Title:Endogenous Cardiotonics: Search and Problems
Volume: 21
Issue: 2
Author(s): Arkady R. Kolpakov and Roman A. Knyazev *
Affiliation:
- Institute of Biochemistry of Federal Research Center for Fundamental and Translational Medicine, Novosibirsk,Russian Federation
Keywords:
Cardiac failure, inotropic preparations, endogenous cardiotonic compounds, digoxin, serum lipoproteins,
apoprotein A-1.
Abstract: Medicinal preparations currently used for the treatment of patients with chronic cardiac
failure involve those that reduce the heart load (vasodilators, diuretics, beta-blockers, and angiotensin-
converting enzyme (ACE) inhibitors). Cardiotonic drugs with the cAMP-dependent
mechanism are unsuitable for long-term administration due to the intensification of metabolic processes
and an increase in the oxygen demand of the myocardium and all tissues of the body. For
many years, digoxin has remained the only preparation enhancing the efficiency of myocardial performance.
The detection of digoxin and ouabain in intact animals has initiated a search for other
compounds with cardiotonic activity. The review summarizes current data on the effect exerted on
the heart performance by endogenous compounds, from simple, such as NO and CO, to steroids,
fatty acids, polypeptides, and proteins. Controversial questions and problems with the introduction
of scientific achievements into clinical practice are discussed. The results obtained by the authors
and their colleagues after many years of studies on the cardiotropic properties of serum lipoproteins
are also reported. The experimentally established cardiotonic activity of apoprotein A-1,
which is accompanied by a decrease in the relative consumption of oxygen, maybe of great interest.
