Summary
Among the early changes in ion concentration during myocardial ischemia the rise in extracellular K+ concentration is the most pronounced. Four possible mechanisms are proposed and evaluated. They are not mutually exclusive and all probably play a role to a variable extent, depending on the degree of hypoxia versus ischemia: 1) Volume contraction of the extracellular space, secondary to the production of intracellular osmotically active molecules, can maximally explain a doubling of the normal K+ concentration. 2) Experimental evidence for inhibition of the active K+ inward transport is controversial. 3) No direct evidence exists for electroneutral K+ transport as a cotransport with anions or an exchange with cations. 4) An increase in electrogenic K+ outward movement has been demonstrated to occur in hypoxia and metabolic inhibition. As to the nature of the K+ current it is difficult to select one of the multiple K+ currents available. An increase in inward current is the conditio sine qua non to explain an important K+ loss at rest. The best candidates for K+ loss in stimulated preparations are the ATP-dependent, the Nai-activated, and the AA-activated K+ channels; they are time-independent and show outward rectification.
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References
Allen DG, Morris PG, Orchard CH, Pirolo JS (1985) A nuclear magnetic resonance study of metabolism in the ferret heart during hypoxia and inhibition of glycolysis. J Physiol, 361: 185–204
Bekheit S-S, Restivo M, Boutjdir M, Henkin R, Gooyandeh K, Assadi M, Khatib S, Gough WB, El-Sherif N (1990) Effects of glyburide on ischemia-induced changes in extracellular potassium and local myocardium activation: a potential new approach to the management of ischemia-induced malignant ventricular arrhythmias. Am Heart J 119: 1025–1033
Benndorf K, Bollmann G, Friedriech M, Hirche H (1992) Anoxia induces time-independent K+ current through KATP channels in isolated heart cells of the guinea-pig. J Physiol 454: 339–357
Bhatnagar A, Srivastava SK, Szabo G (1990) Oxidative stress alters specific membrane currents in isolated cardiac myocytes. Circ Res 67: 535–549
Burnashev NA, Undrovinas AI, Fleidervish IA, Rosenshtraukh LV (1989) Ischemic poison lysophosphatidylcholine modifies heart sodium channels gating inducing long-lasting bursts of openings. Pflüg Arch 415: 124–126
Bustamente JO, Ruknudin A, Sachs F (1991) Stretch-activated channels in heart cells: relevance to cardiac hypertrophy. J Cardiovasc Pharmacol 17, suppl 2, 5110–5113
Carmeliet E (1992) A fiery subsarcolemmal space for intracellular Na+ in cardiac cells? Cardiovasc Res 26: 433–442
Carmeliet E, Storms L, Vereecke J (1990) The ATP-dependent K-channel and metabolic inhibition. In: Zipes DP, Jalife J, eds. “Cardiac Electrophysiology. From cell to bedside.” Philadelphia; WB Saunders, 103–108
Cascio ZE, Yan G-X, Kléber AG (1989) Inhomogeneity of impulse propagation in myocardial ischemia: the critical role of CO2. Circulation 80, II–194
Clarkson CW, Ten Eick RE (1983) On the mechanism of lysophosphatidylcholineinduced depolarization of cat myocardium. Circ Res 52: 543–556
Colquhoun D, Neher E, Reuter H, Stevens CF (1981) Inward current channels activated by intracellular Ca in cultured cardiac cells. Nature, 294: 752–754
Corr PB, Gross RW, Sobel BE (1982) Arrhythmogenic amphiphilic lipids and the myocardial cell membrane? J Mol Cell Card 14: 619–626
Coulombe A, Coraboeuf E (1992) Large-conductance chloride channels of new-born rat myocytes are activated by hypotonic media. Pflüg Arch 422: 143–150
Coulombe A, Lefevre IA, Baro I, Coraboeuf E (1989) Barium-and calcium-permeable channels open at negative membrane potentials in rat ventricular myocytes. J Memb Biol 111: 57–67
