Circulation Research. 2002;90:939-950
doi: 10.1161/01.RES.0000018627.89528.6F
doi: 10.1161/01.RES.0000018627.89528.6F
© 2002 American Heart Association, Inc.
Review |
Differential Distribution of Cardiac Ion Channel Expression as a Basis for Regional Specialization in Electrical Function
From the Departments of Medicine (G.S., M.P., S.N.), Biomedical-Sciences (G.S.), and Pharmacology (M.P.), University of Montreal, Research Center, Montreal Heart Institute, and the Department of Pathology (P.M.), McGill University, Montreal, Quebec, Canada.
Correspondence to Dr Stanley Nattel, 5000 Belanger St E, Montreal, Quebec, Canada H1T 1C8. E-mail nattel{at}icm.umontreal.ca
The cardiac electrical system is designed to ensure the appropriate rate and timing of contraction in all regions of the heart, which are essential for effective cardiac function. Well-controlled cardiac electrical activity depends on specialized properties of various components of the system, including the sinoatrial node, atria, atrioventricular node, His-Purkinje system, and ventricles. Cardiac electrical specialization was first recognized in the mid 1800s, but over the past 15 years, an enormous amount has been learned about how specialization is achieved by differential expression of cardiac ion channels. More recently, many aspects of the molecular basis have been revealed. Although the field is potentially vast, an appreciation of key elements is essential for any clinician or researcher wishing to understand modern cardiac electrophysiology. This article reviews the major regionally determined features of cardiac electrical function, discusses underlying ionic bases, and summarizes present knowledge of ion channel subunit distribution in relation to functional specialization.
Key Words: ion channels • molecular biology • conduction • cardiac arrhythmias • antiarrhythmic drugs
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