ion channels

    Cardiovascular Physiology Concepts
                                    Richard E. Klabunde, Ph.D.

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Arrhythmias

Cardiac Valve Disease

Coronary Artery Disease

Edema

Heart Failure

Hypertension

Peripheral Artery Disease

Click here for information on Cardiovascular Physiology Concepts, published by Lippincott Williams & Wilkins (200 5)

Ion Channels

The cell membrane is permeable to a number of ions, the most important of which are Na⁺, K⁺, Ca⁺⁺ and Cl^-. These ions pass across the membrane through specific ion channels that can open (become activated) and close (become inactivated). Therefore, these channels are said to be gated channels. Their opening and closing can occur in response to

voltage changes (voltage gated channels)
activation of receptors (receptor gated channels)
specific ions and chemical ligands

Cardiac cells can have several different channels for a given ion. For example, there are many different types of potassium channels that play an important role in resting membrane potential and in action potentials. It is the opening and closing of ion channels that alters specific ion conductances in a manner that determines resting potentials and generates action potentials. For example, when an action potential is elicited in a cardiomyocyte, sodium channels transiently open and potassium channels close, which leads to depolarization. Shortly thereafter, the sodium channels close and calcium channels open to maintain a depolarized state. This is followed by inactivation of the calcium channels and a reopening of the potassium channels, which leads to membrane repolarization.

The following table summarizes some of the important ion channels that are found in cardiac and vascular smooth muscle cells.

CHANNEL	CHARACTERISTICS
Sodium Channels
Fast Na⁺	Phase 0 depolarization of non-pacemaker cardiac action potentials
Slow Na⁺	"Funny" pacemaker current (I_f) in cardiac nodal tissue
Potassium Channels
Inward rectifier (I_ir or I_K1)	Maintains phase 4 negative potential in cardiac cells
Transient outward (I_to)	Contributes to phase 1 of non-pacemaker cardiac action potentials
Delayed rectifier (I_Kr)	Phase 3 repolarization of cardiac action potentials
ATP-sensitive (I_{K, ATP})	K_ATP channels; inhibited by ATP; therefore, open when ATP decreases during hypoxia; in vascular smooth muscle, adenosine removes the ATP inhibition and opens these channels, producing vasodilation
Acetylcholine-activated (I_{K, ACh})	Activated by acetylcholine; Gi-protein coupled
Calcium-activated (I_{K, Ca} or BK_Ca)	Open in response to Ca⁺⁺ influx in vascular smooth muscle
Calcium Channels
L-type (I_Ca-L)	Slow inward, long-lasting current; phase 2 non-pacemaker cardiac action potentials and phases 4 and 0 of SA and AV nodal cells; important in vascular smooth muscle contraction
T-type (I_Ca-T)	Transient current that contributes to phase 4 pacemaker currents in SA and AV nodal cells

Many of the antiarrhythmic drugs that are used to treat cardiac arrhythmias have their action on sodium, calcium and potassium channels.

RK Revised 04/02/2007

DISCLAIMER: These materials are for educational purposes only, and are not a source of medical decision-making advice.