兔急性心肌梗死后二月心室肌细胞钠离子通道活性的变化

研究急性心肌梗死 (AMI)后心室肌细胞钠离子通道活性的变化。采用结扎兔冠状动脉左前降支的方法建立AMI动物模型 ,应用膜片钳全细胞记录方法 ,观察AMI后 2个月心外膜梗死区心肌细胞钠通道电流 (INa)的变化。结果 :①正常对照组INa电流密度峰值 (去极化电位 - 30mV时 )为 45 .5± 5 .33pA/pF(n =12 ) ,心肌梗死 (简称心梗 )组为 16 .4± 4.43pA/pF(n =13) ,心梗组较对照组明显下降 ,P <0 .0 1。心梗组INa电流 电压关系曲线较对照组明显下移。②心梗组INa失活曲线较对照组明显左移 (即向超级化方向移动 ) ,对照组半数失活电压 (V0 .5)为 - 76 .2± 5 .3mV(n =5 ) ,心梗组V0 .5为 - 82 .4± 5 .6mV(n =12 ) ,P <0 .0 5。③心梗组钠通道灭活后恢复时程较对照组减慢 ,恢复曲线下移。结论 :AMI可导致梗死区心室肌细胞INa下降、钠通道动力学发生变化 ,引起心肌传导速度下降和不应性延长 ,此可能是导致AMI后出现折返性室性心律失常的原因。     

兔冠状动脉结扎1小时缺血区心室肌细胞瞬间外向钾通道的变化

为探讨在急性心肌梗死 (AMI)早期瞬间外向钾通道的变化及其在室性心律失常发生中的作用 ,以开胸冠状动脉 (简称冠脉 )结扎法制备兔急性心肌缺血模型 ,1h后处死动物分离心室肌细胞 ,采用全细胞膜片钳记录技术观察缺血区心外膜心室肌细胞瞬间外向钾通道电流 (Ito)的变化 ,以正常心肌Ito为对照。结果 :急性冠脉结扎 1h兔缺血区心室肌细胞Ito受到抑制 ,电流密度$C电压关系曲线下移 ,测试电压 + 60mV时的Ito电流密度对比显示 :对照组为 1 7.39± 5 .2 4pA/pF (n =1 2 ) ,冠脉结扎 1h组为 7.75± 3.1 1pA/pF (n =1 0 ) ,与对照组相比下降了 5 7% ,P <0 .0 0 1 ;其失活曲线左移 ,半数最大失活电压 (V1 /2 )对照组为 - 35 .2± 5 .3mV(n =1 2 ) ,冠脉结扎 1h组为 - 5 5 .1± 5 .6mV(n =1 0 ) ,与对照组比较失活速度加快 ,P <0 .0 1 ;冠脉结扎后 1h组Ito恢复明显减慢 ,恢复时程延长 ,P <0 .0 5。结论 :冠脉结扎后 1h缺血区心室肌细胞瞬间外向钾通道受抑制 ,影响动作电位复极 ,容易诱发 2相折返 ,可能为AMI后室性心律失常发生的机制之一。     

伊布利特对兔急性心肌梗死后梗死周边区心外膜心室肌细胞L型钙电流的影响

目的观察伊布利特对急性心肌梗死(AMI)后一周心室肌细胞L型钙通道电流(ICa-L)的影响。方法兔开胸,左前降支结扎造成AMI,1周后酶解分离梗死周边区心外膜心室肌细胞,用全细胞膜片钳技术记录10-6mol/L伊布利特细胞外液(伊布利特组)对梗死周边区心外膜心室肌细胞ICa-L活性的影响,并与正常对照组(对照组)及AMI但未灌流伊布利特组(AMI组)比较。结果①AMI 1周时兔梗死周边区心室肌细胞ICa-L受到抑制,电流密度-电压曲线(I-V)上移,ICa-L电流密度峰值降低[-3.52±0.91 pA/pF(n=10)vs-5.68±1.53 pA/pF(n=10),P<0.05];伊布利特组电流密度峰值为-4.84±1.22 pA/pF(n=8),较AMI组显著增大(P<0.05),与对照组比较,虽有减小,但无差异(P>0.05)。②AMI组、伊布利特组ICa-L失活曲线明显左移,以AMI组左移更加明显,对照组半数失活电压(V0.5)为-32±4 mV(n=10),AMI组V0.5增加为-46±7 mV(n=10,P<0.05),伊布利特组V0.5为-36±6mV(n=8),与对照组比较无差异(P>0.05)。结论AMI后1周梗死周边带心室肌细胞L型钙通道受阻滞,伊布利特对缺血引起的ICa-L的异常有明显改善作用。     

