Litovsky S H, Antzelevitch C
Masonic Medical Research Laboratory, Utica, NY 13504.
Circ Res. 1988 Jan;62(1):116-26. doi: 10.1161/01.res.62.1.116.
Previous studies have denied the presence of a transient outward current (Ito) in ventricular myocardium of dog, sheep, and calf. Using conventional microelectrode techniques, we provide evidence for a significant contribution of Ito to epicardial, but not endocardial, activity of canine ventricular myocardium. The epicardial action potential when compared with that of endocardium shows a smaller phase 0 amplitude, a much more prominent phase 1, and a phase 2 amplitude that is greater than that of phase 0. Epicardial action potentials, unlike those of endocardium, display a "spike and dome" morphology that becomes progressively more accentuated at slower stimulation rates. Using the restitution of phase 1 amplitude as a marker for the process responsible for the spike and dome phenomenon, we were able to delineate two exponential components: 1) a slow component that recovers with a time constant of 350-570 msec and 2) a fast component with a time constant of 41-85 msec. The slow component was largely abolished by 1-5 mM 4-aminopyridine, an Ito blocker. The fast component was diminished by 4-aminopyridine, but it was also inhibited by ryanodine and by Sr2+ replacement of Ca2+, which are interventions known to inhibit the Ca2+-activated component of Ito. Following 4-aminopyridine and Sr2+ or ryanodine treatment, the epicardial responses more closely resembled those of endocardium. In summary, the data demonstrate a marked heterogeneity of active membrane properties in canine ventricular muscle. These observations may aid in understanding the basis for rate-dependent changes in the T wave of the ECG, supernormal conduction in ventricular muscle, the greater sensitivity of epicardium to ischemia, and the rate dependence of some cardiac arrhythmias.
以往的研究否认犬、羊和小牛的心室心肌中存在瞬时外向电流(Ito)。我们采用传统微电极技术,证明Ito对犬心室心肌的心外膜(而非心内膜)电活动有显著贡献。与心内膜动作电位相比,心外膜动作电位的0期振幅较小,1期更为显著,2期振幅大于0期。与心内膜不同,心外膜动作电位呈现“尖峰和圆顶”形态,在较慢刺激频率下这种形态会逐渐更加明显。以1期振幅的恢复情况作为导致尖峰和圆顶现象过程的标志物,我们能够描绘出两个指数成分:1)一个慢成分,其恢复的时间常数为350 - 570毫秒;2)一个快成分,时间常数为41 - 85毫秒。1 - 5毫摩尔的4 - 氨基吡啶(一种Ito阻滞剂)可基本消除慢成分。4 - 氨基吡啶可使快成分减小,但它也受到兰尼碱以及用Sr2 +替代Ca2 +的抑制,这些干预措施已知可抑制Ito的钙激活成分。在4 - 氨基吡啶以及Sr2 +或兰尼碱处理后,心外膜反应更类似于心内膜反应。总之,数据表明犬心室肌中活性膜特性存在明显异质性。这些观察结果可能有助于理解心电图T波的心率依赖性变化、心室肌超常传导、心外膜对缺血更高的敏感性以及某些心律失常的心率依赖性的基础。