Cellular dysfunction

At the cellular level there appear to be abnormalities in cytosolic calcium handling, myofilament sensitivity to calcium, myocyte energetics, and phosphodiesterase and adenyl cyclase production/activity. Other changes include down-regulation of both b r and b2-adrenergic receptors and possible uncoupling of these b-adrenoreceptors from adenylate cyclase. Alterations in the activity and/or number of myocyte enzymes and transport channels involved in the excitation-contraction coupling mechanism are also implicated in many of the above processes.

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