兔心肌梗死1周及2月后心室肌细胞瞬间外向钾电流的变化

目的:研究心肌梗死后心室肌细胞瞬间外向钾电流(I_to)的变化。方法:采用结扎兔冠状动脉左前降支的方法复制心肌梗死动物模型,酶解法分离单个心室肌细胞,应用膜片钳全细胞记录方法,观察心肌梗死后1周及2月心外膜梗死区及非梗死区心室肌细胞I_to的变化。结果:①非梗死区2月组心肌细胞膜电容明显大于对照组,P＜0.05。②梗死区I_to电流密度(+60mV时)的对比显示:对照组为(17.4±5.2)pA/pF(n=16),梗死区1周组为(7.5±2.4)pA/pF(n=12),明显低于对照组(P＜0.01)。梗死区2月组为(10.6±4.1)pA/pF(n=18),明显低于对照组(P＜0.01),但高于梗死区1周组(P＜0.05)。③非梗死区2月组I_to电流密度为(13.2±4.1)pA/pF(n=23),明显低于对照组(P＜0.05),但高于梗死区2月组(P＜0.05)。结论:心肌梗死可引起心室肌细胞I_to电流密度下降,而且不同区域之间(梗死区及远离梗死区)也存在电生理的异质性,可能是导致心肌梗死后出现折返性室性心律失常的原因。心肌梗死后2月梗死区I_to的下降有恢复倾向。     

急性坏死性胰腺炎对心室肌细胞钠和钙离子电流的影响

目的:研究急性坏死性胰腺炎(ANP)后心室肌细胞钠通道电流(I_Na)、L-钙通道电流(I_Ca-L)活性的变化。方法:采用牛磺胆酸钠逆行胰胆管注射建立鼠的ANP动物模型,应用膜片钳全细胞记录方法,观察ANP后1 h心肌细胞I_Na、I_Ca-L的变化。结果:I_Na和I_Ca-L电流-电压关系曲线在ANP组较对照组明显上移。ANP组I_Na电流密度峰值(-30 mV)为(12.45±2.26)pA／pF(n=16),明显低于假手术组(25.32±3.31)pA/pF(n=14),P<0.01;ANP组I_Ca-L电流密度峰值(+10 mV)为(3.63±0.65)pA／pF(n=16),显著低于假手术组(5.46±1.03)pA／pF(n=12),P<0.01。结论:ANP可导致心室肌细胞I_Na和I_Ca-L下降,引起心肌传导速度下降和动作电位时程缩短,可能是导致ANP后出现心律失常的原因。     

兔左室肥厚心肌跨室壁复极不均一性及其膜离子流变化的实验研究

目的:探讨兔左心室肥厚心肌心外膜下、中层、心内膜下3层心肌细胞动作电位及膜离子流变化的不均一性。方法: 心肌肥厚组以腹主动脉缩窄术复制兔压力超负荷心肌肥厚模型,并设正常对照组以作比较。胶原酶两步消化法分离获取兔单个心室肌细胞,其中用植皮刀分离左室游离壁内膜下、中层、外膜下3层心肌。以全细胞膜片钳记录单细胞跨膜动作电位和离子电流。结果: 肥厚组3层心肌细胞动作电位时程(APD₉₀)较对照组3层心肌细胞APD₉₀均分别有明显延长,而以中层心肌细胞APD₉₀延长最为明显(延长比例:中层26.0%±2.7%,外膜14.0%±1.6%,内膜10.0%±1.1%),使肥厚心肌跨室壁复极不均一性明显大于对照组。肥厚组各层心肌细胞瞬时外向钾电流(I_to)和缓慢激活的延迟整流钾电流(I_Ks)密度均低于对照组,且均以中层细胞下降的幅度最大。肥厚组各层心肌细胞L型钙电流(I_Ca,L)与快速激活的延迟整流钾电流(I_Kr) 密度与对照组均无明显差异。肥厚组各层心肌细胞内向整流钾电流(I_K1) 均明显低于对照组,但各层变低的幅度无明显差异。 结论:兔肥厚心肌跨室壁复极不均一性明显增大,I_to及I_Ks的跨室壁不均一性下降可能是其主要原因。     

