The indirect negative inotropic effect of carbachol in beta1-adrenoceptor antagonist-treated human right atria

Cardiac Roles of Serotonin (5-HT) and 5-HT-Receptors in Health and Disease

Serotonin acts solely via 5-HT₄-receptors to control human cardiac contractile function. The effects of serotonin via 5-HT₄-receptors lead to positive inotropic and chronotropic effects, as well as arrhythmias, in the human heart. In addition, 5-HT₄-receptors may play a role in sepsis, ischaemia, and reperfusion. These presumptive effects of 5-HT₄-receptors are the focus of the present review. We also discuss the formation and inactivation of serotonin in the body, namely, in the heart. We identify cardiovascular diseases where serotonin might play a causative or additional role. We address the mechanisms which 5-HT₄-receptors can use for cardiac signal transduction and their possible roles in cardiac diseases. We define areas where further research in this regard should be directed in the future, and identify animal models that might be generated to this end. Finally, we discuss in what regard 5-HT₄-receptor agonists or antagonists might be useful drugs that could enter clinical practice. Serotonin has been the target of many studies for decades; thus, we found it timely to summarise our current knowledge here.

Age-related peculiarities of inotropic response of rat myocardium to selective block of M1-cholinoreceptors

In vitro effect of M1-cholinoreceptor blockade on the cardiac inotropic function was examined in rats aging 1, 3, 6, 8, and 20 weeks. In 1- and 3-week old rat pups, the sympathetic control of the heart has not developed, the age of 7-8 weeks being pubertal. Adult 20-week rats were used as the controls. In rats of all age groups, preliminary blockade of M1-cholinoreceptors did not prevent the inhibitory effect of carbacholine on contractility of the atrial and ventricular myocardium. The inhibitory effect of pirenzepine on the contractile force of ventricular myocardium was revealed in 6-week rats.

Electrophysiological and arrhythmogenic effects of 5-hydroxytryptamine on human atrial cells are reduced in atrial fibrillation

5-Hydroxytryptamine (5-HT) is proarrhythmic in atrial cells from patients in sinus rhythm (SR) via activation of 5-HT₄ receptors, but its effects in atrial cells from patients with atrial fibrillation (AF) are unknown. The whole-cell perforated patch-clamp technique was used to record L-type Ca²⁺ current (I_CaL), action potential duration (APD) and arrhythmic activity at 37 °C in enzymatically isolated atrial cells obtained from patients undergoing cardiac surgery, in SR or with chronic AF. In the AF group, 5-HT (10 μM) produced an increase in I_CaL of 115 ± 21% above control (n = 10 cells, 6 patients) that was significantly smaller than that in the SR group (232 ± 33%; p < 0.05; n = 27 cells, 12 patients). Subsequent co-application of isoproterenol (1 μM) caused a further increase in I_CaL in the AF group (by 256 ± 94%) that was greater than that in the SR group (22 ± 6%; p < 0.05). The APD at 50% repolarisation (APD₅₀) was prolonged by 14 ± 3 ms by 5-HT in the AF group (n = 37 cells, 14 patients). This was less than that in the SR group (27 ± 4 ms; p < 0.05; n = 58 cells, 24 patients). Arrhythmic activity in response to 5-HT was observed in 22% of cells in the SR group, but none was observed in the AF group (p < 0.05). Atrial fibrillation was associated with reduced effects of 5-HT, but not of isoproterenol, on I_CaL in human atrial cells. This reduced effect on I_CaL was associated with a reduced APD₅₀ and arrhythmic activity with 5-HT. Thus, the potentially arrhythmogenic influence of 5-HT may be suppressed in AF-remodelled human atrium.

Autonomic receptor systems in the failing and aging human heart: similarities and differences

Changes in autonomic receptor systems (alpha- and beta-adrenoceptors and muscarinic receptors) were compared in the aging and failing human heart. In both settings responsiveness of beta-adrenoceptors and all other receptor systems that evoke their effects via cyclic AMP accumulation was diminished. Muscarinic receptor function, on the other hand, was decreased in the aging, but unchanged in the failing heart; in contrast, G protein-coupled receptor kinase activity was increased in the failing, but unchanged in the aging heart. alpha-Adrenoceptor function was unchanged or slightly decreased in the failing heart. However, nothing is known on alpha-adrenoceptor changes in the aging heart. These results indicate that in the failing human heart all autonomic receptor systems appear to be altered in the direction to attenuate beta-adrenoceptor responses to sympathetic (over)stimulation while in the aging human heart autonomic receptor systems appear to be altered in a direction that protects the heart against too pronounced reduction in beta-adrenoceptor responsiveness.

Electrophysiological effects of 5-hydroxytryptamine on isolated human atrial myocytes, and the influence of chronic beta-adrenoceptor blockade

5-Hydroxytryptamine (5-HT) has been postulated to play a proarrhythmic role in the human atria via stimulation of 5-HT4 receptors. The aims of this study were to examine the effects of 5-HT on the L-type Ca2+ current (ICaL) action potential duration (APD), the effective refractory period (ERP) and arrhythmic activity in human atrial cells, and to assess the effects of prior treatment with beta-adrenoceptor antagonists. Isolated myocytes, from the right atrial appendage of 27 consenting patients undergoing cardiac surgery who were in sinus rhythm, were studied using the whole-cell perforated patch-clamp technique at 37 degrees C. 5-HT (1 nm-10 microm) caused a concentration-dependent increase in ICaL, which was potentiated in cells from beta-blocked (maximum response to 5-HT, Emax=299+/-12% increase above control) compared to non-beta-blocked patients (Emax=220+/-6%, P<0.05), but with no change in either the potency (log EC50: -7.09+/-0.07 vs -7.26+/-0.06) or Hill coefficient (nH: 1.5+/-0.6 vs 1.5+/-0.3) of the 5-HT concentration-response curve. 5-HT (10 microm) produced a greater increase in the APD at 50% repolarisation (APD50) in cells from beta-blocked patients (of 37+/-10 ms, i.e. 589+/-197%) vs non-beta-blocked patients (of 10+/-4 ms, i.e. 157+/-54%; P<0.05). Both the APD90 and the ERP were unaffected by 5-HT. Arrhythmic activity was observed in response to 5-HT in five of 17 cells (29%) studied from beta-blocked, compared to zero of 16 cells from the non-beta-blocked patients (P<0.05). In summary, the 5-HT-induced increase in calcium current was associated with a prolonged early plateau phase of repolarisation, but not late repolarisation or refractoriness, and the enhancement of these effects by chronic beta-adrenoceptor blockade was associated with arrhythmic potential.