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Myocardial ischemia is associated with pathophysiological conditions such as hyperkalemia, acidosis, and hypoxia. These physiological disorders may lead to changes on the functions of ionic channels, which in turn form the basis for cardiac alternans. In this paper, we investigated the roles of hyperkalemia and calcium handling components played in the genesis of alternans in ischemia at the cellular level by using computational simulations. The results show that hyperkalemic reduced cell excitability and delayed recovery from inactivation of depolarization currents. The inactivation time constant τ f of L-type calcium current (I CaL) increased obviously in hyperkalemia. One cycle length was not enough for I CaL to recover completely. Alternans developed as a result of I CaL responding to stimulation every other beat. Sarcoplasmic reticulum calcium-ATPase (SERCA2a) function decreased in ischemia. This change resulted in intracellular Ca (Cai) alternans of small magnitude. A strong Na+-Ca2+ exchange current (I NCX) increased the magnitude of Cai alternans, leading to APD alternans through excitation-contraction coupling. Some alternated repolarization currents contributed to this repolarization alternans.
Myocardial ischemia is associated with pathophysiological conditions such as hyperkalemia, acidosis, and hypoxia. These physiological disorders may lead to changes on the functions of ionic channels, which in turn form the basis for cardiac alternans. In this paper, we investigated the roles of hyperkalemia and calcium handling components played in the genesis of alternans in ischemia at the cellular level by using computational simulations. The results show that hyperkalemic reduced cell excitability and delayed recovery from inactivation of depolarization currents. The inactivation time constant τ f of L-type calcium current (I CaL) increased obviously in hyperkalemia. One cycle length was not enough for I CaL to recover completely. Alternans developed as a result of I CaL responding to stimulation every other beat. Sarcoplasmic reticulum calcium-ATPase (SERCA2a) function decreased in ischemia. This change resulted in intracellular Ca (Cai) alternans of small magnitude. A strong Na+-Ca2+ exchange current (I NCX) increased the magnitude of Cai alternans, leading to APD alternans through excitation-contraction coupling. Some alternated repolarization currents contributed to this repolarization alternans.
Interconnected mechanisms of ischemia-reperfusion (I-R) has increased the interest in I-R in vitro experiments using human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). We developed a whole-cell computational model of hiPSC-CMs including the electromechanics, a metabolite-sensitive sarcoplasmic reticulum Ca2+-ATPase (SERCA), and an oxygen dynamics formulation to investigate I-R mechanisms. Moreover, we simulated the effect and action mechanism of Levosimendan (LEVO) that recently showed promising anti-arrhythmic effects in hiPSC-CMs in hypoxia. The model was validated using hiPSC-CM and in vitro animal data. The role of SERCA in causing relaxation dysfunction in I-R was anticipated to be comparable to its function in sepsis-induced heart failure. Drug simulations showed that LEVO counteracts the relaxation dysfunction by utilizing a particular Ca2+ sensitizing mechanism involving Ca2+ bound troponin C and Ca2+ flux to the myofilament, rather than inhibiting SERCA phosphorylation. The model demonstrates extensive characterization and promise for drug development, making it suitable for evaluating ischemia-reperfusion therapy strategies based on the changing levels of cardiac metabolites, oxygen, and molecular pathways.
