Malnutrition and the heart.

Earlier concepts that the heart is spared in malnutrition have been shown to be incorrect. Inadequate intake of protein and energy results in proportional loss of skeletal and myocardial muscle. As myocardial mass decreases, so does the ability to generate cardiac output; however, various compensatory factors come into play. Nutritional supplementation for malnourished patients reverses the compensatory factors and may increase the short-term potential for heart failure. Severe cardiac debility results in poor nutrition, which may in turn produce unsuspected but clinically significant myocardial atrophy. Nutritional support may play a role in improving cardiac function in selected patients with cardiac cachexia who are being prepared for cardiac surgery and in patients with rapid weight loss who are at risk for sudden death due to arrhythmias. Malnutrition is common in hospitalized patients, and many patients in hospital now receive nutritional supplementation; both facts have important cardiac implications.     

Changes in the sarcolemma of the hypothyroid heart.

Sarcolemmal membranes prepared from the hearts of thyroidectomised sheep showed a fall of more than 90% in both 5′-nucleotidase activity and the number of β-adrenergic receptor sites. A fall of more than 60% in both Na⁺+K⁺ATPase and adenyl cyclase activities also occurred. Either long-term or short-term treatment with thyroid hormones brought about concerted recovery of these pairs of sarcolemmal functions.     

Muscle cell differentiation in the ascidian heart.

The simple tubular heart of tunicates consists of a single layer of striated muscle cells which display distinct electrical properties at the luminal and extraluminal surfaces. We have investigated heart morphogenesis and cytodifferentiation in the ascidian, Botryllus schlosseri. Myocardium is formed by invagination from the wall of the heart primordium. Cell polarity is clearly apparent in the undifferentiated cells of the heart primordium and is maintained throughout the whole course of cardiac muscle differentiation. Myocardium cells are initially cubic in appearance, then undergo a progressive flattening with the formation of characteristic protrusions at the luminal surface. The first sign of muscle cell differentiation is the formation of close associations between sarcoplasmic reticulum cisterns and the plasma membrane at the luminal and junctional surface. Myofibrillogenesis also occurs near the luminal surface, whereas the cell portion facing the pericardial cavity maintains an undifferentiated structure. The findings support the hypothesis that membrane changes precede and influence myofibril formation in developing muscle cells.