Physiology and Pharmacology
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| show | Parasympathetic via vagus nerve
Sympathetic via postganglionic fibres
Somatic afferent fibres
Intrinsic cardiac nervous system
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| show | Sympathetic - faster heart rate, faster conduction velocity, stronger contraction and faster relaxation
Parasympathetic - slower heart rate, slower conduction velocity - may innervate ventricles but limited evidence
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| show | Mainly on If, Ica and Ik - these control heart rate
Increases these to give a faster pacemaker, upstroke and recovery
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| show | Can activate K channels, causing hyperpolarisation
Antagonises the sympathetic NS and opens IKACh, reducing heart rate and hyperpolarising membrane potential
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| show | Lack of stabilising Ik - more positive and alterable resting potential
Stabilised by IKACh
Early pacemaker current - If
Late pacemaker current - IcaT
Upstroke - IcaL
Recovery - Ik
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| Effect of beta receptors | show 🗑
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| show | ACh and parasympathetic nerve stimulation hyperpolarise the membrane potential, decrease pacemaker and upstroke rate and rate of beating
Increased RR interval
Longer phase 4
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| Positive ionotropic effects of sympathetic nerve stimulation | show 🗑
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| show | Activates adenyl cyclase - cAMP - PKA
Phosphorylates L type calcium channels, phospholamban, Ryr, myofilaments
Increases calcium induced calcium release from stores and inhibits PLB thus enhancing calcium reuptake
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| Ionotropic effects of sympathetic nerve stimulation | show 🗑
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| Evidence that IcaL is altered by PKA | show 🗑
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| Role of protein phosphatase 2A | show 🗑
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| Changed in pressure volume loops during exercise | show 🗑
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| Roles of pharmacological compounds | show 🗑
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| show | Digitalis inhibits NKX
Ca sensitiser alters calcium sensitivity of TnC
PDE inhibitors inhibit phosphodiesterase - increase conc of cAMP
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