ebook img

Cardiac Cellular Electrophysiology PDF

424 Pages·2002·17.186 MB·English
Save to my drive
Quick download
Download
Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.

Preview Cardiac Cellular Electrophysiology

CARDIAC CELLULAR ELECTROPHYSIOLOGY BASIC SCIENCE FOR THE CARDIOLOGIST 1. B. Swyngbedauw (ed.): Molecular Cardiology for the Cardiologist. Second Edition. 1998 ISBN: 0-7923-8323-0 2. B. Levy, A. Tedgui (eds.): Biology of the Arterial Wall. 1999 ISBN 0-7923-8458-X 3. M.R. Sanders, J.B. Kostis (eds): Molecular Cardiology in Clinical Practice. 1999. ISBN 0-7923-8602-7 4. B. Ostadal, F. Kolar (eds.): Cardiac Ischemia: From Injury to Protection. 1999 ISBN 0-7923-8642-6 5. H. Scbunkert, G.A.I. Riegger (eds.): Apoptosis in Cardiac Biology. 1999 ISBN 0-7923-8648-5 6. A. Malliani, (ed.): Principles of Cardiovascular Neural Regulation in Health and Disease. 2000 ISBN 0-7923-7775-3 7. P. Benlian : Genetics of Dyslipidemia. 200 1 ISBN 0-7923-7362-6 8. D. Young: Role of Potassium in Preventive Cardiovascular Medicine. 2001 ISBN 0-7923-7376-6 9. E. Carmeliet, J. Vereecke : Cardiac Cellular Electrophysiology. 2002 ISBN 0-7923-7544-0 KLUWER ACADEMIC PUBLISHERS - DORDRECHT/BOSTON/LONDON CARDIAC CELLULAR ELECTROPHYSIOLOGY by Edward Carmeliet and Johan Vereecke Department ofP hysiology K. UL. University Leuven Belgium SPRINGER SCIENCE+BUSINESS MEDIA, LLC Library of Congress Cataloging-in-Publication Data ISBN 978-1-4613-5692-9 ISBN 978-1-4615-1715-3 (eBook) DOI 10.1007/978-1-4615-1715-3 Copyright © 2002 by Springer Science+Business Media New York Originally published by Kluwer Academic Publishers in 2002 Softcover reprint ofthe hardcover Ist edition 2002 Ali rights reserved. No part ofthis publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise, without the prior written permis sion of the publisher, Springer Science+Business Media, LLC. Printed on acid-free pap er. The Publisher offers discounts on this book for bulk purchases. For further information, send email to[[email protected]} Dedicated to Prof. Silvio Weidmann and in memory of Prof. Edouard Coraboeuf Contents Acknowledgements Preface General description of electrical activity Ionic basis of resting and action potential 7 Excitability, pacemaking and conduction 67 Ionic currents and action potentials in cardiac cells 95 Modulation of electrical activity 179 Electrophysiological basis of the electrocardiogram 229 Acute ischaemia 253 Arrhythmias 279 Remodeling 307 References 331 Abbreviations 407 Index 411 Acknowledgements For copyright permission to reproduce figures we should like to thank the following publishers or societies: Acad Press: IV. 13, IV.l7, IV.29, IV.3I, IV.32, V.24, V.28, V.29. Am Physiol Soc: 1.4, IV.5, IV.6, IV.9, IV.12, IV.20, IV.24, V.S, V.18, V.20, V.26, V.30, V.32, VII.20, VII.22. Am Soc Clin Invest: V.33. Am Soc Pharmacol Exp Ther: IV.I4. Brit Med J Pub Co: V.2. Cambridge University Press, The Physiological Society: 11.16, IV.I, IV.3, IV.4, IV.7, IV.9, IV.10, IV.lS, IV.I9, IV.23, IV.27, IV.28, IV.30, IV.38, IV.39, V.3, V.IO, V.I2, VIII.lS. Can Cardiovasc Soc: VII.6. Ed. J.B. Bailliere: VIII.I7. Elsevier: 1.3, VII.I2, VII.IS, VII.I7, IX.6, IXI6, IX.I7. Futura Publ Co Inc: V.7, VII.14, IX. to, IX.I2. Harwood Acad Publ: IV.l7, IV.37. Kluwer Acad Publ: V.9, V.14. Lippincott Williams & Wilkins: Circ Res: 11.31, III.8, IV.9, IV.Il, IV.l6, IV.22, IV.2S, IV.33, V.IS, V.l6, V.2I, V.2S, VI.7, VII.I, VII.5, VII.8, VII.9, VII.I3, VII. 15, VII.l6, VII. 19, VIII.2, VIII.3, VIII.S, VIII.8, VIII.9, VIII 16, VIII.I8, VIII.20, VIII.2I, IX.2, IX.3, IX.4, IX.8, IX.II, IX.13, IX.I4. Circulation: VI.8, VI.9, VII.7, VII.lO, VIII.6, VIII.lO, VIII.lI, VIII.I2, VIII. 19, lXI, IX.5, IX.7, IX.9, IX.I8. J Cardiovasc Pharmacol: V.27, Nat Acad Sci USA: IV.26. Nature Publ Group, Nature 11.26: IV. I. Nature Pub I Group, British Journal of Pharmacology: V.3I. Raven Press: V.4. Rockefeller University Press, The Journal of General Physiology: 11.16, IV.4, IV.2I, V.6. Sinauer Ass: 11.29, 11.30. Springer