Abstract:
:In the human heart the beta-adrenergic pathways are the primary means of increasing cardiac performance in response to acute or chronic stress. Control of beta pathway function is achieved by changes in the receptors themselves, and to a lesser degree by adjustments in the inhibitory G protein (Gi). In heart failure myocardial beta-receptor function is substantially reduced, but the beta-receptor pathways are so powerful that they remain capable of supporting inotropic function. Certain therapeutic interventions that improve exercise performance in heart failure can partially restore beta-receptor pathway function to normal; these interventions include beta-blocker therapy and treatment with angiotensin converting enzyme inhibitors. Other types of therapy, such as chronic administration of beta-adrenergic agonists, may produce undesirable effects by increasing beta-receptor subsensitivity; however, the effects of beta-agonists on beta-receptor function are somewhat unpredictable and certain beta-agonists do not appear to produce much desensitization. Finally, the failing human heart is in effect partially denervated due to depletion of neuronal norepinephrine, and consequently in advanced heart failure beta-agonists that possess an indirect component of action will be less effective than exclusively direct-acting agents. These observations indicate that the baseline status and the intervention-associated behaviour of the human myocardial beta-adrenergic receptor systems need to be considered in developing therapeutic strategies in congestive heart failure.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Bristow MR,Port JD,Hershberger RE,Gilbert EM,Feldman AMdoi
10.1093/eurheartj/10.suppl_b.45subject
Has Abstractpub_date
1989-06-01 00:00:00pages
45-54eissn
0195-668Xissn
1522-9645journal_volume
10 Suppl Bpub_type
杂志文章,评审abstract::Both epidemiological studies and intervention trials support an important role of diet in reducing the risk of a variety of chronic diseases, including cardiovascular disease, and overall mortality. We discuss available evidence indicating that the generation of a pro-inflammatory milieu might be one mechanism through...
journal_title:European heart journal
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doi:10.1093/eurheartj/ehi605
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abstract:AIMS:There have been no large observational studies attempting to identify predictors of major bleeding in patients with acute coronary syndromes (ACS), particularly from a multinational perspective. The objective of our study was thus to develop a prediction rule for the identification of patients with ACS at higher r...
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pub_type: 杂志文章,多中心研究
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更新日期:2007-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:1985-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2005-09-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061061
更新日期:1995-08-01 00:00:00
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更新日期:2012-05-01 00:00:00
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更新日期:2009-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2000-03-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2013-08-01 00:00:00
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pub_type: 杂志文章
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/10.suppl_g.54
更新日期:1989-12-01 00:00:00
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更新日期:2012-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:1987-05-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2007-04-01 00:00:00
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更新日期:2011-08-01 00:00:00
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journal_title:European heart journal
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更新日期:2009-08-01 00:00:00
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pub_type: 杂志文章
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