Isolated cardiomyocytes can be mechanically stretched by a variety of methods that are reviewed. The cell's electrophysiological response to a homogeneous axial stretch is relatively small, however, it is large during a local stretch that applies an additional shear stress component. If not voltage-clamped, cardiomyocytes respond local stretch with membrane depolarization, prolongation of the action potential duration and eventually with extra systoles. Under voltage clamp, local stretch induces an inward current (ISAC) through non-selective channels and it deactivates the inwardly rectifying K+ current (IK1), both changes contributing to the arrhythmogenicity. ISAC is reviewed in terms of ion selectivity and mechanosensitivity. Putative activation mechanisms require an intact cytoskeleton, details, however, are speculative at present. Stretch increases the concentrations of Na+ and Ca2+ in the cytosol and in the cell organelles, partly because of the Na+- and Ca2+ influx carried by ISAC. The modulation of long-lasting stretch on development of hypertrophy and cardiac failure are not included in this review. Instead, the consequences of stretch-induced ion accumulation are discussed in regard to the slow component of the force staircase, and the consequence of stretch-modulated currents in terms of stretch-induced arrhythmias.
Copyright © 2005, Academia Publishing House Ltd.