent pathways coupled to ß2-ARs.6 9

Role of Gi
PTX, which inhibits Gi, increased the magnitude of ß-AR–stimulated apoptosis and thus mimicked the effect of ß2-AR blockade. Conversely, pretreatment with carbachol, which stimulates Gi in ARVMs via activation of M2 muscarinic receptors, inhibited ß-AR–mediated apoptosis. The antiapoptotic action of carbachol was abolished by PTX, supporting the role of Gi. Gi might oppose the actions of Gs by inhibiting the activation of adenylyl cyclase, which appears to be central to ß-AR–stimulated apoptosis in cardiac myocytes.1 2 However, PTX did not inhibit the ß-AR–stimulated increase in cAMP, suggesting that Gi might inhibit ß-AR–stimulated apoptosis via a cAMP-independent mechanism.4 10

Implications
These findings support the thesis that increased sympathetic activity to the myocardium contributes to myocardial failure via ß1-AR–stimulated apoptosis of cardiac myocytes. This premise is supported by the demonstration that mice overexpressing Gs developed dilated cardiomyopathy associated with myocyte apoptosis,11 and mice overexpressing ß1-ARs developed dilated cardiomyopathy.12 13 In contrast, mice overexpressing ß2-ARs did not develop myocardial dysfunction at ages up to 4 months.14 Our findings further demonstrate that activation of Gi by a muscarinic agonist or ß2-AR stimulation opposes the apoptotic action of ß1-AR stimulation and thus raises the possibility that strategies to activate Gi or to increase the coupling of Gi to ß2-ARs may be of therapeutic value.


*    Acknowledgments
 
This study was supported in part by NIH grants HL-52320, HL-42539, and HL-61639 (Dr Colucci), HL-057947 (Dr Singh), and HL-03878 (Dr Sawyer); a Grant-in-Aid from the AHA, Massachusetts Affiliate (Drs Singh and Sawyer); a Merit grant from the Department of Veterans Affairs (Dr Singh); and a fellowship from the AHA, Massachusetts Affiliate (Dr Communal).

Received August 26, 1999; revision received October 5, 1999; accepted October 8, 1999.


*    References
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up arrowAbstract
up arrowIntroduction
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up arrowResults
up arrowDiscussion
*References
 
1. Communal C, Singh K, Pimentel DR, Colucci WS. Norepinephrine stimulates apoptosis in adult rat ventricular myocytes by activation of the ß-adrenergic pathway. Circulation. 1998;98:1329–1334.[Abstract/Free Full Text]

2. Iwai-Kanai E, Hasegawa K, Araki M, Kakita T, Morimoto T, Sasayama S. {alpha}- and ß-Adrenergic pathways differentially regulate cell type–specific apoptosis in rat cardiac myocytes. Circulation. 1999;100:305–311.[Abstract/Free Full Text]

3. Xiao RP, Lakatta EG. ß1-Adrenoreceptor stimulation and ß2-adrenoreceptor stimulation differ in their effects on contraction, cytosolic calcium, and calcium current in single rat ventricular cells. Circ Res. 1993;73:286–300.[Abstract/Free Full Text]

4. Daaka Y, Luttrell LM, Lefkowitz RJ. Switching of the coupling of the ß2-adrenergic receptor to different G proteins by protein kinase A. Nature. 1997;390:88–91.[Medline] [Order article via Infotrieve]

5. Xiao RP, Ji X, Lakatta EG. Functional coupling of the ß2-adrenoreceptor to a pertussis toxin-sensitive G protein in cardiac myocytes. Mol Pharmacol. 1995;47:322–329.[Abstract]

6. Xiao RP, Avdonin P, Zhou Y, Cheng H, Akhter SA, Eschenhagen T, Lefkowitz RJ, Koch WJ, Lakatta EG. Coupling of ß2-adrenoreceptor to Gi protein and its physiological relevance to murine cardiac myocytes. Circ Res. 1999;84:43–52.[Abstract/Free Full Text]

7. Fraker PJ, King LE, Lill-Elghanian D, Telford WG. Quantification of apoptotic events in pure and heterogeneous populations of cells using the flow cytometer. Methods Cell Biol. 1995;46:57–76.[Medline] [Order article via Infotrieve]

8. Kuznetsov V, Pak E, Robinson RB, Steinberg SF. ß2-Adrenergic receptor actions in neonatal and adult rat ventricular myocytes. Circ Res. 1995;76:40–52.[Abstract/Free Full Text]

9. Wu J, Dent P, Jelinek T, Wolfman A, Weber MJ, Sturgill TW. Inhibition of the EGF-activated MAP kinase signaling pathway by adenosine 3',5'-monophosphate. Science. 1993;262:1065–1069.[Abstract/Free Full Text]

10. Luttrell LM, Ferguson SSG, Daaka Y, Miller WE, Maudsley S, Della Rocca GJ, Lin F-T, Kawakatsu H, Owada K, Luttrell DK, Caron MG, Lefkowitz RJ. ß-Arrestin-dependent formation of ß2 adrenergic receptor-Src protein kinase complexes. Science. 1999;283:655–661.[Abstract/Free Full Text]

11. Geng Y, Ishikawa Y, Vatner DE, Wagner TE, Bishop SP, Vatner SF, Homcy CJ. Apoptosis of cardiac myocytes in Gs alpha transgenic mice. Circ Res. 1999;84:34–42.[Abstract/Free Full Text]

12. Port JD, Weinberger HD, Bisognano JD, Knudson OA, Bohlmeyer TJ, Pende A, Bristow MR. Echocardiographic and histopathological characterization of young and old transgenic mice over-expressing the human ß1-adrenergic receptor. J Am Coll Cardiol. 1998;31:177A. Abstract.

