4. Electrical and molecular events in the CVS Flashcards
Describe how the resting membrane potential is set up in myocytes.
Mainly due to permeability to K+ ions:
- small movement of K+ ions out of the cell down their concentration gradient (inside of cell more negative than outside)
- charge movement out of cell causes an electrical gradient (wants to move K+ back into cell)
- net outflow of K+ until Ek is reached - no net movement as electrical and chemical gradients are equal and opposite
But resting MP (approx -85mV) not completely equal to Ek (-95 mV) due to very small permeability to other ion species.
Describe the extra- and intracellular ion concentrations for myocytes at rest.
Extracellular Intracellular
Na+ 140 10
K+ 4 140
Ca2+ 1.2 0.0001
Cl- 120 30
What is the major difference between action potentials in heart cells and in neurons/skeletal muscle?
Length of depolarisation:
- 0.5 ms in neurons/skeletal muscle
- 100 ms in caridac muscle
How long is the cardiac AP? Why does this happen and why is this important?
- About 280 ms, because of the plateau sustained by the opening of voltage-gated Ca2+ channels.
- Length ensures that:
- once the AP has begun in any part of the heart, the cell will be depolarised when the last cell in the myocardium starts its AP
- muscular contraction in systole is sustained for 200-300 ms (duration is essential for normal pumping activity of the heart)
Describe the phases of the ventricular (cardiac) action potential.
0 : depolarisation (-85mV to 25mV)
- depolarisation to threshold… opening of voltage-gated Na+ channels… Na+ influx
1 : slight repolarisation (25mV to 5mV)
- transient outward K+ current
2 : plateau (5mV to -1mV)
- opening of voltage-gated Ca2+ channels… Ca2+ influx
- some K+ channels also open… small K+ efflux (balance to maintain plateau)
3 : repolarisation (-1mV to -85mV)
- Ca2+ channels inactivate
- voltage-gated K+ channels open… K+ efflux
4 : resting MP
What type of calcium channels are responsible for calcium influx in the plateau phase?
voltage-gated (L-type)
Describe the process of SA node action potentials.
- Pacemaker potential (=long slow depolarisation to threshold, -60 mV to ~-40 mV)
- involves “funny current” - Na+ influx through slow HCN channels - Depolarisation (-40 mV to 20 mV)
- opening of voltage-gated Ca2+ channels… Ca2+ influx - Repolarisation (20 mV to -60 mV)
- opening of voltage-gated K+ channels… K+ efflux
*no proper resting potential in SA node
What is the pacemaker potential? How is it generated?
- Is the initial slope to threshold (funny current)
- Activated at MPs that are more negative than -50mV. The more negatived, the more it activates.
- Generated by the influx of Na+ (depolarises the cell) through HCN channels
What are HCN channels?
- Hyperpolarisation-activated Cyclic Nucleotide-gated channels
- Allow influx of Na+ ions
- Opened by binding of cAMP/GMP (so regulated by the ANS)
What are the differences between APs at pacemaker cells and ventricular myocytes?
Cardiac myocyte AP:
- Initiated by conduction of excitation from neighbouring cell
- Stable resting MP (-85mV) in diastole. No pacemaker potential
- Have fast voltage-gated Na+ channels but no HCN channels
- Depolarisation caused by fast voltage-gated Na+ channels
- Have a plateau phase - sustained opening of Ca2+ channels
- Has a resting MP (diastole)
Pacemaker cell AP:
- Initiated by cell itself
- Unstable resting MP - slow initial depolarisation from -60mV (most neg value) = pacemaker potential
- Have HCN channels but no fast voltage-gated Na+ channels
- Depolarisation caused by voltage-gated Ca2+ channels
- No plateau phase - opening of Ca2+ channels not sustained
- No resting MP
How does the AP spread from the SA node to the rest of the heart?
Via gap junctions between myocytes.
- From SA node to AV node.
- Delay at AV node to allow atrial contraction before ventricular contraction.
- Down Bundle of His and into left and right bundle branches
Why are the SA node cells the pacemakers? Under which conditions would they not set the rhythm?
- Other parts of the conducting system also have automaticity, e.g.AV node, Purkinje fibres. But natural contraction rate is much slower.
- If there is a conduction block between SA node and rest of cell, other parts of conduction system can be important in setting rhythm.
What is wrong with the APs during: bradycardia, asystole, tachycardia and fibrillation?
Bradycardia: APs fire too slowly
Asystole: APs fail
Tachycardia: APs fire too quickly
Fibrillation: electrical activity becomes random
How does an AP lead to myocyte contraction?
- Depolarisation opens L-type Ca2+ channels in T-tubule system.
- Small Ca2+ influx (25%) stimulates opening of ryanodine receptors in SR and Ca2+ release from SR (75%) (= calcium-induced calcium release).
- Ca2+ binds to troponin C… shifts tropomyosin to reveal myosin binding site on actin filament.
- Etc of sliding filament mechanism,
How is relaxation of cardiac myocytes achieved?
Returning [Ca2+]i to resting levels:
- most is pumped back into SR via SERCA (stimulated by raised [Ca2+]i)
- some exits across cell membrane via sarcolemmal Ca2+ ATPase and Na+/Ca2+ exchanger