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


RESULTS
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.


CONCLUSIONS
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.
Hannon
James D
JD
Department of Anesthesiology, Mayo Clinic and Foundation, Rochester, Minnesota, USA. hannon.james@mayo.edu
Housmans
Philippe R
PR
D000758:Anesthesia; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000628:therapy; D001552:Benzazepines / Q000627:therapeutic use; D002118:Calcium / Q000502:physiology*; D020013:Calcium Signaling / Q000502:physiology*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D013504:Cardiovascular Surgical Procedures; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D000077550:Ivabradine; D009218:Myosins / Q000502:physiology; D012519:Sarcoplasmic Reticulum / Q000502:physiology; D012804:Sick Sinus Syndrome / Q000503:physiopathology / Q000628:therapy
D001552:Benzazepines; D002316:Cardiotonic Agents; D000077550:Ivabradine; D009218:Myosins; D002118:Calcium