The control of cardiac ventricular excitability by autonomic pathways

被引:15
|
作者
Finlay, Malcolm [1 ]
Harmer, Stephen C. [1 ]
Tinker, Andrew [1 ]
机构
[1] Barts & London Queen Marys Sch Med & Dent, William Harvey Res Inst, Heart Ctr, Charterhouse Sq, London EC1M 6BQ, England
关键词
Cardiac ventricle; Cardiac arrhythmia; Autonomic nervous system; Ion channels; Excitability; Conduction velocity; NITRIC-OXIDE SYNTHASE; LONG-QT SYNDROME; BETA-ADRENERGIC STIMULATION; TRANSIENT OUTWARD CURRENT; IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS; CHRONIC HEART-FAILURE; PROTEIN-KINASE-A; MUSCARINIC ACETYLCHOLINE-RECEPTORS; ACTION-POTENTIAL DURATION; VAGUS NERVE-STIMULATION;
D O I
10.1016/j.pharmthera.2017.02.023
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Central to the genesis of ventricular cardiac arrhythmia are variations in determinants of excitability. These involve individual ionic channels and transporters in cardiac myocytes but also tissue factors such as variable conduction of the excitation wave, fibrosis and source-sink mismatch. It is also known that in certain diseases and particularly the channelopathies critical events occur with specific stressors. For example, in hereditary long QT syndrome due to mutations in KCNQI arrhythmic episodes are provoked by exercise and in particular swimming. Thus not only is the static substrate important but also how this is modified by dynamic signalling events associated with common physiological responses. In this review, we examine the regulation of ventricular excitability by signalling pathways from a cellular and tissue perspective in an effort to identify key processes, effectors and potential therapeutic approaches. We specifically focus on the autonomic nervous system and related signalling pathways. (C) 2017 Elsevier Inc All rights reserved.
引用
收藏
页码:97 / 111
页数:15
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