The sections in this article are: Structure of Sarcoplasmic Reticulum and Transverse Tubules Structure of Plasmalemma and T Tubules Sarcoplasmic Reticulum Junction Between T Tubules and SR Mechanism of Excitation‐Contraction Coupling Isolation of SR , T Tubules, and Surface Membrane Elements from Skeletal Muscle Separation of Membrane Fractions by Calcium Oxalate or Calcium Phosphate Loading Protein Composition of SR Structure of Ca 2+ ‐Transport ATP ase and Its Disposition in SR Membrane Fragmentation of Ca 2+ ‐ ATP ase With Proteolytic Enzymes Primary Sequence of Ca 2+ ‐Transport ATP ase From Rabbit SR Structure of Proteolipids Structure and Distribution of Calsequestrin and High‐Affinity Ca 2+ ‐Binding Protein in SR Lipid Composition of SR Distribution of Phospholipids in Membrane Bilayer Role of Phospholipids in Atpase Activity and CA 2+ Transport Boundary Lipids and the Problem of Lipid Annulus Rate of ATP Hydrolysis and Physical Properties of the Lipid Phase Mobility of Phospholipids and Ca 2+ ‐Transport ATP ase in SR Mechanism of ATP Hydrolysis and CA 2+ Transport Introduction of Reaction Sequence Ca 2+ Binding to SR Binding of Ca 2+ to Ca 2+ ‐Transport ATP ase Binding of Mg 2+ to Ca 2+ ‐ ATPase Binding of ATP to Ca 2+ ‐ ATPase Binding of Various Substrates to Ca 2+ ‐ ATPase Influence of ATP on Mobility and Reactivity of Protein Side‐Chain Groups Formation of Enzyme‐Substrate Complex Formation and Properties of Phosphoproteins Kinetics of E∼P Formation Relationship Between Enzyme Phosphorylation and Translocation of Calcium Changes in Ca 2+ Affinity of Phosphoenzyme During Ca 2+ Translocation ADP ‐Sensitive and ADP ‐insensitive Phosphoprotein Intermediates Effect of Potassium on ATPase Activity and Ca 2+ Transport Reversal of the CA 2+ Pump Ca 2+ Release Induced by ADP + P i Ca 2+ Gradient‐Dependent Phosphorylation of ATPase by P i Arsenate‐Induced Ca 2+ Release Mechanism of Ca 2+ Release Induced by ADP + P i Ca 2+ Gradient‐Independent Phosphorylation of Ca 2+ ‐ ATPase by P i Role of Ca 2+ ‐Protein Interactions in ATP Synthesis P i HOH Exchange NTP P i Exchange Physical Basis of CA 2+ Translocation Protein‐Protein Interactions in SR and Their Functional Significance Electron Microscopy Fluorescence‐Energy Transfer Electron Spin Resonance Studies ATP ase‐ ATP ase Interactions in Detergent Solutions Chemical Cross‐Linking Effects of Inhibitors on ATPase Activity Possibility of Subunit Heterogeneity Conclusion Permeability of SR Monovalent‐Cation Channels in SR Anion Channels in SR Effect of Membrane Proteins on Permeability of SR Membranes Relationship Between Membrane Potential and Calcium Fluxes Across SR Membrane Probes as Indicators of SR Membrane Potential Influence of SR Membrane Potential on Calcium Permeability Influence of Membrane Potential on Active Calcium Transport Effect of Calcium Uptake on Membrane Potential of SR A Critical Analysis of Experimental Findings on Effects of Ca 2+ Transport on Membrane Potential Effect of Calcium on Optical Response of Positive Cyanine Dyes Response of Negatively Charged Dyes to Calcium Transport by SR Vesicles Membrane Potential of SR In Vivo Effect of Ca 2+ Release on Membrane Potential of SR Transport of CA 2+ by Cardiac SR Kinetic Differences Between SR of Fast‐Twitch and Slow‐Twitch Skeletal Muscles Regulation of CA 2+ Transport by Membrane Phosphorylation Role of Protein Kinase‐Dependent Membrane Phosphorylation in Regulation of Ca 2+ Transport by Skeletal Muscle SR Physiological Significance of Phospholamban Phosphorylation Biosynthesis of SR Studies on SR Development In Vivo Assembly of SR in Cultured Skeletal and Cardiac Muscle Synthesis of Ca 2+ ‐Transport ATPase in Cell‐Free Systems and Its Insertion into the Membrane Synthesis of Calsequestrin Regulation of Synthesis of Ca 2+ ‐Transport ATPase Myogenic Regulation Neural Influence on Concentration of Ca 2+ ‐ ATPase in Muscle Cells
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