title: Chemistry, physiology, and pharmacology of β-adrenergic mechanisms in the heart. Why are β-blocker antiarrhythmics superior?
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 Ca(2+) handling, are reviewed in this paper together with the clinical relevance of cardioprotective β-blocking therapy.
authors.forename: A József
authors.initials: AJ
authors.lastname: Szentmiklosi
authors.forename: Norbert
authors.initials: N
authors.lastname: Szentandrássy
authors.forename: Bence
authors.initials: B
authors.lastname: Hegyi
authors.forename: Balázs
authors.initials: B
authors.lastname: Horvath
authors.forename: János
authors.initials: J
authors.lastname: Magyar
authors.forename: Tamás
authors.initials: T
authors.lastname: Bányász
authors.affiliation: Department of Physiology, University of Debrecen, Nagyerdei krt. 98. H-4012 Debrecen, Hungary. nanasi.peter@med.unideb.hu.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Nanasi
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000503:physiopathology; D006321:Heart / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology*; D006801:Humans; D011943:Receptors, Adrenergic, beta / Q000187:drug effects / Q000502:physiology*; D013329:Structure-Activity Relationship
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D011943:Receptors, Adrenergic, beta