Title:Cannabinoids and Myocardial Ischemia: Novel insights, Updated
Mechanisms, and Implications for Myocardial Infarction
Volume: 29
Issue: 11
关键词:
大麻，心肌梗死，内源性大麻素系统，动脉粥样硬化，四氢大麻酚，心血管疾病。
摘要: Cannabis is the most widely trafficked and abused illicit drug due to its calming
psychoactive properties. It has been increasingly recognized as having potential
health benefits and relatively less adverse health effects as compared to other illicit
drugs; however, growing evidence clearly indicates that cannabis is associated with considerable
adverse cardiovascular events. Recent studies have linked cannabis use to myocardial
infarction (MI); yet, very little is known about the underlying mechanisms. A MI
is a cardiovascular disease characterized by a mismatch in the oxygen supply and demand
of the heart, resulting in ischemia and subsequent necrosis of the myocardium.
Since cannabis is increasingly being considered a risk factor for MI, there is a growing
need for better appreciating its potential health benefits and consequences. Here, we discuss
the cellular mechanisms of cannabis that lead to an increased risk of MI. We provide
a thorough and critical analysis of cannabinoids’ actions, which include modulation
of adipocyte biology, regional fat distribution, and atherosclerosis, as well as precipitation
of hemodynamic stressors relevant in the setting of a MI. By critically dissecting the
modulation of signaling pathways in multiple cell types, this paper highlights the mechanisms
through which cannabis may trigger life-threatening cardiovascular events. This
then provides a framework for future pharmacological studies which can identify targets
or develop drugs that modulate cannabis’ effects on the cardiovascular system as well as
other organ systems. Cannabis’ impact on the autonomic outflow, vascular smooth muscle
cells, myocardium, cortisol levels and other hemodynamic changes are also mechanistically
reviewed.
