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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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    Presentation Transcript
    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