Positive inotropic stimulation

Curr Opin Crit Care. 2002 Oct;8(5):395-403. doi: 10.1097/00075198-200210000-00005.

Abstract

Adrenergic receptors transduce signals through the G proteins to regulate cardiac function. The catecholamines, via alpha- and beta-adrenergic receptor (beta-AR) stimulation, may play a role in the development of heart failure. Norepinephrine and isoproterenol can induce cardiac myocyte apoptosis. Studies suggest that alpha-, beta1-, and beta2-adrenergic pathways differentially regulate cardiac myocyte apoptosis. The stimulation of beta1-AR leads to cyclic AMP-dependent apoptosis, whereas that of the beta2-AR elicits concurrent apoptosis and survival signals in cardiac myocytes coupled to Gs protein. Overexpression of alpha1-adrenergic receptors does not induce apoptosis in wild-type mice. In contrast, the heart failure observed in some murine models has to be related to an enhanced beta-AR kinase expression. These recent advances make it possible to understand the beneficial effects of beta-blockers in the treatment of chronic heart failure and provide novel therapeutic modalities through the stimulation of beta2-ARs or the inhibition of beta-AR kinase expression.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Animals
  • Apoptosis / drug effects
  • Cyclic AMP-Dependent Protein Kinases / antagonists & inhibitors
  • Humans
  • Isoproterenol / therapeutic use
  • Mice
  • Mice, Transgenic
  • Myocytes, Cardiac / drug effects*
  • Myocytes, Cardiac / metabolism
  • Receptors, Adrenergic, beta / drug effects*
  • Receptors, Adrenergic, beta / metabolism
  • Signal Transduction / drug effects*
  • beta-Adrenergic Receptor Kinases

Substances

  • Adrenergic beta-Antagonists
  • Receptors, Adrenergic, beta
  • Cyclic AMP-Dependent Protein Kinases
  • beta-Adrenergic Receptor Kinases
  • Isoproterenol