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Beneficial Role of Alpha-Adrenoceptor Activity in Myocardial Ischemic and Reperfusion Injury

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Recent Advances in Coronary Circulation

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Summary

The role played by alpha-adrenoceptor activity in the heart has not yet been extensively investigated. Several lines of evidence, however, support the idea that this activity is closely related to the pathogenesis of ischemic and reperfusion injury. The major effect of alpha-adrenoceptor stimulation in the coronary arteries is vasoconstriction, which may restrict myocardial oxygen supply. Alpha-adrenoceptor stimulation also increases myocardial contractility without marked increases in intracellular Ca2+, which effect may increase myocardial oxygen demand. Thus, it would seem that alpha-adrenoceptor stimulation exacerbates myocardial ischemia by increasing the imbalance between myocardial oxygen demand and supply. Indeed, electrical sympathetic nerve stimulation is reported to have a deleterious effect on myocardial and coronary function. Sympathetic nerve activation during ischemia, however, may not be as potent as electrical sympathetic nerve stimulation, and mild sympathetic nerve stimulation may be beneficial for ischemia and reperfusion injury. Indeed, alpha1-adrenoceptor stimulation maintains endocardial coronary flow at the expense of epicardial flow, and this stimulation enhances the release of adenosine, while alpha2-adrenoceptor stimulation increases the release of endothelial-dependent relaxing factor (EDRF) and histamine, and increases the sensitivity of adenosine receptors to adenosine, all of which actions may attenuate ischemic injury. Since alpha1-adrenoceptor activation enhances adenosine release (through the activation of 5’-nucleotidase); stimulation of alpha1-adrenoceptors during ischemia and reperfusion produces beneficial effects on reperfusion injury via this enhanced release of adenosine. Further basic studies are necessary to gain a better understanding of the role played by alpha-adrenoceptor activity in the pathogenesis of ischemia and reperfusion injury, and further clinical studies are needed to extend these observations to human ischemic hearts.

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Authors and Affiliations

  1. The First Department of Medicine, Osaka University School of Medicine, 2-2 Yamadagaoka, 565, Suita, Japan

    Hiroshi Sato & Takenobu Kamada

  2. Department of Medical Information Science, Osaka University Hospital, 553, Osaka, Japan

    Michitoshi Inoue

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  1. Masatsugu Hori
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  2. Masafumi Kitakaze
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  3. Seiji Takashima
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  4. Hiroshi Sato
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  5. Michitoshi Inoue
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  6. Takenobu Kamada
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Editors and Affiliations

  1. First Department of Internal Medicine, Fukushima Medical College, Hikarigaoka 1, 960-12, Fukushima, Japan

    Yukio Maruyama M.D., Ph.D. (Professor and Chairman) (Professor and Chairman)

  2. Department of Medical Engineering and Systems Cardiology, Kawasaki Medical School, 577 Matsushima, 701-01, Kurashiki, Japan

    Fumihiko Kajiya M.D., Ph.D. (Professor) (Professor)

  3. Cardiovascular Research Institute, University of California, 94143-0130, San Francisco, CA, USA

    Julien I. E. Hoffman M.D. (Professor of Pediatrics, Senior Staff Member) (Professor of Pediatrics, Senior Staff Member)

  4. University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands

    Jos A. E. Spaan Ph.D. (Professor of Department of Medical Physics, Faculty of Medicine) (Professor of Department of Medical Physics, Faculty of Medicine)

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© 1993 Springer-Verlag Tokyo

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Hori, M., Kitakaze, M., Takashima, S., Sato, H., Inoue, M., Kamada, T. (1993). Beneficial Role of Alpha-Adrenoceptor Activity in Myocardial Ischemic and Reperfusion Injury. In: Maruyama, Y., Kajiya, F., Hoffman, J.I.E., Spaan, J.A.E. (eds) Recent Advances in Coronary Circulation. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68249-3_27

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  • DOI: https://doi.org/10.1007/978-4-431-68249-3_27

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