Of the ions involved in the intricate workings of the heart, calcium is considered perhaps the most important. It is crucial to the very process that enables the chambers of the heart to contract and relax, a process called excitation-contraction coupling. It is important to understand in quantitative detail exactly how calcium is moved around the various organelles of the myocyte in order to bring about excitation-contraction coupling if we are to understand the basic physiology of heart function. Furthermore, spatial microdomains within the cell are important in localizing the molecular players that orchestrate cardiac function.

Cardiac excitation–contraction coupling

Microglial cells are the resident macrophages in the central nervous system. These cells of mesodermal/mesenchymal origin migrate into all regions of the central nervous system, disseminate through the brain parenchyma, and acquire a specific ramified morphological phenotype termed "resting microglia." Recent studies indicate that even in the normal brain, microglia have highly motile processes by which they scan their territorial domains. By a large number of signaling pathways they can communicate with macroglial cells and neurons and with cells of the immune system. Likewise, microglial cells express receptors classically described for brain-specific communication such as neurotransmitter receptors and those first discovered as immune cell-specific such as for cytokines. Microglial cells are considered the most susceptible sensors of brain pathology. Upon any detection of signs for brain lesions or nervous system dysfunction, microglial cells undergo a complex, multistage activation process that converts them into the "activated microglial cell." This cell form has the capacity to release a large number of substances that can act detrimental or beneficial for the surrounding cells. Activated microglial cells can migrate to the site of injury, proliferate, and phagocytose cells and cellular compartments.

Physiology of Microglia

Spontaneous local increases in the concentration of intracellular calcium, called "calcium sparks," were detected in quiescent rat heart cells with a laser scanning confocal microscope and the fluorescent calcium indicator fluo-3 Estimates of calcium flux associated with the sparks suggest that calcium sparks result from spontaneous openings of single sarcoplasmic reticulum (SR) calcium-release channels, a finding supported by ryanodine-dependent changes of spark kinetics At resting intracellular calcium concentrations, these SR calcium-release channels had a low rate of opening (approximately 00001 per second) An increase in the calcium content of the SR, however, was associated with a fourfold increase in opening rate and resulted in some sparks triggering propagating waves of increased intracellular calcium concentration The calcium spark is the consequence of elementary events underlying excitation-contraction coupling and provides an explanation for both spontaneous and triggered changes in the intracellular calcium concentration in the mammalian heart

https://science.sciencemag.org/content/sci/262/5134/740.full.pdf

Calcium sparks: elementary events underlying excitation-contraction coupling in heart muscle

The Na+/Ca2+ exchanger, an ion transport protein, is expressed in the plasma membrane (PM) of virtually all animal cells. It extrudes Ca2+ in parallel with the PM ATP-driven Ca2+ pump. As a reversible transporter, it also mediates Ca2+ entry in parallel with various ion channels. The energy for net Ca2+ transport by the Na+/Ca2+ exchanger and its direction depend on the Na+, Ca2+, and K+ gradients across the PM, the membrane potential, and the transport stoichiometry. In most cells, three Na+ are exchanged for one Ca2+. In vertebrate photoreceptors, some neurons, and certain other cells, K+ is transported in the same direction as Ca2+, with a coupling ratio of four Na+ to one Ca2+ plus one K+. The exchanger kinetics are affected by nontransported Ca2+, Na+, protons, ATP, and diverse other modulators. Five genes that code for the exchangers have been identified in mammals: three in the Na+/Ca2+ exchanger family (NCX1, NCX2, and NCX3) and two in the Na+/Ca2+ plus K+ family (NCKX1 and NCKX2). Genes homologous to NCX1 have been identified in frog, squid, lobster, and Drosophila. In mammals, alternatively spliced variants of NCX1 have been identified; dominant expression of these variants is cell type specific, which suggests that the variations are involved in targeting and/or functional differences. In cardiac myocytes, and probably other cell types, the exchanger serves a housekeeping role by maintaining a low intracellular Ca2+ concentration; its possible role in cardiac excitation-contraction coupling is controversial. Cellular increases in Na+ concentration lead to increases in Ca2+ concentration mediated by the Na+/Ca2+ exchanger; this is important in the therapeutic action of cardiotonic steroids like digitalis. Similarly, alterations of Na+ and Ca2+ apparently modulate basolateral K+ conductance in some epithelia, signaling in some special sense organs (e.g., photoreceptors and olfactory receptors) and Ca2+-dependent secretion in neurons and in many secretory cells. The juxtaposition of PM and sarco(endo)plasmic reticulum membranes may permit the PM Na+/Ca2+ exchanger to regulate sarco(endo)plasmic reticulum Ca2+ stores and influence cellular Ca2+ signaling.

https://www.physiology.org/doi/pdf/10.1152/physrev.1999.79.3.763

Sodium/Calcium Exchange: Its Physiological Implications

https://www.cell.com/cell/pdf/0092-8674(95)90359-3.pdf

SCN5A mutations associated with an inherited cardiac arrhythmia, long QT syndrome

