Chapter

Intracellular calcium handling in heart failure

Godfrey L. Smith and Rachel C. Myles

in Oxford Textbook of Heart Failure

Published on behalf of Oxford University Press

ISBN: 9780199577729
Published online July 2011 | e-ISBN: 9780199697809 | DOI: http://dx.doi.org/10.1093/med/9780199577729.003.0010

Series: Oxford Textbooks

Intracellular calcium handling in heart failure

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Heart failure (HF) is a heterogeneous clinical syndrome which may be characterized by a variety of phenotypic changes, many of which have been linked to abnormalities in the intracellular calcium(Ca2+) signal. These range from mechanical dysfunction, usually characterized by reduced systolic contractile function, to electrophysiological dysfunction including QT interval prolongation, an increased incidence of ventricular premature beats (VPBs) and arrhythmic sudden cardiac death (SCD). In ventricular myocardial cells, intracellular Ca2+ ion fluxes govern the translation of the depolarizing signal into mechanical contraction, a process termed excitation–contraction (E-C) coupling. Abnormalities of intracellular Ca2+ handling are thought to underlie both mechanical and electrophysiological dysfunction in failing myocardium. This chapter summarizes the events involved in normal E-C coupling and describes the changes observed in HF, with particular focus on the changes reported in remodelled ventricular myocardium. Changes in intracellular Ca2+ signalling in other cardiac cell types, such as atrial cardiomyocytes and Purkinje fibre cells, may also be crucial to the final HF phenotype, but less is known about pathological changes in these tissues, and therefore these will only be mentioned briefly.

Chapter.  5900 words.  Illustrated.

Subjects: Cardiovascular Medicine

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