Biomedical Engineering Reference
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than that of Ca V 1.2 channel. However, Na + -Ca 2 + exchangers can induce a Ca 2 +
influx able to trigger release of Ca 2 + from the sarcoplasmic reticulum [ 446 ].
Furthermore, Na + -Ca 2 + exchangers have limited activity, because the intracellular
Na + concentration decays during depolarization.
In cardiomyocytes, phospholemman 86 regulates Na + -Ca 2 + exchangers NCX1
and Na + -K + ATPases, hence Na + -Ca 2 + -exchange ( i NaCaX )andNa + -K + -pump
( i NaK AT P ) currents. Phosphorylated phospholemman (Ser68) disinhibits Na + -
K + ATPase, but mainly inhibits NCX1 [ 447 ]. Association of phospholemman
with Na + -K + ATPase does not require NCX1 exchanger. Phospholemman is
phosphorylated in response to
β
-adrenergic stimulation. Under stress conditions
with high [Na + ] i ,
β
-adrenergic-induced phosphorylation of phospholemman causes
a reduction in inotropy due to the relief of inhibition of Na + -K + AT P a s e [ 448 ].
5.10.3
Myocardial Calcium Channels
5.10.3.1
Voltage-Gated Calcium Channels
Cardiomyocytes possess 2 classes of voltage-gated Ca 2 + channels: Ca V 1.2 (L-type)
and Ca V 3 (T-type). Although these Ca 2 + channels have similar unitary Ca 2 +
conductances, Ca V 1.2 trigger more efficiently cardiomyocyte contraction. Calcium
influx through Ca V 1.2 produces greater amplitude and faster contractions.
Ca V 1.2a
Channel Ca V 1.2a 87 localizes mainly to junctions between the sarcolemma and
sarcoplasmic reticulum close to ryanodine receptors. Many of the Ca V 1.2 channels
reside in T tubules.
Channel Ca V 1.2 is composed of several types of subunits: a pore-forming
α
1
and auxiliary
β
,
γ
,and
α
2
δ
subunits (
α
2
δ
1-
α
2
δ
4), in addition to channel-resident
1 88 is not necessary to direct the plasmalemmal
Ca V 1.2 density, but boosts its activation and inactivation kinetics.
Channel Ca V 1.2 triggers Ca 2 + -induced Ca 2 + release from the junctional
sarcoplasmic reticulum through Ca V 1.2-coupled ryanodin recptors (Ca V 1.2-RyR
couplon ). A single small cluster of Ca V 1.2 channels provokes a local Ca 2 +
sparklet that activates a small cluster of closely apposed ryanodine receptors on
the sarcoplasmic reticulum membrane to create a Ca 2 + spark . The synchronous
occurrence of multiple Ca 2 + sparks in the entire cardiomyocyte after action potential
arrival causes a massive release of Ca 2 + from the sarcoplasmic reticulum to trigger
contraction.
calmodulin [ 449 ]. Subunit
α
2
δ
86 A.k.a. FXYD domain-containing ion transport regulator-1 (FXYD1).
87 A.k.a. dihydropyridine receptors.
88 Subunit α 2 δ 1 is also synthesized at high levels in vascular smooth myocytes.
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