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(Circulation. 2000;102:2162.)
© 2000 American Heart Association, Inc.

Editorial

Nitric Oxide and Viral Cardiomyopathy

Mitchell S. Finkel, MD

From the West Virginia University School of Medicine, WVU Cardiology, Morgantown, WVa, and Louis A. Johnson VA Medical Center, Clarksburg, WVa.

Correspondence to Mitchell S. Finkel, MD, Department of Medicine, West Virginia University School of Medicine, Medical Center Dr, PO Box 9157, Morgantown, WV 26506-9157. E-mail mfinkel@wvu.edu

Key Words: Editorials • heart failure • ischemia • infection

The report by Badorff et al¹ in this issue of Circulation provides an opportunity to reflect on the enormous impact that the discovery of nitric oxide (NO) has already had in furthering our understanding of the basic biology of human disease processes. This report also helps to illustrate how basic insights coupled with clinical observations will ultimately lead to redefining previously unrelated clinical conditions along more pathophysiologically relevant lines.

The 1998 Nobel Prize for Medicine or Physiology was awarded to Louis J. Ignarro, Ferid Murad, and Robert Furchgott for the discovery of the role of NO as a signaling molecule in the cardiovascular system.² Ignarro studied the mechanism of action of nitroglycerin, which was first synthesized by Sobrero more than 150 years ago, and discovered that it mediates its effects through NO. Murad discovered that NO mediates effects through that "other," less appreciated (ie, not cAMP), cyclic nucleotide, cGMP. Furchgott’s simple experiments with rabbit aortas provided physiological relevance by revealing that vascular endothelium normally produces a relaxing factor, endothelium-derived relaxing factor, which Ignarro showed to be NO. Shortly thereafter, inhibitors were identified, enzyme proteins isolated, and NO synthases (NOS) successively cloned from neurons (type 1), macrophages (type 2), and endothelial cells (type 3).³ It was clear from the beginning that the constitutive, basal production of small quantities of NO by NOS types 1 and 3 played a critical role in normal physiological processes. What has been less obvious, however, is the benefits conferred by the production of much larger quantities . . . [Full Text of this Article]