急性心肌梗死对心室肌细胞钾电流的影响

目的 :研究急性心肌梗死 （AMI）心室肌细胞瞬时外向钾电流 （Ito）和内向整流性钾电流 （IK1 ）的变化。方法 :采用结扎兔冠状动脉左前降支的方法建立 AMI动物模型 ,应用膜片钳全细胞记录方法 ,记录比较 AMI后 1周心外膜梗死区心肌细胞 Ito和 IK1 的变化。结果 :心梗组 Ito明显下降 ,I- V曲线明显下移。指令电位为 +60 m V时 ,Ito在心梗组为 1.0 8± 0 .2 4n A（n=12 ） ,与对照组 （2 .0 9± 0 .3 9n A ,n=16）相比 ,显著下降 ,P<0 .0 1;心梗组 IK1 与对照组比较 ,明显下降 ,特别在超极化时。指令电位为 - 12 0 m V时 ,心梗组 IK1 为 3 .0 1± 0 .49n A （n=11） ,对照组为 4.12±0 .5 1n A（n=10 ,P<0 .0 5 ）。结论 :AMI可引起心室肌细胞 Ito和 IK1 的下降 ,从而导致动作电位平台期延长、复极异常 ,这可能是导致 AMI后出现折返性室性心律失常的原因     

正常大鼠心室肌细胞动作电位和瞬时外向钾离子流的特点

目的研究正常Spraque-Dawley大鼠外层、中层和内层心室肌细胞动作电位(AP)和瞬时外向钾离子流(Ito)的特点。方法采用酶消化法获得大鼠外层、中层和内层心室肌细胞,以全细胞膜片钳技术记录心室肌细胞AP和Ito。结果成功记录到大鼠心室肌细胞外、中和内层心肌细胞AP和Ito。外层至内层心室肌细胞动作电位时程(APD)逐渐延长(P<0.05)。在+70mV刺激时外层至内层心室肌细胞Ito电流密度逐渐减小,分别为59.50±15.99,29.15±5.53和12.29±3.62pA/pF(P<0.05)。三层心室肌细胞曲线半激活电压、半失活电压及失活后恢复时间均无差异(P>0.05)。结论大鼠三层心室肌细胞AP形态和Ito大小存在分层差别。     

心肌梗死后残存心室肌细胞L型钙通道的改变

目的　探讨L型钙通道在急性心肌梗死 (AMI)后室性心律失常发生中的作用及其机制。方法　开胸冠脉结扎制备兔AMI模型 ,于 1周和 2个月处死动物分离心室肌细胞 ,以膜片钳技术记录梗死及周边区心外膜细胞L -型钙通道电流 (ICa -L)的变化。结果　AMI兔梗死周边区心外膜细胞L型钙电流受到抑制 ,电流密度 -电压关系 (I -V)曲线上移 ,其峰值电流密度在正常对照组、AMI后 1周和 2个月分别为 - ( 5 5 8± 1 5 3) pA /pF(n =10 )、- ( 3 5 2± 0 93) pA/ pF (n =6 ,与对照组比较P <0 0 5 )和 - ( 4 84± 1 4 8)pA/ pF(n =11,与对照组比较P <0 0 5 ) ,但I -V曲线的形态轨迹不变。其失活曲线左移 ,失活速度加快 ,半数最大失活电位 3组分别为 -( 13 1± 4 2 )mV、- ( 2 5 9± 7 0 )mV和 - ( 2 1 3± 5 6 )mV ,P <0 0 5。结论　AMI后梗死周边带心外膜细胞L型钙通道受抑制 ,可能为AMI后室性心律失常发生的机制之一 ;AMI后 2个月钙通道的异常程度减轻 ,有恢复正常的趋势     

