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EL PAPEL DEL RECEPTOR Β3 ADRENERGICO EN LA FISIOPATOLOGIA DE LA INSUFICIENCIA CARDIACA

(especial para SIIC © Derechos reservados)
El receptor adrenérgico β3 aparenta ser el responsable del efecto inotrópico negativo en los ventrículos de pacientes con insuficiencia cardíaca. Este efecto a largo plazo podría empeorar la disfunción miocárdica.
moniotte9.jpg Autor:
Moniotte, stephane
Columnista Experto de SIIC

Institución:
Department of Cardiology The Children's Hospital Boston, MA, USA

Artículos publicados por Moniotte, stephane
Recepción del artículo
12 de Mayo, 2004 		Aprobación
24 de Agosto, 2004
Primera edición
13 de Abril, 2005 		Segunda edición, ampliada y corregida
7 de Junio, 2021

EL PAPEL DEL RECEPTOR Β3 ADRENERGICO EN LA FISIOPATOLOGIA DE LA INSUFICIENCIA CARDIACA

Resumen
La identificación del gen que codifica el receptor adrenérgico β3 ayudó a interpretar los resultados de experimentos farmacológicos en los que se identificaron efectos atípicos de las catecolaminas diferentes de los observados luego de la activación de los receptores adrenérgicos β1 y β2. En los roedores, el receptor adrenérgico β3 se expresa en el tejido adiposo general y en la grasa parda. El tratamiento de estos animales con agonistas del receptor adrenérgico β3 induce la pérdida de peso secundaria a la estimulación de la lipólisis en ambos tejidos. Sin embargo, el escaso efecto lipolítico sobre el tejido adiposo humano y el descubrimiento reciente de los receptores adrenérgicos β3 en el corazón generan nuevas preguntas acerca del uso de estos agonistas en el hombre. En el ventrículo de los seres humanos, estos agonistas desencadenan un efecto inotrópico negativo. Como este efecto se conserva en el corazón con insuficiencia cardíaca podría explicar el papel que desempeña el aumento del estímulo adrenérgico asociado con la insuficiencia cardíaca, como también el tratamiento de esta condición con bloqueantes de los receptores betadrenérgicos. Esta revisión resume los efectos y la justificación del bloqueo betadrenérgico en la insuficiencia cardíaca crónica y principalmente trata de responder a la pregunta acerca del uso potencial de antagonistas de los receptores β3 en el tratamiento de esta insuficiencia.

Palabras clave
Receptores, adrenérgico, catecolaminas, contractilidad, insuficiencia cardíaca


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ROLE OF THE CARDIAC β3-ADRENOCEPTOR IN THE PATHOPHYSIOLOGY OF HEART FAILURE

Abstract
The characterization of the gene encoding the β3-adrenoceptor helped to interpret the results of pharmacological experiments on atypical effects of catecholamines distinct from the classical activation of β1 and β2 adrenoceptors. In rodents, the β3 adrenoceptor is abundantly expressed in white adipose tissue as well as in brown adipose tissue. Treatment of rodents with β3 adrenoceptor agonists induces a weight loss related to the stimulation of lipolysis in these two tissues. However, their poor lipolytic effect in human adipose tissue and the recent discovery of functional β3 adrenoceptors in the human heart raise new questions on the use of agonists in man. In the human ventricle, these agonists induce a negative inotropic effect. As this effect is conserved in the failing heart, it could shed a new light on the pathogenic role of the hyperadrenergism associated with cardiac failure, as well as on its treatment with beta-adrenoceptor blockers. This review summarizes the rationale and effects of beta-adrenergic blockade in chronic heart failure and specifically addresses the question of the potential use of β3-adrenoceptor antagonists in the treatment of heart failure and other pathophysiological conditions associated with a decreased cardiac contractility.

Key words
Receptors, adrenergic, catecholamines, contractility, heart failure, sepsis


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Especialidades
Principal: Cardiología
Relacionadas: Farmacología, Geriatría, Medicina Farmacéutica, Medicina Interna



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Bibliografía del artículo
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