Verlag: Pfliigers Archiv: IV.12, IV.14, IV.26, IV.38, VIII. I. Basic Res Cardiolol: V.5. Preface This book on "Cardiac Cellular Electrophysiology" appears in a series of "Basic Science for the Cardiologist". However in addition for use by clinicians needing a more thorough understanding of the electro physiological basis of heart function, this book is also intended for a wider public, undergraduate students and medical students interested in the basis of the electrical activity of the heart, graduate students, research workers, pharmacologists, teachers in physiology, pharmacology and other biomedical sciences. Our goal in writing the book was twofold. Our first aim was to give a primer on basic electrophysiology, the cardiac action potential and the physiological basis of the electrocardiogram. For many non electrophysiologists, original papers in cellular electrophysiology are often difficult to read. We wanted to provide the necessary background and to convince the readers that cellular electrophysiology is not so difficult to grasp after all. It was our intention to make these parts accessible to a wide audience. Our second aim, after having introduced the basic concepts, was to continue with giving an overview of the properties of the most important ionic currents in the heart, and to treat their modulation, in order to deal with the mechanisms underlying cardiac ischaemia, arrhythmias and remodeling. A huge literature exists about cardiac electrophysiology. With the invention of the patch clamp technique by Neher and Sakmann in 1981, the field exploded, and with the more recent application of molecular biology to the study of ion channels, a large literature exists about the functioning of channels at the molecular and single channel level. However throughout the book our emphasis is on function rather than on channel biophysics, molecular biology or structure -function relations. Therefore our emphasis is much more on whole cell currents and their relation to cardiac electrical activity than on single channel studies. Chapter I contains a brief general description of the electrical activity in the heart. It defines the different phases of the action potential and their variation in different parts of the heart. Chapter II provides the ionic mechanisms underlying resting and action potential. After introducing some general principles of electric circuit theory Preface and applying these principles to the movement of ions across cell membranes, in a second section it briefly describes the electrophysiological techniques used to study electrical properties at the protein, the cellular, the multicellular and the organ level, emphasising cellular electrophysiological methods. In the third section a brief overview is first given of the major types of membrane transport processes, distinguishing primary active, secondary active and passive processes, and making the distinction between channels and carriers. This is followed with the principles of description and analysis of ion channel properties, discussing ion permeation, channel gating, regulation and block, channel molecular structure and distribution. The initiation and the propagation of the action potential is the subject of Chapter III. This chapter describes the concept and mechanisms of excitability and automaticity, and the basic mechanism underlying normal and abnormal conduction. It starts with the concept of threshold and the factors modulating excitability. Next it treats automaticity and the main determinants of 'the initiation of the heart beat'. In the last section it gives an introduction to one-dimensional cable theory and its application to propagation of the action potential. It describes the concepts of electrotonic potential, source - sink, short-circuit current and liminal length, conduction velocity and safety factor. It then deals with the complications introduced by the three-dimensional structure of the heart and provides some background information on discontinuous