兔急性心肌梗死后梗死周边带心肌细胞L-型钙通道的变化

探讨L型钙通道在急性心肌梗死 (AMI)后室性心律失常发生中的作用及其机制。方法 :以开胸冠状动脉结扎法制备兔AMI模型 ,1周后处死动物分离心室肌细胞 ,采用全细胞膜片钳记录技术观察梗死周边缺血带心外膜心室肌细胞L型钙通道电流 (ICa L)的变化 ,以正常心肌ICa L为对照。结果 :AMI 1周时兔梗死周边区心室肌细胞L型钙电流受到抑制 ,其电流峰值由正常状态下的 - 5 .58± 1 .53pA/pF(对照组 ,n =1 0 )降至 - 3 .52± 0 .93pA/pF(AMI组 ,n=6) ,最大峰电流下降 2 9.1 % ,P <0 .0 5 ,I V曲线上移 ;其失活曲线左移 ,半数最大失活电位由 - 1 3 .1± 4 .2mV左移至 - 2 5 .9± 7.0mV ,P <0 .0 5 ,失活速度加快。结论 :AMI后 1周梗死周边带心外膜心室肌细胞L型钙通道受抑制 ,可能为AMI后室性心律失常发生的机制之一。     

糖尿病对大鼠心肌细胞动作电位和瞬时外向钾电流的影响

目的探讨糖尿病对大鼠心室肌细胞动作电位(AP)和瞬时外向钾电流(Ito)的影响。方法通过链脲佐菌素诱导糖尿病大鼠模型,双酶法急性分离出对照组和糖尿病组心室肌细胞,全细胞膜片钳技术分别观察心肌细胞AP和Ito电流密度变化以及Ito动力学改变。结果与对照组比较,糖尿病组心肌细胞AP形态明显增宽,AP复极20%、50%和90%的时程均明显延长(64.3±7.5 ms vs 29.7±9.2 ms;174.3±6.8 ms vs 98.9±4.2 ms;276.7±8.3 ms vs 173.7±7.2 ms,P均<0.01,n=12);在钳制电位为+50mV时,与对照组比较,糖尿病组心肌细胞Ito的电流密度显著降低(11.51±1.37 pA/pF vs 17.43±1.98 pA/pF,P<0.05,n=12);与对照组比较,糖尿病组心肌细胞Ito的I-V曲线明显下移;失活曲线显著左移(P<0.01,n=12);失活恢复曲线明显减慢。结论糖尿病引起了心肌细胞AP时程延长,Ito幅度降低,并使Ito的失活加快以及失活后恢复减慢。     

辛伐他汀对急性心肌梗死兔的心室肌细胞钠离子通道电流的影响

目的 研究辛伐他汀预处理对兔急性心肌梗死（AMI）后24 h心室肌细胞钠离子通道电流的影响,并探讨他汀类药物抗心律失常的细胞学离子机制。方法 采用结扎兔冠状动脉左前降支的方法,建立AMI动物模型。将45只新西兰大耳白兔随机分为3组:心梗组、辛伐他汀治疗组［他汀组,手术前3 d给予辛伐他汀 5 mg/(kg·d)］及假手术对照组（只开胸不结扎血管）。采用酶解法分离心室肌外膜单个心室肌细胞;采用全细胞膜片钳技术,记录跨膜钠离子通道电流（INa）,同时应用全自动生化分析仪检测各组血脂的水平。结果 各组动物血脂的水平无显著差异。对照组、心梗组和他汀组的INa电流密度峰值（-30 mV）分别为(-42.78±5.48)pA/pF(n=16)、(-23.26±5.18)pA/pF(n=12)和(-39.23±5.45)pA/pF(n=13)。心梗组较对照组明显下降（P<0.01）,他汀组较心梗组明显升高（P<0.01）。另外,心梗组INa失活曲线左移,失活后恢复时间延长,他汀组这些异常也明显恢复。结论 AMI可导致梗死区心肌细胞INa明显下降,辛伐他汀预处理可减轻INa的异常变化,逆转电重构,而不依赖于降血脂的效应,可能为他汀类药物降低心律失常发生率的细胞学离子机制。     

