Cardiac stimulant

A cardiac stimulant is a drug which acts as a stimulant of the heart to increase cardiac output. They can work via positive chronotropic action (increased heart rate) and/or positive inotropic action (increased myocardial contractility).

Within positive inotropes, there are calcium mobilizers and calcium sensitizers.[1][2][3] Calcium mobilizers are conventional positive inotropes that elevate intracellular calcium, whereas calcium sensitizers do not elevated intracellular calcium but instead increase sensitivity to it.[1][2][3]

Cardiac stimulants are known to be used (and banned) as performance-enhancing drugs, including for doping in sport.[4][5]

Examples

Exercise is a cardiac stimulant by increasing levels of the sympathomimetic catecholamines epinephrine and norepinephrine.[9][10]

References

  1. ^ a b Pollesello P, Papp Z, Papp JG (January 2016). "Calcium sensitizers: What have we learned over the last 25 years?". Int J Cardiol. 203: 543–548. doi:10.1016/j.ijcard.2015.10.240. PMID 26580334.
  2. ^ a b Ge Z, Li A, McNamara J, Dos Remedios C, Lal S (September 2019). "Pathogenesis and pathophysiology of heart failure with reduced ejection fraction: translation to human studies". Heart Fail Rev. 24 (5): 743–758. doi:10.1007/s10741-019-09806-0. PMID 31209771.
  3. ^ a b Nagy L, Pollesello P, Papp Z (September 2014). "Inotropes and inodilators for acute heart failure: sarcomere active drugs in focus". J Cardiovasc Pharmacol. 64 (3): 199–208. doi:10.1097/FJC.0000000000000113. PMC 4232335. PMID 24785346.
  4. ^ Docherty JR (June 2008). "Pharmacology of stimulants prohibited by the World Anti-Doping Agency (WADA)". Br J Pharmacol. 154 (3): 606–622. doi:10.1038/bjp.2008.124. PMC 2439527. PMID 18500382.
  5. ^ Docherty JR, Alsufyani HA (August 2021). "Pharmacology of Drugs Used as Stimulants". J Clin Pharmacol. 61 Suppl 2: S53–S69. doi:10.1002/jcph.1918. PMID 34396557.
  6. ^ a b Overgaard CB, Dzavík V (September 2008). "Inotropes and vasopressors: review of physiology and clinical use in cardiovascular disease". Circulation. 118 (10): 1047–56. doi:10.1161/CIRCULATIONAHA.107.728840. PMID 18765387.
  7. ^ a b c Morrill P (January 2000). "Pharmacotherapeutics of positive inotropes". AORN J. 71 (1): 173–8, 181–5, quiz 186–8, 190–2. doi:10.1016/s0001-2092(06)62180-7. PMID 10686650.
  8. ^ a b c d e f g h i Mladěnka P, Applová L, Patočka J, Costa VM, Remiao F, Pourová J, Mladěnka A, Karlíčková J, Jahodář L, Vopršalová M, Varner KJ, Štěrba M (July 2018). "Comprehensive review of cardiovascular toxicity of drugs and related agents". Med Res Rev. 38 (4): 1332–1403. doi:10.1002/med.21476. PMC 6033155. PMID 29315692.
  9. ^ Hackney AC (November 2006). "Stress and the neuroendocrine system: the role of exercise as a stressor and modifier of stress". Expert Rev Endocrinol Metab. 1 (6): 783–792. doi:10.1586/17446651.1.6.783. PMC 2953272. PMID 20948580.
  10. ^ Grosman-Rimon L, Wright E, Sabovich S, Rimon J, Gleitman S, Sudarsky D, Lubovich A, Gabizon I, Lalonde SD, Tsuk S, McDonald MA, Rao V, Gutterman D, Jorde UP, Carasso S, Kachel E (January 2023). "Relationships among norepinephrine levels, exercise capacity, and chronotropic responses in heart failure patients". Heart Fail Rev. 28 (1): 35–45. doi:10.1007/s10741-022-10232-y. PMID 35325323.
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