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Action potential control of cardiac contractility.

¹Department of Physiology and Biophysics, Mayo Graduate School of Medicine, Rochester, MN 55905, USA. wood.earl@mayo.edu

Annals of Biomedical Engineering

|January 6, 2001

Summary

The cardiac action potential, particularly its plateau phase, controls heart muscle contraction. New technology could noninvasively measure cardiac reserve in humans.

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Area of Science:

Cardiology
Electrophysiology
Cardiac Physiology

Background:

Cardiac contractility is primarily regulated by the action potential, influenced by trans-sarcolemmal voltage.
Extracellular calcium levels modulate peak tension, correlating with the action potential's plateau phase duration and magnitude.

Discussion:

Extrasystolic potentiation and sustained contracture demonstrate the action potential's role in peak tension.
Prolonged action potential plateau can induce maximal ventricular fiber tension within a single cardiac cycle.

Key Insights:

The action potential's plateau phase is the predominant controller of cardiac contractility.
Maximal tension capability, or peak inotropic state, is achievable via action potential manipulation.

Outlook:

Developing analogous noninvasive techniques for humans could objectively measure cardiac reserve.
High-fidelity spatial (1 mm3 voxel) and temporal (10 ms) resolution systems are needed for clinical diagnostic applications.

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