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(Circulation. 2003;107:2753.)
© 2003 American Heart Association, Inc.
Basic Science Reports |
From the Department of Cardiology, Cardiovascular Research Institute Maastricht, Academic Hospital Maastricht, Netherlands; Aventis Pharma Deutschland GmbH, Medicinal Chemistry (U.G.), Frankfurt/Main, Germany; and the Laboratory of Experimental Cardiology (K.R.S.), University of Leuven, Belgium.
Correspondence to Paul G.A. Volders, MD, PhD, Department of Cardiology, Cardiovascular Research Institute Maastricht, Academic Hospital Maastricht, PO Box 5800, 6202 AZ, Maastricht, Netherlands. E-mail p.volders{at}cardio.azm.nl
Background In large mammals and humans, the contribution of IKs to ventricular repolarization is still incompletely understood.
Methods and Results In vivo and cellular electrophysiological experiments were conducted to study IKs in canine ventricular repolarization. In conscious dogs, administration of the selective IKs blocker HMR 1556 (3, 10, or 30 mg/kg PO) caused substantial dose-dependent QT prolongations with broad-based T waves. In isolated ventricular myocytes under baseline conditions, however, IKs block (chromanols HMR 1556 and 293B) did not significantly prolong action potential duration (APD) at fast or slow steady-state pacing rates. This was because of the limited activation of IKs in the voltage and time domains of the AP, although at seconds-long depolarizations, the current was substantial. Isoproterenol increased and accelerated IKs activation to promote APD95 shortening. This shortening was importantly reversed by HMR 1556 and 293B. Quantitatively similar effects were obtained in ventricular-tissue preparations. Finally, when cellular repolarization was impaired by IKr block, IKs block exaggerated repolarization instability with further prolongation of APD.
Conclusions Ventricular repolarization in conscious dogs is importantly dependent on IKs. IKs function becomes prominent during ß-adrenergic receptor stimulation, when it promotes AP shortening by increased activation, and during IKr block, when it limits repolarization instability by time-dependent activation. Unstimulated IKs does not contribute to cellular APD at baseline. These data highlight the importance of the synergism between an intact basal IKs and the sympathetic nervous system in vivo.
Key Words: ion channels action potentials receptors, adrenergic, beta long-QT syndrome ventricles
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