黄芪对兔急性心肌梗死心室肌细胞钠通道电流的影响

目的 :研究黄芪对兔急性心肌梗死 （AMI）后心室肌细胞钠通道电流 （INa）的影响。方法 :采用结扎兔冠状动脉左前降支的方法建立 AMI动物模型 ,应用膜片钳全细胞记录方法 ,观察 AMI后 1周心外膜梗死区心肌细胞 INa的变化。结果 :AMI后 1周 INa的 I- V曲线明显上移。对照组 INa电流密度峰值 （- 30 m V）为 4 5 .5 0± 5 .33p A/ p F（n=12 ） ,AMI组为 2 2 .4 8± 4 .6 2 p A/ p F（n=14 ） ,显著低于对照组 （P<0 .0 1） ;黄芪组为 37.14± 3.79p A / p F（n=15 ） ,与 AMI组相比 ,显著增大 （P<0 .0 5 ）。结论 :AMI后 1周梗死区心室肌细胞 INa明显下降 ,黄芪可以使 AMI后下降的 INa趋于正常 ,逆转 AMI后形成的电重构。     

Altered Pharmacologic Responsiveness of Reduced L-Type Calcium Currents in Myocytes Surviving in the Infarcted Heart

Altered Pharmacology of I_ca,L in Myocytes From Infarcted Heart. The pharmacologic responses of macroscopic L-type calcium channel currents to the dihydropyridine agonist, Bay K 8644, and β-adrenergic receptor stimulation by isoproterenol were studied in myocytes enzymatically dissociated from the epicardial border zone of the arrhythmic 5-day infarcted canine heart (IZs). Calcium currents were recorded at 36° to 37° C using the whole cell, patch clamp method and elicited by applying step depolarizations from a holding potential of -40 mV to various test potentials for 250-msec duration at 8-second intervals. A Cs⁺ -rich and 10 mM EGTA-containing pipette solution and a Na⁺-and K⁺-free external solutions were used to isolate calcium currents from other contaminating currents. During control, peak I_ca,L, density was found to be significantly less in IZs (4.0 ± 1.1 pA/pF) than in myocytes dispersed from the epicardium of the normal noninfarcted heart (NZs; 6.5 ± 1.8 pA/pF). Bay K 8644 (I μM) significantly increased peak I_ca,L density 3.5-fold above control levels in both NZs (to 22.5 ± 6.2 pA/pF; n = 7) and IZs (to 12.8 ± 3.0 pA/pF; n = 5), yet peak I_ca,L density in the presence of drug was significantly less in IZs than NZs. The effects of Bay K 8644 on kinetics of current decay and steady-state inactivation relations of peak I_ca,L were similar in the two cell types. In contrast, the response of peak L-type current density to isoproterenol (1 μM) was significantly diminished in IZs compared to NZs regardless of whether Ba²⁺ or Ca²⁺ ions carried the current. Thus, these results indicate an altered responsiveness to β-adrenergic stimulation in cells that survive in the infarcted heart. Furthermore, application of forskolin (1 μM and 10 μM) or intracellular cAMP (200 μM), agents known to act downstream of the β-receptor, also produced a smaller increase in peak I_Ba density in IZs versus NZs, suggesting that multiple defects exist in the β-adrenergic signaling pathway of IZs. In conclusion, these studies illustrate that reduced macroscopic calcium currents of cells in the infracted heart exhibit an altered pharmacologic profile that has important implications in the development of drugs for the diseased heart.     

Abnormal electrical properties of myocytes from chronically infarcted canine heart. Alterations in Vmax and the transient outward current.

BACKGROUND. Reentrant ventricular arrhythmias can occur in the surviving muscle fibers of the epicardial border zone of the canine heart 5 days after coronary artery occlusion. To understand the cellular basis of these arrhythmias, we developed a method of dispersing myocytes (IZs) from the epicardial border zone. METHODS AND RESULTS. We compared the electrophysiological properties of IZs with those of cells dispersed from the epicardium of control noninfarcted (NZs) and of sham-operated animals (NZsham). Transmembrane action potentials of IZs are reduced in total action potential amplitude and maximum upstroke velocity compared with NZs. However, resting potential of IZs is no different from that of NZs. Action potential duration at -10 mV is significantly reduced in IZs compared with control, and IZ potentials do not show the typical "spike and dome" morphology that is evident in all NZs. Using Vmax as an indirect measure of the peak inward current available for the upstroke of the action potential, we found that the availability curve for IZs is significantly different from the NZ curve. Furthermore, the time course of recovery of Vmax after a depolarizing voltage clamp step was significantly altered in IZs. Using whole-cell voltage clamp techniques, we determined that the voltage-dependent, Ca(2+)-independent, 4-aminopyridine-sensitive transient outward current (ito1) occurred in all NZs (n = 16) but existed in only 37% of IZs (n = 16). There was a significant reduction in the density of ito1 elicited by depolarizing steps in those IZs showing ito1 compared with ito1 density in NZs. CONCLUSIONS. We have developed a single-cell model of cells that survive in the infarcted heart. Our studies indicate that there are changes in Vmax in IZs. In addition, there is no prominent phase 1 of repolarization in IZ action potentials. This is consistent with the dramatic loss in the function of the ionic channel responsible for the voltage-dependent transient outward current, ito1.     