cGMP对慢性低氧大鼠肺动脉平滑肌细胞膜电压门控钾通道的作用

目的:探讨cGMP对慢性低氧大鼠肺动脉平滑肌细胞(PASMC)膜电压门控钾通道(Kv通道)的作用, 为进一步阐明慢性低氧性肺动脉高压的发病机理提供理论依据。方法: Wistar大鼠, 随机分为对照组和慢性低氧组, 低氧组大鼠每天低氧(氧浓度10%±1%)8 h, 连续4周。单个大鼠PASMC的获得采用急性酶分离法(胶原酶Ⅰ型和木瓜蛋白酶)。采用全细胞膜片钳技术测定两组PASMC的静息膜电位(Em)和电压门控钾通道的钾离子电流(I_KV), 观察并比较cGMP (1 mmol/L) 以及cGMP和蛋白激酶G(PKG)抑制剂H-8 (1 mmol/L) 应用后两组PASMC I_KV的不同变化。结果:慢性低氧大鼠PASMC的静息膜电位和电压门控钾通道电流明显低于正常对照组。cGMP可抑制正常和慢性低氧大鼠PASMC +50 mV刺激时的峰值I_KV[正常组从(118.0±5.0)pA/pF下降到(89.9±16.5) pA/pF, n=6, P<0.05;慢性低氧组则从(81.0±5.0) pA/pF 下降到(56.8±9.1) pA/pF, n=6, P<0.05], 该抑制作用可被PKG的抑制剂H-8阻断[正常组(119.2±10.3) pA/pF vs (117.8±9.1)　pA/pF, n=6, P>0.05;慢性低氧组(96.8±6.2) pA/pF vs (98.0±2.2)　pA/pF, n=6, P>0.05]。结论:慢性低氧抑制肺动脉平滑肌细胞的电压门控钾通道。cGMP可能通过磷酸化作用而抑制正常和慢性低氧肺动脉平滑肌细胞的电压门控钾通道电流。     

心脏复极储备电流IKs在糖尿病QT间期延长性别差异中的作用

目的: 观察不同性别糖尿病家兔QT间期延长病理条件下的缓慢延迟整流钾电流(I_Ks)以及蛋白变化,为探讨糖尿病性长QT综合征性别差异的离子机制做基础。方法: 取体重2-2.5 kg家兔,一次性注射预热(37 ℃)的四氧嘧啶(140 mg/kg),8周后造成1型糖尿病模型,测定血糖,记录标准II导联心电图,采用酶解法分离家兔单个心室肌细胞,应用全细胞膜片钳技术记录动作电位时程(APD)和I_Ks,并且运用Western blotting法检测KvLQT1和mink蛋白表达变化。结果: 雌雄糖尿病组QT间期和APD均较对照组延长,雄性延长明显,且延长百分比差异显著(P<0.05)。在+40 mV到+70 mV测试电压范围内,雄性糖尿病组I_Ks step电流密度均低于对照组(P<0.05),在+70 mV时,由对照组(3.08±0.67)pA/pF(n=17)降低到(1.27±0.20)pA/pF(n=16),在0 mV~+70 mV测试电压范围内,雌性糖尿病组I_Ks step电流密度均高于对照组(P<0.05),在+70 mV时,由对照组的(1.56±0.20)pA/pF(n=13)增加到(3.65±0.50)pA/pF(n=14)。Western blotting结果显示雄性糖尿病组KvLQT1和mink蛋白表达水平分别下 调21.6%和18.5%;雌性糖尿病组KvLQT1和mink蛋白表达水平分别上调42.3%和20.5%(P<0.05)。结论: I_Ks参与了糖尿病QT间期延长的发生,并且存在性别差异。在雌性家兔早期糖尿病模型中,作为一个复极储备,代偿性上调,限制了QT间期的过度延长。     

胡椒碱减轻H2O2 引起的兔心房肌细胞内向整流钾电流及超速激活延迟整流钾电流的异常改变

目的: 研究胡椒碱对H₂O₂引起的兔单个心房肌细胞内向整流钾电流(I_K1)及超速激活的延迟整流钾电流(I_KUr)异常的影响。方法: 采用全细胞膜片钳技术分析50 μmol/L H₂O₂对兔单个心房肌细胞I_K1和I_KUr的影响,并研究预先应用7 μmol/L胡椒碱对其的保护作用。结果: 7 μmol/L胡椒碱对正常兔心房肌细胞I_K1和I_KUr及其通道动力学无显著影响。在50 μmol/L H₂O₂作用下,兔心房肌细胞I_K1峰值由(-148.2±16.7)pA/pF降低至(-64.2±9.8)pA/pF (P<0.05),电流-电压曲线上移;而I_KUr峰值由(16.0±2.1)pA/pF降低至(6.1±1.4)pA/pF (P<0.05),电流-电压曲线下移,通道稳态激活曲线右移,通道稳态失活曲线左移及恢复时间减慢,而且存在频率依赖性特征。预先给予7 μmol/L胡椒碱,明显减轻H₂O₂对I_K1和I_KUr的抑制作用(P<0.01),并可减少H₂O₂对超速激活延迟整流钾通道动力学的异常影响。结论: 胡椒碱可减轻氧化应激对心房肌细胞I_K1和I_KUr的影响。     

