Received May 18, 2007
Revised June 18, 2007
Accepted after revision August 14, 2007
Heart/Cardiac Muscle [240]
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GL Brown Prize Lecture
Matters of the Heart: The Physiology of Cardiac Function
and Failure
Godfrey L Smith 1*
1 University of Glasgow
* To whom correspondence should be addressed. E-mail: g.smith{at}bio.gla.ac.uk.
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Abstract |
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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: (i) enhancing contractility by alteration of the expression of a single protein (e.g. SERCA) could potentially reverse both mechanical and electrical abnormalities. But 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 normalising a number of aspects of myocardial physiology.
Key Words:
Cardiac arrhythmia, Contraction, Myocardium
