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Presented in part in abstract form at the 39th meeting of the Biophysical Society, San Francisco, Calif, February 12-16, 1995.
From the Cardiac Bioelectricity Research and Training Center, Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio.
Abstract Two distinct delayed rectifier K+
currents, IKr and IKs, were found
recently in ventricular cells. We formulated these currents
theoretically and investigated their roles in action potential
repolarization and the restitution of action potential duration (APD).
The Luo-Rudy (L-R) model of the ventricular action
potential was used in the simulations. The single delayed rectifier
K+ current in the model was replaced by IKr and
IKs. Our results show that IKs is the major
outward current during the plateau repolarization. A specific block of
either IKr or IKs can effectively prolong APD
to the same degree. Therefore, either channel provides a target for
class III antiarrhythmic drugs. In the simulated guinea pig
ventricular cell, complete block of IKr does
not result in early afterdepolarizations (EADs). In contrast, >80%
block of IKs results in abnormal repolarization and EADs.
This behavior reflects the high IKs-to-IKr
density ratio (
8:1) in this cell and can be reversed (ie,
IKr block can cause EADs) by reducing the ratio of
Iks to IKr. The computed APD restitution curve
is consistent with the experimental behavior, displaying fast
APD variation at short diastolic intervals (DIs) and
downward shift at longer DIs with the decrease of basic drive cycle
length (BCL). Examining the ionic currents and their underlying kinetic
processes, we found that activation of both IKr and
IKs is the primary determinant of the APD restitution at
shorter DIs, with Ca2+ current through L-type
channels (ICa) playing a minor role. The rate of APD change
depends on the relative densities of IKr and
IKs; it increases when the
IKr-to-IKs density ratio is large. The
BCL-dependent shift of restitution at longer DIs is primarily
attributed to long-lasting changes in
[Ca2+]i. This in turn causes different
degrees of Ca2+-dependent inactivation of
ICa and different degrees of
Ca2+-dependent conductance of IKs at
very long DIs (>5 s) for different BCLs. This BCL dependence of
ICa and IKs that is secondary to long-lasting
changes in [Ca2+]i is responsible for
APD changes at long DIs and can be viewed as a "memory property"
of cardiac cells.
Key Words: K+ current action potential duration repolarization simulation optical mapping
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