Chemistry, Physiology, and Pharmacology of β-Adrenergic Mechanisms in the Heart. Why are β-Blocker Antiarrhythmics Superior?

Author(s): A. Jozsef Szentmiklosi , Norbert Szentandrassy , Bence Hegyi , Balazs Horvath , Janos Magyar , Tamas Banyasz , Peter P. Nanasi .

Journal Name: Current Pharmaceutical Design

Volume 21 , Issue 8 , 2015

Abstract:

Stimulation of β-adrenergic receptors in the heart is the most effective endogenous way to increase the mechanical performance of cardiac tissues to meet the requirements of a fight-or-flight situation or stress. On the other hand, sustained activation of cardiac β-receptors initiates maladaptive remodeling of the myocardium leading to cardiomyopathies and heart failure. Since both acute and chronic stimulation of β-adrenoceptors are arrhythmogenic, the application of β-receptor blockers exerts effective antiarrhytmic actions at both short and long time scale. Compared to other classes of antiarrhythmic agents, β-blockers are the class of antiarrhythmics that was shown to decrease mortality in postinfarct patients. Chemical, physiological, and pharmacological properties of the β-adrenoceptor related signaling, the role of β-1, β-2, and β-3 receptor subtypes, consequences of acute and long term β-adrenergic stimulation and the underlying proarrhythmic mechanisms, including the changes in cardiac ion currents and Ca2+ handling, are reviewed in this paper together with the clinical relevance of cardioprotective β-blocking therapy.

Keywords: β-adrenergic receptors, β-receptor blockers, proarrhythmic mechanisms, antiarrhythmic drugs, cardiac ion currents, cardiac remodeling.

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Article Details

VOLUME: 21
ISSUE: 8
Year: 2015
Page: [1030 - 1041]
Pages: 12
DOI: 10.2174/1381612820666141029111240
Price: $58

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