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European Heart Journal 1995 16(Supplement C):20-23; doi:10.1093/eurheartj/16.suppl_C.20
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

Myocardial phenotypic changes in Na+, K+ATPase in left ventricular hypertrophy: pharmacological consequences

D. Charlemagne and B. Swynghedauw

U127-INSERM, Hopital Lariboisieère Paris, France

Correspondence: B. Swynghedauw, U127-INSERM, Hopital Lariboisieère, 41 Bd de la Chapelle, 75010, Paris France

Cardiac adaptation to permanent overload induces several phenotypic changes which finally result in a system which works more economically, together with a slower Vmax. The molecular target of digitalis is the NA+, K+ ATPase, which is a polymorphic molecule. We have recently demonstrated that during cardiac hypertrophy this target is modified and that a shift occurs in the {alpha}1 subunit, from the normally present {alpha}2 isosubunit to {alpha}3, which is a fetal isoform with a lower affinity for sodium and a higher affinity for ouabain. Such a shift explains why, in rat cardiac hypertrophy ouabain is less toxic than normal and is released from its target more slowly. It may also explain at least in part the discrepancies observed in clinical trials on the efficacy of digitalis

Key Words: Na+ pump • cardiac hypertrophy • glycoside therapy • digitalis


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