Erythrocyte Na+,K(+)-ATPase properties and adenylate energy charge in normotensives and in essential hypertensives.

The activity and some kinetic properties of RBC Na+,K(+)-ATPase (EC 3.6.1.37) were investigated in essential hypertensives (EH; 40 subjects) and normotensives (NT; 20 subjects). A decrease in ouabain-sensitive 86Rb uptake as well as ouabain-sensitive ATPase activity was found in EH. [Na+]i and [K+]i of EH did not show any statistical difference from NT. Na+,K(+)-ATPase showed a reduced Mg2+ activation and the apparent Km value for Mg2+ was 2-fold increased in the EH group. The influence of temperature on the Na+,K(+)-ATPase showed a reduced modulation and a minor activity peak at 37 degrees C in the patients, consequently the calculated activation energy of the enzyme was increased at temperatures lower than 40 degrees C. Increased RBC adenylate energy charge (EC) was observed in EH when compared with NT. A negative correlation between EC and total Na+,K(+)-ATPase activity was found when all subjects were compared and also in both groups, showing a possible pump involvement in the regulation of the RBC metabolic flux in EH. These data provide evidence about some modifications in active Na+,K+ transport and in EC in RBC which allows a further characterization of membrane cation fluxes in EH.

[Various properties of the Na+, K(+)-ATPase and the Mg (2+)-ATPase in erythrocytes from normotensive and hypertensive subjects]. / Alcune proprieta' della Na+,K(+)-ATPasi e della Mg(2+)-ATPasi negli eritrociti di soggetti ipertesi e normotesi.

In the present work we reported the results of the study of erythrocyte membrane Na+,K(+)-adenosine triphosphatase (ATPase) and Mg(2+)-ATPase in patients with essential hypertension and controls. In the 40 patients with hypertension, a more marked decrease of Na+, K(+)-ATPase was observed. The behavior of the enzyme at Mg2+ activation, ouabain inhibition and the response to different temperature suggest the possibility of differences between the two groups. The normal erythrocyte Mg(2+)-ATPase activity in two groups suggest also the possible role of ratio Na+, K(+)-ATPase/Mg(2+)-ATPase in the study of essential hypertension. However the relevance of magnesium and Mg(2+)-ATPase to the pathogenesis of essential hypertension remains unclear but merits further study. On the basis of these considerations the aim of the present study was to identify, in a kinetic approach, the presence of different abnormalities of Na+ transport and Na+, K(+)-ATPase in erythrocytes from patients with essential hypertension. Much evidence has supported the hypothesis that essential hypertension is a heterogeneous disease in the pathophysiological mechanisms as well as in its clinical and therapeutical consideration.

[Cardioinhibitory reflex provoked by stimulation of carotid sinus in normal subjects and those with cardiovascular disease]. / Il riflesso cardioinibitore provocato dalla stimolazione del seno carotideo nei soggetti normali e con malattie cardiovascolari.

The normal range and the reproducibility of the cardioinhibitory carotid sinus reflex were studied in 288 apparently healthy subjects of different ages (aged from 17 to 84 yrs., 156 males, 132 females). In each subject we chose the longest RR interval as an activation index of the reflex obtained by carotid sinus massage; its mean value increased slightly with advancing age. In the were 1, 5, 2, 5, 3, 3 sec. respectively, with a 99% confidence limit. No sex difference was found. We studied also a group of 105 patients (aged from 39 to 82 yrs., 67 males, 38 females) with various types of cardiovascular disorders, without a previous history of spontaneous syncope. Abnormal maximum RR values were found in 18 of them (17%). This percentage was significantly higher than in normals (2%). In 11 patients (10%) the carotid sinus stimulation evoked a syncopal attack. It seems therefore that a statistically abnormal carotid sinus hypersensitivity can occur in a substantial number of cardiovascular patients without necessarily leading to spontaneous syncopal attacks. Finally the reproducibility of the cardioinhibitory reflex was tested in 42 patients with maximum RR interval values ranging from normal to extremely abnormal. In each subject a significant correlation (r = 0.79) was found between the maximum RR interval values tested in two occasions at intervals ranging from 1 hour to 3 months; besides a concordance in normal or abnormal result was present in 93% of the cases.

[Acute myocardial infarction in young patients as a manifestation of pheochromocytoma. Apropos of 2 cases]. / Infarto miocardico acuto in soggetti giovani quale manifestazione di feocromocitoma. A proposito di due casi.

Two patients with acute myocardial infarction and hypertensive crises were found to have a pheochromocytoma. We advise that patients with an acute myocardial infarction and hypertensive crises be evaluated with a computerized axial tomography, lest the presence of a pheochromocytoma be overlooked.