propagation, anisotropy, unidirectional propagation, to lay a basis for understanding reentrant arrhythmias. Chapter IV first describes the properties of the most important ionic currents contributing to the electrical activity of the heart. The emphasis is on currents that have been identified in human cardiac cells, or that appear to be generally present in mammalian hearts. As such this chapter is somewhat encyclopaedic, and reading of the properties of some of the transport mechanisms may eventually be postponed until needed to understand some topic treated in later chapters, especially since not all transport processes have (yet) been identified in human cardiac cells. In the last section of this chapter the action potential morphology in different cardiac cells is explained in terms of the different ion transport mechanisms, as described in the previous sections. Chapter V deals with the modulation of the electrical activity by rate, by the autonomic nervous system, by humoral, autocrine and paracrine factors and by the hormonal state. It also treats the effects of drugs, and discusses the problems related to antiarrhythmic treatment and possible future approaches. Chapter VI handles the electrophysiological basis of the electro cardiogram and the normal electrocardiographic waves. It also briefly deals with abnormalities of ST segment, T wave and U wave. This chapter also Preface includes the dispersion of action potential duration and its influence on the electrocardiogram. Chapter VII successively treats acute ischaemia and reperfusion. Following a description of the biochemical alterations upon acute interruption of the coronary circulation, a detailed analysis is presented of the changes in resting and action potential, excitability and conduction, and the mechanisms involved. The second section treats the biochemical and electrophysiological changes occurring upon reperfusion, distinguishing between reversible and irreversible phases. Chapter VIII deals with arrhythmias. In a first part an analysis is presented of the basic mechanisms, including automatism, triggered activity and reentry. Emphasis is given to recent developments, such as anisotropic reentry and spiral wave activity. In a second part we provide a description of the origin and type of arrhythmias occurring under specific conditions. We discuss arrhythmias during acute ischaemia and reperfusion, and arrhythmias at a later stage of the infarct when remodeling becomes important. We also deal with atrial fibrillation, congenital and acquired long QT syndromes, the Brugada syndrome, and arrhythmias accompanying hypertrophy and heart failure. The final chapter in the book, Chapter IX, provides an analysis of electrical remodeling processes that develop during certain patho physiological conditions such as hypertrophy and heart failure, atrial fibrillation, and myocardial infarction. In contrast to short-term changes described in Chapter V on Modulation, these processes include mid-term and long-term alterations of the function and structure of ionic channels, receptors and signaling pathways. Similar long-term physiological adaptations occur during preconditioning and artificial pacing. It is considered that a better knowledge of the mechanisms underlying remodeling may offer new therapeutical approaches. We want to express our sincere and warm thanks to Mrs Lies Vereecke Peeters, the wife of one of the authors, for her skilful work in making the numerous original figures and schemes and in adapting published figures and, in this way, fulfilling the wishes and dreams of the authors. We want to dedicate the book to Prof. Silvio Weidmann and to the late Prof. Edouard Coraboeuf, founding fathers of cardiac cellular electro physiology. In 1949, they were the first to register cardiac action potentials with microelectrodes during their stay in Prof. Alan Hodgkin's laboratory. Edward Carmeliet Johan Vereecke

See more

The list of books you might like

Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.