The classical cannabinoid receptors CB1 and CB2 as well as the cannabinoid-sensitive receptor GPR55 are widely distributed throughout the mammalian body. In the cardiovascular field, CB1 and CB2 crucially impact on diseases characterized by inflammatory processes, such as atherosclerosis and acute myocardial infarction. Both receptors and their endogenous ligands anandamide and 2-arachidonoylglycerol are up-regulated in the ischaemic heart in humans and animal models. Pharmacological and genetic interventions with CB1 and CB2 vitally affect acute ischaemia-induced cardiac inflammation. Herein, CB1 rather aggravates the inflammatory response whereas CB2 mitigates inflammation via directly affecting immune cell attraction, macrophage polarization and lymphocyte clusters in the pericardial adipose tissue. Furthermore, cannabinoids and their receptors affect numerous cardiac risk factors. In this context, cannabis consumption is debated to trigger arrhythmias and even myocardial infarction. Moreover, CB1 activation is linked to impaired lipid and glucose metabolism and therefore obesity and diabetes, while its antagonism leads to the reduction of plasma triglycerides, low-density lipoprotein cholesterol, leptin, insulin and glucose. On the other hand, activation of cannabinoid-sensitive receptors can also counteract unfavourable predictors for cardiovascular diseases. In particular, hypertension can be mitigated via CB1 agonism and impaired adrenoceptor responsiveness prevented by functional GPR55. Taken together, current insights identify the cannabinoid system as promising target not only to therapeutically interfere with the vasculature, but also to affect the heart as target organ. This review discusses current knowledge regarding a direct cardiac role of the cannabinoid system and points out its feasible therapeutic manipulation in the ischaemic myocardium.

中文翻译：

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大麻素敏感性受体在心脏生理和局部缺血中的作用。

经典的大麻素受体CB1和CB2以及对大麻素敏感的受体GPR55广泛分布于整个哺乳动物体内。在心血管领域，CB1和CB2对以炎症过程为特征的疾病（如动脉粥样硬化和急性心肌梗塞）至关重要。在人类和动物模型的缺血性心脏中，受体及其内源性配体金刚烷酰胺和2-花生四烯酰甘油均被上调。用CB1和CB2进行药理和遗传干预会严重影响急性缺血引起的心脏炎症。在本文中，CB1会加重炎症反应，而CB2通过直接影响心包脂肪组织中的免疫细胞吸引力，巨噬细胞极化和淋巴细胞簇来减轻炎症。此外，大麻素及其受体会影响许多心脏危险因素。在这种情况下，人们争论食用大麻会引发心律不齐，甚至引发心肌梗塞。此外，CB1激活与脂质和葡萄糖代谢受损有关，因此与肥胖症和糖尿病有关，而CB1的拮抗作用则导致血浆甘油三酸酯，低密度脂蛋白胆固醇，瘦素，胰岛素和葡萄糖的减少。另一方面，大麻素敏感受体的激活也可以抵消心血管疾病的不利预测因素。特别是，高血压可通过CB1激动作用减轻，并且功能性GPR55可防止肾上腺素受体反应性降低。综上所述，目前的见解将大麻素系统确定为有前途的目标，不仅可以治疗性地干扰脉管系统，而且也以心脏为靶器官。这篇综述讨论了有关大麻素系统的直接心脏作用的当前知识，并指出了其在缺血性心肌中的可行治疗操作。