A method is described to activate the systolic rise of [Ca2+]i in only one region of a single, isolated cell. This is achieved by applying the calcium chelator BAPTA to the rest of the cell from a pipette. Under control conditions electrical stimulation produced a Ca transient which was uniform throughout the cell. If a BAPTA containing solution was applied to one region of the cell for 100-500 ms before stimulation then there was no systolic Ca transient in that region of the cell. In the rest of the cell, however, the Ca transient was identical to that in control conditions. If BAPTA application was discontinued the Ca transient was normal throughout the cell on the next stimulation. In the presence of ouabain the locally activated systolic Ca transient propagated through the cell. Propagation was associated with an increase of systolic but not diastolic [Ca2+]i. These results show that the systolic Ca transient propagates if the cell Ca content is elevated. We suggest that the fact that Ca-overload produces spontaneous Ca release may be due to the fact that it allows spontaneous Ca release (which may always be occurring) to propagate.

Factors affecting the propagation of locally activated systolic Ca transients in rat ventricular myocytes

To examine the possible cardiotoxicity of the antimalarial drug mefloquine, increasing doses (0.3–30 mg kg−1) were given i.v. to anaesthetized guinea-pigs. Mefloquine did not alter ECG intervals significantly but gradually increased systolic blood pressure (at 3 mg kg−1) then had a depressor effect (at 10 mg kg−1). Death due to profound hypotension, probably resulting from cardiac contractile failure or AV block, occurred after either 10 mg kg−1 (2/6) or 30 mg kg−1 (4/6) mefloquine.




In isolated cardiac preparations mefloquine (3–100 μM) did not alter the effective refractory period but at the higher concentrations resting tension increased. Developed tension was reduced by 100 μM mefloquine in left atria (from 5.8±1.7 to 2.2±0.4 mN) whereas in papillary muscles although 30 μM mefloquine reduced developed tension (from 2.6±0.5 to 1.1±0.1 mN) subsequent addition of 100 μM caused a marked, but not sustained, positive inotropic effect (from 1.2±0.1 to 3.8±0.8 mN).




In single ventricular myocytes, mefloquine (10 μM) shortened action potential duration (e.g. APD90 from 285±29 to 141±12 ms) and reduced the amplitude of the systolic Ca2+ transient. These effects were accompanied by a decrease in the L-type Ca2+ current.




These results indicate that the main adverse effect of mefloquine on the heart is a negative inotropic action. This action can be explained by blockade of L-type Ca2+ channels.






British Journal of Pharmacology (2000) 129, 323–330; doi:10.1038/sj.bjp.0703060

/pdf/effects-of-mefloquine-on-cardiac-contractility-and-1urq221r2z.pdf

Effects of mefloquine on cardiac contractility and electrical activity in vivo, in isolated cardiac preparations, and in single ventricular myocytes

Mechanisms by which cytoplasmic calcium wave propagation and alternans are generated in cardiac atrial myocytes lacking T-tubules-insights from a simulation study.

1. The concentrations of phosphorus-containing metabolites were measured using 31P nuclear magnetic resonance (n.m.r.) in Langendorff-perfused ferret hearts. The hearts were stimulated at a constant rate and developed pressure was measured. 2. The inhibition of oxidative phosphorylation with cyanide (2 mM) decreased developed pressure. This was accompanied by an intracellular acidosis, a fall in the concentration of phosphocreatine ([PCr]) and a rise in that of inorganic phosphate ([Pi]). 3. The effects of cyanide on developed pressure were compared with those of simply decreasing the intracellular pH (pHi) (by elevating CO2) to match the change produced by cyanide. The change of pHi alone resulted in about 33% of the decrease of force produced by cyanide. 4. The relationship between developed pressure and pHi was investigated by altering CO2. It could be described by an equation of the form:log developed pressure = a + b pHi where a and b were independent of pHi. The addition of cyanide decreased a but had no significant effect on b. In other words a given change of pHi had the same fractional effect on pressure in the absence as in the presence of cyanide. 5. In another series of experiments, after cyanide had been added, pHi was returned to control levels by decreasing CO2. This increased developed pressure. Nevertheless the pressure was still considerably less than in control. Furthermore, if the acidosis was abolished by decreasing CO2 at the same time as cyanide was added developed pressure still decreased. 6. We conclude that most of the decrease of developed pressure produced by cyanide is not produced by intracellular acidosis and may result from increased [Pi].

https://physoc.onlinelibrary.wiley.com/doi/pdf/10.1113/jphysiol.1987.sp016728

David A. Eisner

Papers

Factors affecting the propagation of locally activated systolic Ca transients in rat ventricular myocytes

Effects of mefloquine on cardiac contractility and electrical activity in vivo, in isolated cardiac preparations, and in single ventricular myocytes

Mechanisms by which cytoplasmic calcium wave propagation and alternans are generated in cardiac atrial myocytes lacking T-tubules-insights from a simulation study.

The contribution of intracellular acidosis to the decline of developed pressure in ferret hearts exposed to cyanide.

Sodium pump: Birthday present for digitalis