Circulation, Vol 81, 1-13, Copyright © 1990 by American Heart Association
G Heusch
alpha-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 alpha- adrenoceptor subtypes is
presented, and the effects of alpha- adrenoceptor activation on presynaptic
sympathetic nerve terminals, cardiomyocytes, endothelium, platelets, and
coronary smooth muscle cells are discussed. alpha-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 alpha-adrenergic coronary vasoconstriction to
experimental and clinical myocardial ischemia is provided. Cardiomyocyte
alpha-adrenoceptor activation may be involved in ischemic and reperfusion
arrhythmias. The participation of presynaptic and postsynaptic
alpha-adrenoceptors, as well as of alpha 1- and alpha 2- adrenoceptors, in
experimental and clinical myocardial ischemia will require further
investigation.
ARTICLES
Alpha-adrenergic mechanisms in myocardial ischemia
Department of Pathophysiology, University of Essen Medical School, FRG.
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