Mechanisms of Adrenergic and Cholinergic Regulation of Myocardial Contractility

  • August M. Watanabe
  • Jon P. Lindemann
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 34)


The autonomic nervous system is the major system extrinsic to the heart which regulates myocardial contractility. This system can be subdivided on the basis of anatomy, functional effects, and neurotransmitters released from postganglionic nerves into two major divisions: the sympathetic and parasympathetic nervous systems (fig. 17-1). In general, an increase in sympathetic nerve activity stimulates the heart (i.e., increases heart rate, conduction velocity through specialized conducting tissues, and myocardial contractility) whereas augmentation of parasympathetic activity inhibits the heart (i.e., reduces heart rate, conduction velocity through the atrioventricular node, and myocardial contractility). The heart is innervated by sympathetic nerves and the vagus, which is the parasympathetic innervation. The neurotransmitter released from preganglionic nerves in both the sympathetic and parasympathetic nervous systems is acetylcholine. Norepinephrine is the neurotransmitter that is released from postganglionic sympathetic nerves that innervates the heart. The transmitter released from postganglionic parasympathetic (vagal) nerve endings is acetylcholine (fig. 17-1). Both norepinephrine and acetylcholine produce their effects locally in the immediate area into which they are released, that is, they function as neurotransmitters. Epinephrine is a catecholamine which is released from the adrenal medulla and travels via the circulation to the heart and vasculature and thus functions as a hormone.


Adenylate Cyclase Muscarinic Receptor cAMP Level Guanylate Cyclase Myocardial Contractility 
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© Springer Science+Business Media Dordrecht 1984

Authors and Affiliations

  • August M. Watanabe
  • Jon P. Lindemann

There are no affiliations available

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