Creer MH, Dobmeyer DJ, Corr PB (1990) Amphipathic lipid metabolites and arrhythmias during myocardial ischemia. “Cardiac Electrophysiology. From cell to bedside” Zipes DP, Jalife J (eds) WB Saunders Company, pp 417–433
Cuevas J, Bassett AL, Cameron JS, Furukawa T, Myerburg RJ, Kimura S (1991) Effect of H+ on ATP-regulated K+ channels in feline ventricular myocytes. Am J Physiol, 261: H755–H761
Ehara T, Noma A, Ono K (1988) Calcium-activated non-selective cation channel in ventricular cells isolated from adult guinea-pig hearts. J Physiol 403: 117–133
Ellingsen O, Sejersted OM, Vengen O A, Ilebekk A (1991) Frequency dependent myocardial potassium fluxes during ß adrenergic stimulation of intact pig hearts. Cardiovasc Res 25: 364–370
Faivre J-F, Findlay I (1990) Action potential duration and activation of ATP-sensitive potassium current in isolated guinea-pig ventricular myocytes. Biochim Biophy Acta 1029: 167–172
Fan Z, Makielski JC (1993) Intracellular H+ and Ca’ modulation of trypsinmodified ATP-sensitive K+ channels in rabbit ventricular myocytes. Circ Res 72: 715–722
Findlay I (1988) Effects of ADP upon the ATP-sensitive K+ channel in rat ventricular myocytes. J Memb Biol 101: 83–93
Findlay I, Faivre J-F (1991) ATP-sensitive K channels in heart muscle. Spare channels. FEBS letters 279: 95–97
Fosset M, De Weille JR, Green RD, Schmid-Antomarchi H, Lazdunski, M (1988) Antidiabetic sulfonylureas control action potential properties in heart cells via high affinity receptors that are linked to ATP-dependent K+ channels. J Biol Chem, 263: 7933–7936
Friedrich M, Benndorf K, Schwabb M, Hirche HJ (1990) Effects of anoxia on K and Ca currents in isolated guinea pig cardiocytes. Pflüg Arch 416: 207–209
Friel DD, Bean BP (1988) Two ATP-activated conductances in bullfrog atrial cells. J Gen Physiol, 91: 1–27
Furukawa T, Kimura S, Furukawa N, Bassett AL, Myerburg RJ (1991) Role of cardiac ATP-regulated potassium channels in differential responses of endocardial and epicardial cells to ischemia. Circ Res 68: 1693–1702
Gasser RNA, Vaughan-Jones RD (1990) Mechanism of potassium efflux and action potential shortening during ischaemia in isolated mammalian cardiac muscle. J Physiol 431: 713–741
Guarnieri T (1987) Intracellular sodium-calcium dissociation in early contractile failure in hypoxic ferret papillary muscle. J Physiol 388: 449–465
Hagiwara N, Masuda H, Shoda M, Irisawa H (1992) Stretch-activated anion currents of rabbit cardiac myocytes. J Physiol, 456: 285–302
Heathers GP, Yamada KA, Kanter EM, Corr PB (1987) Long-chain acylcarnitines mediate the hypoxia-induced increase in al-adrenergic receptors on adult canine myocytes. Circ Res 61: 735–746
Hicks MN, Cobbe SM (1991) Effect of glibenclamide on extracellular potassium accumulation and the electrophysiological changes during myocardial ischaemia in the arterially perfused interventricular septum of rabbit. Cardiovasc Res 25: 407–413
Hill JA Jr, Coronado R, Strauss HC (1988) Reconstitution and characterization of a calcium-activated channel from heart. Circ Res 62: 411–415
Hill JL, Gettes LS (1980) Effect of acute coronary occlusion on local myocardial extracellular K + activity in swine. Circulation 61: 768–778
Huang JM-C, Xian H, Bacaner M (1992) Long-chain fatty acids activate calcium channels in ventricular myocytes. Proc Nat Acad Sci 89: 6452–6456
Hume JR, Harvey RD (1991) Chloride conductance pathways in heart. Am J Physiol 261: C399–C412
Isenberg G, Vereecke J, Van der Heyden G, Carmeliet E (1983) The shortening of the action potential by DNP in guinea-pig ventricular myocytes is mediated by an increase in time-independent K conductance. Pflüg Arch 397: 251–259
Ito H, Tung RT, Sugimoto T, Kobayashi I, Takahashi K, Katada T, Ui M, Kurachi Y (1992) On the mechanism of G protein fly subunit activation of the muscarinic K channel in guinea pig atrial cell membrane. Comparison with the ATP-sensitive K channel. J Gen Physiol 99: 961–983
