1. The Heart physiology I. Milan Chovanec Department of Physiology 2 nd Medical School, Charles University, Prague

2. The Heart Physiology The heart action potential (working myocardium) The heart automaticity and electrical conduction system Excitation – Contraction coupling in the heart muscle cells

3. Myocardium = syncytium Gap junction = nexus

4. Different types of the action potential in the heart Skeletal muscle, nerveMyocardium

5. Voltage gated Ca 2+ channels (L-type) are resposible for AP in the myocardium

6. Calcium influx plays role in strength and duration of the myocardial AP Relationship between the strength + duration of the AP and calcium channels blocker (Verapamil)

7. Prolonged AP prevents tetanic myocardial contraction

8. Cardiac cells types working myocardium cells, about 99% electrical conduction system cells, about 1%

9. sinoatrial (SA) pacemaker action potencial i f – „funny current“, Na + - channels i Ca(T) – „transient“ Ca 2+ channels i Ca(L) – „long lasting“ Ca 2+ channels Electrical conduction system AP

10. Difference between AP of the working myocardium and the conduction system BMP

11. Conduction system of the heart

12. Conduction of the heart

13. The heart AP propagation

14. Electrical characterization of the myocardium velocity of the activation is constant refraktory period of the myocardium is constant anatomical dimensions are constant

15. Excitation – Contraction coupling in the cardiac muscle Spontaneous the heart AP (automacity) T-tubules Gap junctions Contractile elements SR Mitochondria (ATP) Ca 2+ ionts

16. Structure of the myocardium

17. Contractile elements Myosin – the heads=ATPase activity Aktin Tropomyosin Troponin komplex – TnT, TnC, TnI

18. Actin and myosin interaction

19. Excitation – Contraction coupling: initiation of the contraction mechanism Calcium influx is essential to initiation of the myocardium contraction (about 20% of Ca 2+ ), but this amount of calcium is not sufficient to induced whole contraction

20. Excitation – Contraction coupling: calcium release from SR CIRC – calcium-induced calcium release Calcium supply from SR is about 80% amout inevitiable for contraction

21. Excitation – Contraction coupling: relaxation mechanism Energy dependent processes – ATPase activity SERCA

22. Excitation – Contraction coupling

23. Calcium ionts during excitation – contraction coupling

24. Homeometrické ovlivnění kontrakce katecholaminy Fosforylace fosfolambamu, Rychlejší relaxace Aktivace Ca 2+ kanálů (L-typ), více vápníku v buňce

25. Thank you