Cellular basis for age-related differences in cardiac excitation-contraction coupling

Clinical experience indicates that infants and young children respond to a variety of cardiovascular pharmacological and physiological interventions d ifferently than adults. What is less clear, however, are the cellular and m olecular mechanisms that contribute to these age-related differences. Based largely upon results from animal models, it is apparent that developmental changes occur in numerous pathways and proteins involved in the regulation of contractile function and in the determinants of inotropic responsivenes s. The purposes of this review are to provide a brief overview of cardiac e xcitation-contraction and to illustrate some of the important age-related d ifferences in the mechanisms involved in calcium regulation in the heart. T his scientific foundation may help to explain certain clinical observations in the very young. Furthermore, it is hoped that a better understanding of the Fundamental processes involved in controlling cardiac contractile func tion will stimulate additional research in the search for more specific, ra tional and age-appropriate cardiovascular therapeutics. (C) 2000 Elsevier S cience Ireland Ltd. All rights reserved.