Ito H, Vereecke J, Carmeliet E (1992) Intracellular protons inhibit inward rectifier K channel of guinea-pig ventricular cell membrane. Pflug Arch 422: 280–286
Jabr RI, Cole WC (1993) Alterations in electrical activity and membrane currents induced by intracellular oxygen-derived free radical stress in guinea pig ventricular myocytes. Circ Res 72: 1299–1244
Janse MJ, Kléber AG (1981) Electrophysiological changes and ventricular arrhythmias in the early phase of regional myocardial ischemia. Circ Res 49: 1069–1081
Jennings RB, Reimer KA, Steenbergen C (1986) Myocardial ischemia revised. The osmolar load, membrane damage and reperfusion. J Mol and Cell Card 18: 769–780
Kameyama M, Kakei M, Sato R, Shibasaki T, Matsuda H, Irisawa H (1984) Intracellular Na+ activates a K+ channel in mammalian cardiac cells. Nature 309: 354–456
Kammermeier H, Schmidt P, Jüngling E (1982) Free energy change of ATP hydrolysis: a causal factor of early hypoxic failure of the myocardium? J Mol Cell Card 14: 267–277
Kantor PF, Coetzee WA, Carmeliet EE, Dennis SC, Opie LH (1990) Reduction of ischemic K loss and arrhythmias in rat hearts. Effect of glibenclamide, a sulfonylurea. Circ Res 66: 478–485
Keung EC, Li Q (1991) Lactate activates ATP-sensitive potassium channels in guinea pig ventricular myocytes. J Clin Invest 88: 1772–1777
Kim D (1992) A mechanosensitive K channel in heart cells. Activation by arachidonic acid. J Gen Physiol 100: 1021–1040
Kim D (1993) Novel cation-selective mechanosensitive ion channel in the atrial cell membrane. Circ Res 72: 225–231
Kim D, Clapham DE (1989) Potassium channels in cardiac cells activated by arachidonic acid and phospholipids. Science 244: 1174–1176
Kim D, Duff RA (1990) Regulation of K channels in cardiac myocytes by free fatty acids. Circ Res 67: 1040–1046
Kirsch GE, Codina J, Birnbaumer L, Brown AM (1990) Coupling of ATP-sensitive K channels to Al receptors by G proteins in rat ventricular myocytes. Am J Physiol 259: H820-H 826
Kiyosue T, Arita M (1986) Effects of lysophosphatidylcholine on resting potassium conductance of isolated guinea pig ventricular cells. Pflug Arch 406: 296–302
Kléber AG (1983) Resting membrane potential, extracellular potassium activity, and intracellular sodium activity during acute global ischemia in isolated perfused guinea pig hearts. Circ Res 52: 442–450
Kléber AG, Riegger CB, Janse MJ (1987) Extracellular K+ and H shifts in early ischemia: mechanisms and relation to changes in impulse propagation. J Mol Cell Card 19: Suppl V, 35–44
Knopf H, Theising R, Hirche HJ (1988) The effect of desipramine on ischaemia induced changes in extracellular K+-, Na +- and H+- concentrations and noradrenaline release in the isolated rat heart during global ischaemia. J Cardiovasc Pharmacol 12: 8–14
Knopf H, Theising R, Moon CH, Hirche HJ (1990) Continuous determination of extracellular space and changes of K+, Na, Ca2+, and H+ during global ischaemia in isolated rat hearts. J Mol Cell Card 22: 1259–1272
Koyano T, Kakei M, Nakashima H, Yoshinaga M, Matsuoka T, Tanaka H (1993) ATP-regelated K channels are modulated by intracellular H in guinea pig ventricular cells. J Physiol, 463: 747–766
Lederer JW, Niggli E, Hadley RW (1990) Sodium-calcium exchange in excitable cells: Fuzzy space. Science 248: 283
Lee HC, Mohabir R, Smith N, Franz MR, Clusin WT (1988) Effect of ischemia on Ca-dependent fluorescence transients in rabbit hearts containing Indo 1. Circulation 78: 1047–1059
Le Guennec J-Y, White E, Gannier F, Argibay JA, Garnier D (1991) Stretch-induced increase of resting intracellular calcium concentration in single guinea-pig ventricular myocytes. Exp Physiol 76: 975–978
