Circulation, Vol 83, 248-259, Copyright © 1991 by American Heart Association
SG Priori, KA Yamada and PB Corr
Although findings from several reports suggest that nonreentrant or focal
mechanisms contribute to the genesis of arrhythmias during early ischemia,
the contribution of triggered activity arising from early or delayed
afterdepolarizations has not been resolved. We have previously demonstrated
that beta- but not alpha-adrenergic stimulation induces
afterdepolarizations and triggered activity in isolated normoxic myocytes.
In the present study, the influence of the extent of cellular derangements
as well as increases in [K+]o on alpha- and beta- adrenergic-mediated
afterdepolarizations and triggered activity was evaluated. Adult canine
myocytes were exposed to one of the following experimental conditions with
simultaneous intracellular transmembrane action potential recordings: 1)
low PO2 (less than 10 mm Hg, obtained using a specially designed hypoxic
chamber) and low (6.8) pH; 2) low PO2, low pH, and high extracellular
potassium ([K+]o) (10 mM); or 3) severe metabolic inhibition with cyanide
(10(-6) M). Cells from each group were superfused with either the
alpha-agonist phenylephrine (10(- 5) or 10(-7) M, with 10(-5) M nadolol) or
the beta-agonist isoproterenol (10(-6) M). Moderate changes in the action
potentials were observed under conditions 1 and 2 (moderate hypoxia),
whereas marked but reversible changes were observed with cyanide (severe
metabolic inhibition). During moderate hypoxia in normal [K+]o, delayed
afterdepolarizations or triggered activity were elicited by both alpha- (12
of 13 cells) and beta-adrenergic (five of five cells) stimulation.
Increasing [K+]o during moderate hypoxia completely abolished the
afterdepolarizations induced by alpha-adrenergic stimulation and prevented
the occurrence of triggered activity. In contrast, the influence of
beta-adrenergic stimulation was only attenuated by an increase in [K+]o.
Exposure to cyanide completely prevented the induction of
afterdepolarizations and triggered activity by both alpha- and
beta-adrenergic stimulation. Our findings indicate that moderate hypoxia in
normal [K+]o is associated with the development of adrenergic-mediated
afterdepolarizations and triggered activity. In contrast, accumulation of
[K+]o or severe impairment of cellular metabolism is accompanied by
inhibition of adrenergic-mediated afterdepolarizations and triggered
activity.
ARTICLES
Influence of hypoxia on adrenergic modulation of triggered activity in isolated adult canine myocytes
Department of Internal Medicine, Washington University School of Medicine, St. Louis, Mo 63110.
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