乙酰胆碱对犬右室三层心肌细胞L型钙电流不均一性的影响

目的测定犬右室三层心肌细胞上的L型钙电流(ICa,L),并研究其对自主神经递质乙酰胆碱的反应。方法经酶解法分离获得犬右室三层心肌细胞,应用全细胞膜片钳技术,记录并比较三层心肌细胞的ICa,L,以及应用2μmol/L乙酰胆碱前后电流-电压曲线的差异。结果ICa,L的峰值电流密度外膜下大于M细胞,而M细胞又大于内膜下心肌细胞,分别为-4.896±1.907pA/pF(n=31),-3.406±0.904pA/pF(n=37),-2.788±0.756pA/pF(n=33)(P<0.05)。使用乙酰胆碱后,右室外膜下及M细胞的峰值电流密度减小[-4.921±1.023pA/pF vs -3.462±0.997pA/pF(n=12);-3.803±1.115pA/pF vs -2.959±0.883pA/pF(n=13),P均<0.05]。心内膜下心肌细胞用药前后无差异(P>0.05)。结论ICa,L在犬右室三层心肌细胞存在不均一性,乙酰胆碱可以减小心外膜下、M细胞的ICa,L,对内膜下心肌细胞的ICa,L无影响。     

Can PKA activators rescue Na+ channel function in epicardial border zone cells that survive in the infarcted canine heart?

OBJECTIVE AND METHODS: In this study, we investigated the effects of a PKA stimulating cocktail on sodium currents from normal epicardial cells (NZs) and on those from cells dispersed from the epicardial zone of the 5-day infarcted canine heart (IZs). To do so, we used whole-cell voltage-clamp techniques. RESULTS: During superfusion with the PKA activator cocktail, peak sodium current (I(Na)) density significantly increased by 32+/-5.3% (NZs) and 17+/-5.4% (IZs). However, despite this increase, IZ peak I(Na) still was not fully restored to NZ values. In both cell types, the density effect was accompanied by a shift in I/I(max) curves, as well as a slowing in recovery from inactivation. Inactivation from a closed state was accelerated. Furthermore, in the presence of chloroquine, which is known to interrupt intracellular vesicular traffic, PKA activator effects to augment I(Na) were only partially inhibited in NZs but abolished in IZs. To understand whether the phosphorylation status of basal Na(+) channels in the two cell groups differed, the effects of okadaic acid and PP2A1 were studied. Results suggest that in IZs, Na(+) channels in the basal state are already phosphorylated. CONCLUSIONS: PKA stimulation of I(Na) of the remodeled IZ does augment current density possibly by augmenting the trafficking of channels to an active site on the membrane. However, the resulting I(Na), while partially rescued, is not similar to the potentiated I(Na) of NZs. Specific kinetic changes also occur with the PKA stimulation of IZs and results with okadaic acid and PP2A1 suggest that in their remodeled state, Na(+) channels in IZs are already phosphorylated.     

辛伐他汀对血脂正常兔心肌缺血再灌注后L型钙电流的影响

目的通过研究辛伐他汀预处理对兔心肌缺血再灌注后L型钙离子通道电流(ICa-L)的影响,探讨他汀类药物抗心律失常的细胞学离子机制。方法45只新西兰大耳白兔随机分为3组:缺血再灌注组(I-R组,结扎冠状动脉左前降支30min后再开放120min);辛伐他汀治疗组(他汀组,手术前给予辛伐他汀5mg·kg-1·d-1,3天);假手术对照组(对照组,只开胸不结扎血管)。观察心律失常发生情况。采用酶解法分离缺血部位心室肌外膜单个心室肌细胞,采用全细胞膜片钳技术,记录ICa-L,同时检测各组血脂水平。结果各组动物血脂水平无显著差异。I-R组心律失常发生率较对照组增加,他汀组较I-R组心律失常发生率明显下降。对照组、I-R组和他汀组ICa-L电流密度峰值(0mV)分别为-3.13±1.22pA/pF(n=16),-4.24±0.92pA/pF(n=15)和-3.46±0.85pA/pF(n=13)。I-R组较对照组明显升高(P<0.05),他汀组较I-R组明显下降(P<0.05),他汀组与对照组无差异(P>0.05)。结论缺血再灌注可导致梗死区心室肌细胞I明显增加,辛伐他汀预处理可逆转这种变化。     

