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1983 Upjohn Award lecture. Endocrine dysfunction and cardiac performance.

Studies were carried out to study the effect of endocrine changes on rat cardiac performance, biochemistry, and responses to drugs. Hyperthyroidism increased contractility in rat hearts and enhanced the phosphorylase response to catecholamine. The inotropic response may be due to an increase in cardiac mass while the enzyme changes may be due to several factors. Hypothyroidism decreased force of contraction, enhanced alpha-adrenergic inotropic and chronotropic responses, and decreased beta-adrenergic responses in isolated atrial preparations. An interaction between cyclic AMP and cyclic GMP is suggested as a possible explanation. Diabetes induced by alloxan or streptozotocin produced a decrease in cardiac performance after 42 days which was correlated with a decrease in sarcoplasmic reticulum (SR) Ca2+ uptake. Insulin treatment reversed or prevented both SR and functional changes; other treatments were not as successful. Responses to cardiotonic drugs were altered by the diabetic state. The phosphorylase response to isoproterenol was enhanced while the inotropic response was not affected. An initial subsensitivity to carbachol at 30-100 days of diabetes subsequently converted to a supersensitivity to the muscarinic agent. Ouabain responses were decreased in atrial and papillary preparations from diabetic animals. Studies are continuing to elucidate the mechanisms involved in the altered pharmacological responses seen in hearts from diabetic animals.