Luk H-N, Carmeliet E (1990) Nat-activated K current in cardiac cells: rectification, open probability, block and role in digitalis toxicity. Pflüg Arch 416: 766–768
Malloy CR, Buster DC, Castro MMCA, Geraldes CFGC, Jeffrey JMH, Sherry AD (1990) Influence of global ischemia on intracellular sodium in the perfused rat heart. Magn Res Med 15: 33–44
Matsuda H (1988) Open-state substructure of inwardly rectifying potassium channels revealed by magnesium block in guinea-pig heart cells. J Physiol 397: 237–258
Matsuura H (1993) Effects of internal and external Na+ ions on inwardly rectifying K channels in guinea-pig ventricular cells. J Physiol, 460: 311–326
Matsuda H, Ehara T (1992) Activation of chloride current by purinergic stimulation in guinea pig heart cells. Circ Res 70: 851–855
Mazzanti M, DiFrancesco D (1989) Intracellular Ca modulates K-inward rectification in cardiac myocytes. Pflüg Arch 413: 322–324
Mitan A, Shattock MJ (1992) Role of Na-activated K channel, Na—K—Cl cotransport, and Na—K pump in [K]e changes during ischemia in rat heart. Am J Physiol 263: H333–H340
Morley GE, Anumonwo JMB, Delmar M (1992) Effects of 2, 4-dinitrophenol or low (ATP); on cell excitability and action potential propagation in guinea pig ventricular myocytes. Circ Res 71: 821–830
Nakao M, Gadsby DC (1989) (Na) and ( K) dependence of the Na/K pump current-voltage relationship in guinea-pig ventricular myocytes. J Gen Physiol 94: 539–565
Nichols CG, Ripoll C, Lederer WJ (1991) ATP-sensitive potassium channel modulation of the guinea pig ventricular action potential and contraction. Circ Res 68: 280–287
Noma A (1983) ATP-regulated K+ channels in cardiac muscle. Nature 305: 147–148
Pike MM, Kitakaze M, Marban E (1990) 23Na—NMR measurements of intracellular sodium in intact perfused ferret hearts during ischemia and reperfusion. Am J Physiol 259: H1767–H1773
Rau EE, Shine KI, Langer GA (1977) Potassium exchange and mechanical performance in anoxic mammalian myocardium. Am J Physiol 232: H85–H94
Rosenberg RL, Hess P, Reeves JP, Smilowitz H, Tsien RW (1986) Calcium channels in planar lipid bilayers: insights into mechanisms of ion permeation and gating, Science, 231: 1564–1566
Saint DA, Ju Y-K, Gage PW (1992) A persistent sodium current in rat ventricular myocytes. J Physiol 453: 219–231
Sanguinetti MC, Jurkiewicz NK (1990) Two components of cardiac delayed rectifier K current: Differential sensitivity to block by class III antiarrhythmic agents. J Gen Physiol 96: 195–215
Schömig A, Fischer S, Kurz T, Richardt G, Schömig E (1987) Non-exocytotic release of noradrenaline in the ischemic and anoxic rat heart: mechanism and metabolic requirements. Circ Res 60: 194–205
Shattock M, Matsuura H (1993) Measurement of Na+- K+ pump current in isolated rabbit ventricular myocytes using the whole-cell voltage-clamp technique Inhibition of the pump by oxidant stress. Circ Res 72: 91–101
Shieh R-C, Stuart JS, Goldhaber JI, Weiss JN (1993) Transsarcolemmal lactate transport in guinea-pig ventricular myocytes. Biophys J 64: A403
Sigurdson W, Ruknudin A, Sachs F (1992) Calcium imaging of mechanically induced fluxes in tissue-cultured chick heart: role of stretch-activated ion channels. Am J Physiol 262: H1110–H1115
Sipido K, Callewaert G, Carmeliet E (1993) (Ca2+), transients and (Ca2+);dependent chloride current in single Purkinje cells from rabbit heart. J Physiol 468: 641–667
Sorota S (1992) Swelling-induced chloride-sensitive current in canine atrial cells revealed by whole-cell patch-clamp method. Circ Res 70: 679–687
Steenbergen C, Murphy E, Levy L, London RE (1987) Elevation in cytosolic free calcium concentration early in myocardial ischemia in perfused rat hearts. Cire Res 60: 700–707
Tanaka M, Gilbert J, Pappano AJ (1992) Inhibition of sodium pump by 1-palmitoylcarnitine in single guinea-pig ventricular myocytes. J Mol Cell Card 24: 711–720
