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Electrical and Biochemical aspects of cardiac physiology

Electrical and Biochemical aspects of cardiac physiology. Overview. Electrical aspects of cardiac physiology Biochemical aspects of cardiac physiology Other Bio-electrical aspects of cardiac physiology Tightly integrated. Electrical aspects of cardiac physiology. Anatomy Action potential

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Electrical and Biochemical aspects of cardiac physiology

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  1. Electrical and Biochemical aspects of cardiac physiology

  2. Overview • Electrical aspects of cardiac physiology • Biochemical aspects of cardiac physiology • Other Bio-electrical aspects of cardiac physiology • Tightly integrated

  3. Electrical aspects of cardiac physiology • Anatomy • Action potential • Travel in conduction system • Ion channels • Receptors

  4. Biochemical aspects of cardiac physiology • Structural • Metabolic • Contractile • Endothelial

  5. Other Bio-electrical aspects of cardiac physiology • ANP • Cardioplegia • Hibernating myocardium • Stunned myocardium • Digoxin • GIK • Rigor mortis

  6. Electrical aspects of cardiac physiology

  7. Electrical Anatomy

  8. Travel in the conduction system

  9. Action potential of pacemaker tissue

  10. Action Potential Of Myocyte O Depolarisation 1 Rapid repolarisation 2 Plateau 3 Late repolarisation 4 baseline

  11. Effect of sympathetic or parasympathetic stimulation

  12. Nerve endings on the heart

  13. Electrical Mechanical Association ARP vs RRP & Vulnerable Point or R on T

  14. Receptors • Sympathetic • Beta 1 • alpha • Para sympathetic • Muscurinic • Atria and ventricles • Dopamine • Adenosine • Ischaemic conditioning

  15. Beta receptor 7 trans membrane family of receptors

  16. STIM Enoximone Catalytic regulatory aspects of cAMP

  17. cAMP pathway

  18. IP3 pathway

  19. Noradrenergic neuron

  20. Ion channels • Na+ • K+ • Ca2+ at least 2 types • T transient - depolarisation • L long acting – less voltage dependent • H+ • Exchange channels Na+ -K + • Exchange channels Na+ -Ca2+

  21. Cardiac ion channels 1 2 3 4

  22. Ca2+ antagonists • Calcium entry blockers NOT direct calcium antagonists

  23. Biochemical aspects of cardiac physiology • Structural • Metabolic • Contractile • Endothelial

  24. Heart structure Discs Nucleus Cytoplasm Membrane Connective tissue

  25. Metabolic • Glycolysis • Pyruvate • TCA • Fat - the main source of cardiac energy • Lactate or Cori cycle • ATP • Adrenaline • Q10

  26. Carbohydrate metabolism

  27. Glycolysis

  28. Glucose transport • GLUT 1 to 4 • 1 and 4 on heart • 4 on heart - insulin sensitive • ?GIK mechanism

  29. Fate Of Pyruvate

  30. TCA

  31. Fat metabolism

  32. Lactate metabolism Cori cycle

  33. Sources of ATP

  34. Hormonal milieu • Glucose metabolism affected by • Catecholamines • Insulin • Glucagon • Thyroid hormones • Acetylcholine • Bradykinin • TNF

  35. Adrenaline Inotropic Chronotropic Metabolic

  36. Glycogen phosphorylase and adrenaline

  37. Glycogen synthetase and adrenaline

  38. Regulation of glycogen

  39. Glycogen importance • Conflicting views • Glycogen depletion • Increased deposition • Increased utilisation • Decreased utilisation • May be important in preconditioning and ischaemia reperfusion • Poullis point • ? Importance of pre operative starvation

  40. Q10 100% Metabolic Rate 50% 10oC Temp

  41. Metabolic cardiac disease • McArdles

  42. Contraction

  43. Muscle structure

  44. Contractile assembly 1 light chains

  45. Contractile assembly 2 heavy chains

  46. Actin myosin ATP

  47. Contraction movement

  48. Sarcoplasmic reticulum Sarcoplasmic reticulum Troponin C Ca 2+ Mobilisation for contraction

  49. Frank Starling

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