Drugs that interact with cardiac electro-mechanics: old and new targets for treatment

Prog Biophys Mol Biol. 2008 Jun-Jul;97(2-3):497-512. doi: 10.1016/j.pbiomolbio.2008.02.003. Epub 2008 Feb 12.

Abstract

The concept of mechano-electrical feedback was derived from the observation that a short stretch applied to the beating heart can invoke an electrical response in the form of an afterdepolarization or a premature ventricular beat. More recent work has identified stretch-activated channels whose specific inhibition might help to treat atrial fibrillation in the near future. But the interaction between electrical and mechanical function of the heart is a continuum from short-term (within milliseconds) to long-term (within weeks or months) effects. The long-term effects of pressure overload have been well-described on the molecular and cellular level, and substances that interact with these processes are used in clinical routine in the care of patients with cardiac hypertrophy and heart failure. These treatments help to prevent lethal arrhythmias (sudden death) and potentially atrial fibrillation. The intermediate interaction between mechanical and electrical function of the heart is less well-understood. Several recently identified regulatory mechanisms may provide novel antiarrhythmic targets associated with the "intermediate" response of the myocardium to stretch.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Arrhythmia Agents / pharmacology*
  • Anti-Arrhythmia Agents / therapeutic use
  • Aortic Valve Stenosis / drug therapy
  • Aortic Valve Stenosis / physiopathology
  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / metabolism
  • Atrial Fibrillation / physiopathology
  • Calcium / physiology
  • Cardiomegaly / drug therapy
  • Cardiomegaly / physiopathology
  • Heart Conduction System / drug effects
  • Humans
  • Mechanotransduction, Cellular
  • Mice
  • Mitral Valve Stenosis / drug therapy
  • Mitral Valve Stenosis / physiopathology
  • Myocardial Contraction / drug effects
  • Myocardial Contraction / physiology*
  • Sodium / metabolism*
  • Ventricular Fibrillation / drug therapy
  • Ventricular Fibrillation / physiopathology

Substances

  • Anti-Arrhythmia Agents
  • Sodium
  • Calcium