灯盏花素对大鼠心室肌细胞瞬间外向和内向整流钾电流的影响

目的：研究灯盏花素对大鼠心室肌细胞膜瞬间外向钾电流（I_to）和内向整流钾电流(I_K1)的影响，在离子通道水平探讨灯盏花素的抗心律失常作用机制。方法： 用急性酶解法获得单个大鼠心室肌细胞，标准的全细胞膜片钳技术记录I_to和I_K1。结果：(1) 灯盏花素呈浓度依赖性抑制I_to，在+50 mV时，0.02、0.05、0.08、0.10 (g· L^-1)灯盏花素分别阻断Ito峰电流(10.07±0.30)%、(27.47±1.25)%、(42.72%±1.30)% 和(56.09±2.10)%，冲洗后可以完全恢复。在+50 mV时，0.10 g·L^-1灯盏花素使峰电流从（29.61±3.40）pA/pF 减少至（13.00±1.80）pA/pF (n=5，P<0.05)。（2）灯盏花素呈电压依赖性抑制I_to，在0～+50 mV,各浓度随电压增加抑制作用明显减弱。（3）0.10 g·L^-1灯盏花素对I_to失活、激活和复活曲线无明显影响。（4）0.10 g·L^-1灯盏花素对I_K1无明显影响。结论： 灯盏花素能够抑制心肌细胞I_to，呈浓度依赖性和电压依赖性，对I_K1无明显影响，这可能是其抗心律失常作用的重要机制之一。     

磷酸肌酸对缺血大鼠心室中层心肌细胞瞬间外向钾电流的影响

目的:观察不同浓度外源性磷酸肌酸(phosphocreatine, PCr)对大鼠缺血心室中层心肌细胞(M细胞)瞬间外向钾通道(I_to)电流的影响,探讨其预防缺血性心律失常的电生理学机制。方法: 单个M细胞经酶解从大鼠左心室中层获得,采用膜片钳全细胞模式记录I_to电流,通过灌注模拟缺血液并充以95%N₂+5%CO₂的混合气体建立缺血模型,将PCr加入模拟缺血液中分别配成终浓度5、10、20和30 mmol/L。将细胞分成6组,分别给予模拟缺血液,含有5、10、20和30 mmol/L PCr的模拟缺血液以及台氏液灌流,后者充以95% O₂+5% CO₂的混合气体。10 min后记录各组的峰电流及电流密度。结果: 与台氏液组相比,单纯模拟缺血液组I_to峰电流密度降低(76.1±6.3)%(P<0.05),含有5、10、20和30 mmol/L PCr的模拟缺血液组I_to峰电流密度分别降低(57.1±9.6)%(P<0.05)、(40.3±10.3)%(P<0.05)、(34.3±9.6)%(P<0.05)和(32.1±10.6)%(P<0.05)。PCr为0、5、10 mmol/L时三者峰电流密度具有明显差异(P<0.05)。PCr为10、20、30 mmol/L对I_to峰电流密度的影响无显著差异(P>0.05)。结论: PCr能增加缺血时受抑制的M细胞I_to峰电流及电流密度,这可能是其预防缺血性心律失常的电生理学机制。低浓度 (0~10 mmol/L)PCr对I_to峰电流及电流密度的影响呈现明显的量效关系。     

丹参酮ⅡA对豚鼠肥厚心肌延迟整流钾通道的影响

目的: 通过研究丹参酮ⅡA(TSN)对豚鼠肥厚心肌细胞快激活延迟整流钾电流(I_Kr)和慢激活延迟整流钾电流(I_Ks)的影响,在离子通道水平探讨丹参酮ⅡA抗肥厚心肌心律失常的机制。方法: 采用腹主动脉结扎技术制造心肌肥厚模型,将豚鼠随机分为假手术组(A组)、肥厚模型组(B组)、低剂量丹参组(C组,10 mg·kg^-1·d^-1)、高剂量丹参组(D组,20 mg·kg^-1·d^-1)和缬沙坦治疗组(E组,10 mg·kg^-1·d^-1),每组12只。通过应用标准的全细胞膜片钳技术记录各实验组心肌细胞膜上动作电位时程(APD)、I_Ks和I_Kr密度的变化。结果: (1)与A组相比,B组、C组、D组和E组手术后4周血压均明显升高,差异有显著差异(P＜0.01),B、C、D和E组间血压无显著差异(P＞0.05)。(2)与A组相比,B组心肌细胞的膜电容明显升高,APD显著延长(P＜0.01)。 (3)与B组相比,C、D和E组显著缩短肥大心肌细胞APD的延长,降低膜电容和阻断心肌细胞上I_Kr、I_Ks的密度(P＜0.01);C和D组间无显著差异(P＞0.05)。结论: 丹参酮Ⅱ-A能降低肥厚心肌细胞上I_Kr 和I_Ks的密度,可能是其干预肥厚心肌电生理异常的重要机制之一。     