陈旧性心肌梗死对家兔动作电位时程跨室壁离散及L型钙电流的影响

探讨陈旧性心肌梗死 (MI) (MI后 3个月 ) ,远离MI中心区的心肌细胞电活动的改变。结扎家兔左前降支造成MI模型 ,3个月后酶解分离左室游离壁远离MI中心区的三层 (Epi、M、Endo)心肌细胞 ,采用全细胞膜片钳技术记录单细胞动作电位 (AP)和L型钙电流 (ICa ,L) ,并观察三层心肌细胞AP时程 (APD)的离散性 (TD APD)变化。结果 :MI后 3个月 ,远离MI区的三层心肌细胞的APD明显延长 ,其中Endo心肌细胞的APD明显短于Epi和M心肌细胞(P <0 .0 1)。陈旧性MI组 (OMI)与假手术组 (Sham)及对照组 (Control)比较 ,TD APD显著增加 (2 88.32± 19.5 6vs2 2 8.4 5± 13.94 ,2 10 .32± 17.4 3ms ,P <0 .0 1)。且在OMI组 ,ICa ,L的幅值增加 ,但密度降低 ,其中Endo的ICa,L密度降低最明显 (+10mV时 ,从 16 .12± 1.6 0降至 10 .73± 0 .0 6pA/pF ,降低了 33.4 3% ,Epi从 16 .5 9± 0 .5 0降至 11.75±0 .6 9pA/pF ,降低了 2 9.17% ,M细胞从 18.70± 1.0 3降至 13.2 7± 1.0 5pA/pF ,降低了 2 9.0 3% ,P <0 .0 5 )。结论 :MI3个月后远离MI区的心肌细胞ICa ,L密度明显降低 ,且以Endo降低最明显 ,三层心肌细胞的APD明显延长 ,并且En do心肌细胞的APD明显短于Epi和M心肌细胞 ,TD APD明显增加     

Delayed rectifier K currents have reduced amplitudes and altered kinetics in myocytes from infarcted canine ventricle

OBJECTIVE: The rapid (I(Kr)) and slow (I(Ks)) components of delayed rectifier currents play an important role in determining the cardiac action potential configuration. Abnormalities in their function may contribute to arrhythmogenesis under pathological conditions. We studied the effects of myocardial infarction on I(Kr) and I(Ks) in canine ventricular myocytes and their molecular basis. METHODS: Infarct zone myocytes (IZs) were isolated from a thin layer of surviving epicardium overlying an infarct 5 days after a total occlusion of the left anterior descending (LAD) coronary artery. Normal myocytes (NZs) were isolated from the corresponding region of control hearts for comparison. Currents were recorded under the whole-cell patch clamp conditions. RESULTS: Both I(Kr) and I(Ks) current densities were reduced in IZs versus NZs. Kinetic analysis further suggests an acceleration of I(Kr) activation and I(Ks) deactivation. RNase protection assays were used to quantify the mRNA levels of I(Kr) and I(Ks) channel subunits (dERG, dIsK and dKvLQT1) in tissue immediately adjacent to the region where myocytes were isolated. mRNA levels of all three subunits were reduced 2 days after LAD occlusion (by 48+/-9%, 68+/-5%, and 45+/-4% for dERG, dIsK and dKvLQT1, respectively, n=8 each). By day 5, the dKvLQT1 message returned to control while those of dERG and dIsK remained reduced (by 52+/-7% and 76+/-6%, respectively). CONCLUSIONS: The decrease in I(Kr) and I(Ks) amplitudes and changes in their kinetics in infarcted tissue might be due to a decrease in functional channels and/or changes in their subunit composition. Heterogeneous changes in I(Kr) and I(Ks) in infarcted hearts may impact on the effects of varying heart rate or neurohumoral modulation on repolarization.