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Ca2+: is there something new for the cardiovascular anesthesiologist?

机译:Ca2 +:心血管麻醉师有什么新东西吗?

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PURPOSE OF REVIEW: Anesthesiologists are frequently called upon to treat abnormalities of heart rhythm or pumping ability. Intracellular Ca is crucial for normal excitation-contraction coupling in the heart and plays a major role in the sequence of events that starts with an electrical signal generated in the atria and ends with myocardial contraction. RECENT FINDINGS: From controlled diffusion within the cell to a potential role as a biological clock, intracellular Ca is receiving a great deal of attention. For example, the pacemaking electrical signal is known to originate in the sinoatrial node myocyte, but exactly what role Ca plays is controversial despite the fact that the sinoatrial node was discovered over 100 years ago. Basic mechanisms involved in disease processes such as atrial fibrillation and new interventions for heart rate control are beginning to emerge. New discoveries in ventricular myocytes are also stimulating the development of promising therapeutic interventions to safely increase the pumping ability of the heart. SUMMARY: As our understanding of cardiac physiology and pharmacology progresses at the subcellular and molecular levels, new therapies will continue to emerge and the practice of anesthesia will benefit greatly.
机译:审查目的:经常要求麻醉师治疗心律或泵浦能力异常。细胞内钙对于心脏中正常的兴奋-收缩耦合至关重要,并且在一系列事件中起着重要作用,这些事件以心房中产生的电信号开始并以心肌收缩结束。最近的发现:从细胞内的受控扩散到作为生物钟的潜在作用,细胞内Ca受到了广泛的关注。例如,已知起搏电信号起源于窦房结肌细胞,但是尽管实际上窦房结是在100多年前发现的,但Ca到底起什么作用还是有争议的。诸如房颤和控制心率的新干预等疾病过程中涉及的基本机制开始出现。心室肌细胞的新发现也正在刺激有前途的治疗干预措施的发展,以安全地增加心脏的泵血能力。摘要:随着我们对心脏生理学和药理学的理解在亚细胞和分子水平上的发展,新的疗法将继续出现,麻醉的实践将大大受益。

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