13. Engelhardt S, Hein L, Wiesmann F, Lohse MJ. Progressive hypertrophy and heart failure in ß1-adenergic receptor transgenic mice. Proc Natl Acad Sci U S A. 1999;96:7059–7064.[Abstract/Free Full Text]

14. Rockman HA, Hamilton RA, Jones LR, Milano CA, Mao L, Lefkowitz RJ. Enhanced myocardial relaxation in vivo in transgenic mice overexpressing the beta2-adrenergic receptor is associated with reduced phospholamban protein. J Clin Invest. 1996;97:1618–1623.[Medline] [Order article via Infotrieve]




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Exercise-based cardiac rehabilitation improves heart rate recovery in elderly patients after acute myocardial infarction.
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Y.-T. Tseng, N. Yano, A. Rojan, J. P. Stabila, B. G. McGonnigal, V. Ianus, R. Wadhawan, and J. F. Padbury
Ontogeny of phosphoinositide 3-kinase signaling in developing heart: effect of acute {beta}-adrenergic stimulation
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The Cytosolic Phospholipase A2 Pathway, a Safeguard of {beta}2-Adrenergic Cardiac Effects in Rat
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Activation of PI3K-Akt pathway mediates antiapoptotic effects of {beta}-adrenergic agonist in airway eosinophils
Am J Physiol Lung Cell Mol Physiol, May 1, 2005; 288(5): L860 - L867.
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L. Wang, Y.-H. Feng, and G. I. Gorodeski
Epidermal Growth Factor Facilitates Epinephrine Inhibition of P2X7-Receptor-Mediated Pore Formation and Apoptosis: A Novel Signaling Network
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Phosphatidylinositol 3-Kinase Offsets cAMP-Mediated Positive Inotropic Effect via Inhibiting Ca2+ Influx in Cardiomyocytes
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I. Ahmet, M. Krawczyk, P. Heller, C. Moon, E. G. Lakatta, and M. I. Talan
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L. Barki-Harrington, C. Perrino, and H. A Rockman
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M. Ito, T. Adachi, D. R. Pimentel, Y. Ido, and W. S. Colucci
Statins Inhibit {beta}-Adrenergic Receptor-Stimulated Apoptosis in Adult Rat Ventricular Myocytes via a Rac1-Dependent Mechanism
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A. El-Armouche, O. Zolk, T. Rau, and T. Eschenhagen
Inhibitory G-proteins and their role in desensitization of the adenylyl cyclase pathway in heart failure
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{beta}2-Adrenergic Signaling in Human Heart: Shift from the Cyclic AMP to the Arachidonic Acid Pathway
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Resistance of the Human {beta}1-Adrenergic Receptor to Agonist-mediated Down-regulation: ROLE OF THE C TERMINUS IN DETERMINING {beta}-SUBTYPE DEGRADATION
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R.-P. Xiao, S.-J. Zhang, K. Chakir, P. Avdonin, W. Zhu, R. A. Bond, C. W. Balke, E. G. Lakatta, and H. Cheng
Enhanced Gi Signaling Selectively Negates {beta}2-Adrenergic Receptor (AR)- but Not {beta}1-AR-Mediated Positive Inotropic Effect in Myocytes From Failing Rat Hearts
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C. Maack, M. Bohm, L. Vlaskin, E. Dabew, K. Lorenz, H.-J. Schafers, M. J. Lohse, and S. Engelhardt
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A. Abbate, G. G. L. Biondi-Zoccai, R. Bussani, A. Dobrina, D. Camilot, F. Feroce, R. Rossiello, F. Baldi, F. Silvestri, L. M. Biasucci, et al.
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A. Remondino, S. H. Kwon, C. Communal, D. R. Pimentel, D. B. Sawyer, K. Singh, and W. S. Colucci
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{beta}-Blockers in Chronic Heart Failure: Considerations for Selecting an Agent
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B. J. A. Janssen and J. F. M. Smits
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H. Gong, H. Sun, W. J. Koch, T. Rau, T. Eschenhagen, U. Ravens, J. F. Heubach, D. L. Adamson, and S. E. Harding
Specific {beta}2AR Blocker ICI 118,551 Actively Decreases Contraction Through a Gi-Coupled Form of the {beta}2AR in Myocytes From Failing Human Heart
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P. Andreka, N. Aiyar, L. C. Olson, J. Q. Wei, M. S. Turner, K. A. Webster, E. H. Ohlstein, and N. H. Bishopric
Bucindolol Displays Intrinsic Sympathomimetic Activity in Human Myocardium
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L.-M. Zhang, Z. Wang, and S. Nattel
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Catecholamine stimulation is associated with impaired myocardial O2 utilization in heart failure
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B Andersson, B Gruner Svealv, M Scharin Tang, and R Mobini
Longitudinal myocardial contraction improves early during titration with metoprolol CR/XL in patients with heart failure
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P. K. Tithof, M. Elgayyar, H. M. Schuller, M. Barnhill, and R. Andrews
4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone, a nicotine derivative, induces apoptosis of endothelial cells
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{beta}-Adrenergic Signaling in the Heart: Dual Coupling of the {beta}2-Adrenergic Receptor to Gs and Gi Proteins
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J Am Coll CardiolHome page
H. N. Sabbah, V. G. Sharov, R. C. Gupta, A. Todor, V. Singh, and S. Goldstein
Chronic therapy with metoprolol attenuates cardiomyocyte apoptosis in dogs with heart failure
J. Am. Coll. Cardiol., November 1, 2000; 36(5): 1698 - 1705.
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