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Cardiovascular Specific Gene Expression pp 125–137Cite as

Sympathetic Regulation of Cardiac Delayed Rectification: Relationship to Cardiac Arrhythmias

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Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 214))

Abstract

Electrical impulses control the frequency, strength, and duration of contraction of the heart. During the normal cardiac cycle, a regular rhythmic pattern must be established of time-dependent changes in cellular permeability to maintain the cardiac cycle that underlies normal cardiac function. Impulses, which originate in the sinoatrial (SA) node, are conducted by the myocardium throughout the atria until they converge at the atrioventricular (AV) node, pass through the bundle of His and the Purkinje fiber conducting system, and eventually excite the working myocardial cells in the ventricles. As the heart is a dynamic organ and must adjust its output with changes in physiological demand, control of electrical activity by neurohormones is essential in the maintenance of proper cardiovascular function. Recent work has linked defects in several ion channel proteins to at least two forms of inherited cardiac arrhythmias: the Long QT Syndrome (LQTS) [1] and the Brugada Syndrome [2]. In the cases of these diseases identified mutations in ion channel structure have been shown to cause functional changes in channel properties using heterologous expression of the channel proteins [3]. The data obtained to date indicate that the inherited changes (mutations) in channel structure change channel activity in a manner that is consistent with most disease phenotypes, but by themselves, are not sufficient to account for fatal cardiac events and sudden cardiac death (SCD). Other factors must be considered. Here one factor, the regulation of a key potassium current, the slow delayed rectifier channel IKs, will be discussed in the context of a possible link to fatal events in one form of the long QT syndrome: LQT 1 as this form of LQTS is most likely to lead to fatal arrhythmias in the face of sympathetic stimulation [4].

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  1. Robert S. Kass
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Editors and Affiliations

  1. Department of Cardiology, Academic Hospital Maastricht, Maastricht, The Netherlands

    Pieter A. Doevendans

  2. Academic Hospital Maastricht, CARIM, Maastricht, The Netherlands

    Robert S. Reneman

  3. Department of Physiology, Academic Hospital Maastricht, Maastricht, The Netherlands

    Marc van Bilsen

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Kass, R.S. (1999). Sympathetic Regulation of Cardiac Delayed Rectification: Relationship to Cardiac Arrhythmias. In: Doevendans, P.A., Reneman, R.S., van Bilsen, M. (eds) Cardiovascular Specific Gene Expression. Developments in Cardiovascular Medicine, vol 214. Springer, Dordrecht. https://doi.org/10.1007/978-94-015-9321-2_12

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  • DOI: https://doi.org/10.1007/978-94-015-9321-2_12

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  • Print ISBN: 978-90-481-5189-9

  • Online ISBN: 978-94-015-9321-2

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