Heart failure - Electrical remodelling in heart failure
15 important questions on Heart failure - Electrical remodelling in heart failure
What is the effect of fibrosis of the heart?
How do cardiac cells transmit signals?
The gap junctions (connexions) and ion channels are affected in heart failure
What is necessary to generate and conduct the electrical signal through the heart?
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What is the order in cardiac conduction?
2. Conducted throught the atria
3. Arrives at AV node (delayed)
4. Bundle of His
5. Left and right bundle branch
6. Purkinje fibers
Which ion channels are involved in AP generation in the heart?
ligand-gated channels (extracellular and intracellular)
Mechanically gated
What happens to the anisotropic progagation in heart failure
Which ion channels are active during the different phases of AP in the heart?
phase 0 = rapid Na+ influx through the fast opening Na channels
phase 1 = transient K+ channels open and potential decreases (first repolarization)
phase 2 = influx of Ca2+ through L type calcium channels and K+ efflux by delayed rectifier K+ channels
phase 3 = second repolarisation, Ca2+ channels close but delayed K+ channels remain open and membrane potential returns to -90 mV
What is the structure of gap junctions?
What is anisotropic conduction?
-> CV in longitudinal direction is faster than in perpendicular/transverse direction
What is the molecular mechanism of early afterdepolarization (EAD)?
Which ion channels are involved in EAD?
Late sodium channel (increased current inwards)
K+ channels (decreased outward current) - IKs, IKr, IKur
What is the molecular mechanism of DAD?
What are the two modes of the NCX exchanger?
Forward = Ca out and 3 Na in
Which ion channels are involved in delayed afterdepolarizations (DAD)?
NCX
What is an anti-arrhythmic treatment?
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