Selective myocyte eNOS overexpression improves the sympathovagal balance of the heart and protects it against excessive beta-adrenegic stimulation, in part through potentiation of vagal inhibition of cardiac contraction and prevention of ectopic contractions. Benefit of eNOS overexpression can further be extended on cardiac stem cells, with a favorable role of eNOS on their transdifferentiation and possibly on their survival through an anti-apopotic effect. Finally, cardioprotective drugs such as statins and insulin precisely increase myocyte eNOS expression. This observation links well-known unexplained pleiotropic effects to a potential powerful mechanism, i.e. an increase of endogenous myocyte eNOS expression and activity. Myocyte eNOS can be considered as an "endogenous b-blocker" for the heart. It is also a key protein in the survival response of the cardiomyocyte, working in conjunction with others (e.g. PKB, insulin ), even able to promote cardiac regeneration. Finally, myocyte eNOS is a common effector of many cardioprotective drugs or even assist device, and its preservation in patients could prevent their evolution to cardiac decompensation.
Massion, P. (2005). Endothelial intric oxide synthase in the cardiomyocyte : modulatory roles on contractility and cell biology. https://hdl.handle.net/2078.5/129678