Taniguchi J, Noma A, Irisawa H (1983) Modification of the cardiac action potential by intracellular injection of adenosine triphosphate and related substances in guinea pig single ventricular cells. Circ Res 53: 131–139
Tranum-Jensen J, Janse MJ, Fiolet JWT, Krieger WJG (1981) Tissue osmolality, cell swelling, and reperfusion in acute regional myocardial ischemia in the isolated porcine heart. Cire Res 49: 364–381
Trube G, Hescheler J (1984) Inward-rectifying channels in isolated patches of the heart cell membrane: ATP-dependence and comparison with cell-attached patches. Pflüg Arch 401: 178–184
Tseng G-N (1992) Cell swelling increases membrane conductance of canine cardiac cells: evidence for a volume-sensitive Cl channel. Am J Physiol 262: C1056–C1068
Undrovinas AI, Fleidervish IA, Makielski JC (1992) Inward sodium current at resting potentials in single cardiac myocytes induced by the ischemic metabolite lysophosphatidylcholine. Circ Res 71: 1231–1241
Van der Heyden G, Vereecke J, Carmeliet E (1985) The effect of cyanide on the K-current in guinea-pig ventricular myocytes. Basic Res Cardiol 80, Suppl 1: 93–96
Vanheel B, de Hemptinne A (1992) Influence of KAT? channel modulation on net potassium efflux from ischaemic mammalian cardiac tissue. Cardiovasc Res 26: 1030–1039
Vanheel B, de Hemptinne A, Leusen I (1990) Acidification and intracellular sodium ion activity during simulated myocardial ischemia. Am J Physiol 259: C169–C179
Van Wagoner DR (1993) Mechanosensitive gating of atrial ATP-sensitive potassium channels. Circ Res 72: 973–983
Veldkamp MW (1993) Potassium channels in the heart. Thesis. Febodruk Enschede, The Netherlands, p 97
Venkatesh N, Lamp ST, Weiss JN (1991) Sulfonylureas, ATP-sensitive K+ channels, and cellular K+ loss during hypoxia, ischemia, and metabolic inhibition in mammalian ventricle. Cire Res 69: 623–637
Vleugels A, Carmeliet E (1976) Hypoxia increases potassium efflux from mammalian myocardium. Experientia 32: 483–484
Weiss J, Hiltbrand B (1985) Functional compartmentation of glycolytic versus oxidation metabolism in isolated rabbit heart. J Clin Invest 75: 436–447
Weiss JN, Lamp ST (1989) Cardiac ATP-sensitive K+ channels. Evidence for preferential regulation by glycolysis. J Gen Physiol 94: 911–935
Weiss JN, Lamp ST, Shine KI (1989) Cellular K+ loss and anion efflux during myocardial ischemia and metabolic inhibition. Am J Physiol 256: H1165–H1175
Weiss JN, Shine KI (1982) Extracellular K + accumulation during myocardial ischemia in isolated rabbit heart. Am J Physiol 242: H619–H628
Weiss J, Shine K (1986) Effects of heart rate on (K+) accumulation during myocardial ischemia. Am J Physiol 250: H982–H1001
Wilde AAM, Escande D, Schumacher CA, Thuringer D, Mestre M, Fiolet JWT, Janse MJ (1990) Potassium accumulation in the globally ischemic mammalian heart. A role for the ATP-sensitive potassium channel Circ Res 67: 835–843
Woodley SL, Ikenouchi H, Barry WH (1991) Lysophosphatidylcholine increases cytosolic calcium in ventricular myocytes by direct action on the sarcolemma. Journal of Mol Cell Card 23: 671–680
Yan G-X, Yamada KA, Kléber AG, McHowat J, Corr PB (1993) Dissociation between cellular K + loss, reduction in repolarization time, and tissue ATP levels during myocardial hypoxia and ischemia. Circ Res 72: 560–570
Zygmunt AC, Gibbons WR (1991) Calcium-activated chloride current in rabbit ventricular myocytes. Circ Res 68: 424–437
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Carmeliet, E., Vereecke, J. (1994). Ischemia and early extracellular K+ accumulation in cardiac cells. In: Zehender, M., Meinertz, T., Just, H. (eds) Myocardial Ischemia and Arrhythmia. Steinkopff. https://doi.org/10.1007/978-3-642-72505-0_4
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