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This Article Full Text Full Text (PDF) All Versions of this Article: 92/6/973    most recent expphysiol.2006.034314v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Smith, G. Search for Related Content PubMed PubMed Citation Articles by Smith, G. Related Collections Heart/Cardiac Muscle

¹ Institute of Biomedical and Life Sciences² BHF Cardiovascular Centre, University of Glasgow, Glasgow G12 8QQ, UK

Abstract

Heart failure as a result of a myocardial infarction (MI) is a common condition with a poor prognosis. The adaptive changes in the surviving myocardium appear to be insufficient in terms of both mechanical/contractile performance and electrical stability. The modification of the underlying myocardial physiology is complex, varying across the different layers within the wall of the ventricle and within one layer. Two therapeutic strategies are briefly discussed, as outlined here. (i) Enhancing contractility by alteration of the expression of a single protein (e.g. sarco-endoplasmic reticulum Ca²⁺ ATPase, SERCA) could potentially reverse both mechanical and electrical abnormalities. However, experimental data involving the upregulation of SERCA suggest that the therapeutic range of this approach is narrow. (ii) The use of regular exercise training to improve cardiac performance in heart failure. This appears to act by normalizing a number of aspects of myocardial physiology.

(Received 18 May 2007; accepted after revision 14 August 2007; first published online 14 September 2007)
Corresponding author G. Smith: Institute of Biomedical and Life Sciences IBLS, University of Glasgow, Glasgow G12 8QQ, UK. Email: g.smith{at}bio.gla.ac.uk

This is the 2005/2006 G. L. Brown Prize Lecture, which was given by Professor G. L. Smith at the Universities of Bristol, Birmingham, Cardiff, King's College London, University College Cork, Manchester and Dundee.