Autonomic control of the heart: going beyond the classical neurotransmitters

<strong>New Findings</strong><br> What is the topic of this review?<br> This symposium report discusses the evidence for release of cardiac sympathetic cotransmitters in addition to noradrenaline.<br> <br> What advances does it highlight?<br> It highlights...

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Main Author: Herring, N
Format: Journal article
Language:English
Published: Wiley 2014
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author Herring, N
author_facet Herring, N
author_sort Herring, N
collection OXFORD
description <strong>New Findings</strong><br> What is the topic of this review?<br> This symposium report discusses the evidence for release of cardiac sympathetic cotransmitters in addition to noradrenaline.<br> <br> What advances does it highlight?<br> It highlights the potential role of neuropeptide Y in reducing vagal neurotransmission and directly influencing ventricular myocyte excitability in the presence of β-receptor blockade. <br><br> Acute myocardial infarction and congestive cardiac failure are characterized by high levels of cardiac sympathetic drive. In these conditions, sympathetic neurotransmitters such as neuropeptide Y (NPY) can be released in addition to noradrenaline, and plasma levels correlate with infarct size and mortality. Even in the presence of β-blockers, NPY is able to bind to its own receptors located on cholinergic ganglia and ventricular myocytes. In this symposium report, I review the evidence that NPY can inhibit acetylcholine release during vagus nerve stimulation and limit the subsequent bradycardia. I also present preliminary, as yet unpublished data, demonstrating that NPY may be pro-arrhythmic by directly influencing ventricular electrophysiology. Targeting NPY receptors pharmacologically may therefore be a useful therapeutic strategy both to reduce heart rate and to prevent arrhythmias in the setting of myocardial infarction and chronic heart failure. Such medications would be expected to act synergistically with β-blockers, angiotensin-converting enzyme inhibitors and implantable cardiac devices, such as defibrillators and vagus nerve stimulators.
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spelling oxford-uuid:0b0e9ad9-c96e-4c8c-8e79-8b0767c87af22022-03-26T09:27:27ZAutonomic control of the heart: going beyond the classical neurotransmittersJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0b0e9ad9-c96e-4c8c-8e79-8b0767c87af2EnglishSymplectic Elements at OxfordWiley2014Herring, N<strong>New Findings</strong><br> What is the topic of this review?<br> This symposium report discusses the evidence for release of cardiac sympathetic cotransmitters in addition to noradrenaline.<br> <br> What advances does it highlight?<br> It highlights the potential role of neuropeptide Y in reducing vagal neurotransmission and directly influencing ventricular myocyte excitability in the presence of β-receptor blockade. <br><br> Acute myocardial infarction and congestive cardiac failure are characterized by high levels of cardiac sympathetic drive. In these conditions, sympathetic neurotransmitters such as neuropeptide Y (NPY) can be released in addition to noradrenaline, and plasma levels correlate with infarct size and mortality. Even in the presence of β-blockers, NPY is able to bind to its own receptors located on cholinergic ganglia and ventricular myocytes. In this symposium report, I review the evidence that NPY can inhibit acetylcholine release during vagus nerve stimulation and limit the subsequent bradycardia. I also present preliminary, as yet unpublished data, demonstrating that NPY may be pro-arrhythmic by directly influencing ventricular electrophysiology. Targeting NPY receptors pharmacologically may therefore be a useful therapeutic strategy both to reduce heart rate and to prevent arrhythmias in the setting of myocardial infarction and chronic heart failure. Such medications would be expected to act synergistically with β-blockers, angiotensin-converting enzyme inhibitors and implantable cardiac devices, such as defibrillators and vagus nerve stimulators.
spellingShingle Herring, N
Autonomic control of the heart: going beyond the classical neurotransmitters
title Autonomic control of the heart: going beyond the classical neurotransmitters
title_full Autonomic control of the heart: going beyond the classical neurotransmitters
title_fullStr Autonomic control of the heart: going beyond the classical neurotransmitters
title_full_unstemmed Autonomic control of the heart: going beyond the classical neurotransmitters
title_short Autonomic control of the heart: going beyond the classical neurotransmitters
title_sort autonomic control of the heart going beyond the classical neurotransmitters
work_keys_str_mv AT herringn autonomiccontroloftheheartgoingbeyondtheclassicalneurotransmitters