Neuronal control and neuroeffector transmission to regulate cardiac functions

Major advances have been made that make it necessary to revise our thinking about the mechanisms of neuronal control to regulate cardiac functions, and that have implications for our understanding of cardiac diseases and their treatment. These advances include: function-specific pathways, co-transmitters, neuromodulators, sensory-efferent functions, changes in expression of autonomic nerves, neuroeffector junctions, and subtypes of neurotransmitter receptors. Studies of the molecular structure of the superfamily of the cation amine receptors have revealed that there might be a common ancestral G-protein coupled receptor to be derived from. Although noradrenaline effectively stimulates alpha 1- and alpha 2-adrenoceptors, they are completely different as a beta-adrenoceptors subfamily. The possible subtypes of beta 1-adrenoceptors are discussed in relation with the treatment of cardiac failure.