ALPHA-ADRENERGIC MECHANISMS IN MYOCARDIAL ISCHEMIA

被引:191
作者
HEUSCH, G
机构
[1] Department of Pathophysiology, Center of Internal Medicine, University of Essen Medical School, Essen
[2] Department of Pathophysiology, Center of Internal Medicine, University of Essen Medical School, 4300 Essen
关键词
Coronary circulation; Ischemia; Myocardium; Receptors; α-adrenergic;
D O I
10.1161/01.CIR.81.1.1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
α-Adrenoceptor-mediated effects of sympathetic activation on the heart and coronary circulation are reviewed with emphasis on the pathophysiology of myocardial ischemia. A classification of α-adrenoceptor subtypes is presented, and the effects of α-adrenoceptor activation on presynaptic sympathetic nerve terminals, cardiomyocytes, endothelium, platelets, and coronary smooth muscle cells are discussed. α-Adrenergic coronary vasoconstriction at rest and during situations of sympathetic activation such as exercise and excitement is analyzed for the segmental, transmural, and regional distribution of coronary blood flow. Evidence for a significant contribution of α-adrenergic coronary vasoconstriction to experimental and clinical myocardial ischemia is provided. Cardiomyocyte α-adrenoceptor activation may be involved in ischemic and reperfusion arrhythmias. The participation of presynaptic and postsynaptic α-adrenoceptors, as well as of α1- and α2-adrenoceptors, in experimental and clinical myocardial ischemia will require further investigation.
引用
收藏
页码:1 / 13
页数:13
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