老龄大鼠心房肌细胞起搏电流的特征

目的: 研究老龄大鼠心房肌细胞起搏电流(I_f)的特征,探讨其可能参与心房颤动的机制。方法: 选择22-24月龄SD大鼠分离心房肌细胞,利用全细胞膜片钳技术记录I_f。结果: 约85%的老龄大鼠心房肌细胞可以记录到的超极化激活I_f,在-150 mV时,I_f的电流幅值约为(382±23)pA,电流密度约为(3.2±0.4)pA/pF。而青年大鼠只有40％的心房肌细胞记录到I_f的电流幅值约为(86.9±8.4)pA,电流密度约为(0.9±0.1)pA/pF。从I-V曲线可见,老龄大鼠随着超极化电位的增加,电流增加幅度明显加快。在-150 mV时,其激活时间常数(τ)为(230.2±14.4)ms,而青年对照组心房肌细胞的τ则为(670.5±23.6)ms。此外,老龄大鼠心房肌细胞电流的半激活电压为(-87.2±2.3)mV,明显向更正的电位方向移动,而青年鼠细胞的半激活电压为(-104.4±6.3)mV,这使得老龄鼠的起搏电流更易激活。相反,二者的翻转电位和激活曲线斜率差异不大。结论: 老龄大鼠心房肌细胞起搏电流的密度和激活均高于青年鼠。     

牵张刺激对乳大鼠心房肌细胞瞬时外向钾电流和内向整流钾电流的影响

 目的：探究牵张刺激对乳鼠心房肌细胞瞬时外向钾电流（Ito）、内向整流钾电流（IK1）和动作电位时程（APD）的影响。方法：取1日龄SD乳大鼠心脏,分离、消化获得心房肌细胞。于细胞牵引装置培养24 h分组：对照组不予牵张刺激;牵张组予增加12%硅胶膜面积牵张刺激24 h。膜片钳全细胞记录方法记录细胞膜Ito、IK1和APD的变化。结果：在+60 mV刺激电压水平,牵张组Ito密度与对照组相比明显降低［(16±04）pA/pF vs (121±29) pA/pF,P<001］。在-120 mV刺激电压下,牵张组IK1密度较对照组增大［（-108± 08） pA/pF vs (-88±09)pA/pF,P<001］。牵张组动作电位复极50%（APD50）和复极90％（APD90）均较对照组明显缩短［(105±14）ms vs (155±24) ms,(300± 28) ms vs (563±36) ms,P<001］。结论：牵张刺激可降低乳大鼠心房肌细胞Ito密度,增大IK1密度,缩短APD,这可能是压力负荷增大致心房电重构的基础之一。     

血小板活化因子对豚鼠心室肌细胞钾电流及动作电位的影响

 目的：研究血小板活化因子(PAF)对豚鼠心室肌细胞钾电流及动作电位的影响。 方法:应用全细胞膜片钳技术，记录豚鼠心室肌细胞动作电位及钾电流(I_K 与I_K1)。 结果:当电极内液ATP浓度为5 mmol/L，1 μmol/L PAF使APD₉₀由对照的(225.8±23.3)ms延长至(352.8±29.8)ms(n=5, P<0.05)；使I_K尾电流在指令电压 +30 mV 时由对照的(173.5±16.7)pA降为(152.1±11.5)pA(P<0.05, n=4)；使I_K1在指令电压 -120 mV 时从(-6.1±1.3)nA降为(-5.6±1.1)nA(P<0.05, n=5)；当电极内液ATP 为0 mmol/L，APD₉₀明显缩短，1 μmol/L PAF使APD₉₀由对照的(153.0±24.6)ms缩短为(88.2±19.4)ms (n=5, P<0.01)，而用1 μmol/L格列本脲 ( I_KATP特异性阻滞剂)预处理后，恢复了PAF可显著延长动作电位时程的作用。 结论: PAF使缺血区K_ATP开放，动作电位时程缩短，却可抑制正常区I_K 与I_K1，使动作电位延长，从而放大了缺血区与正常区的不均一性，这可能与缺血时心律失常的发生有关。     

Effect of trimetazidine treatment on the transient outward potassium current of the left ventricular myocytes of rats with streptozotocin-induced type 1 diabetes mellitus

Cardiovascular complications are a leading cause of mortality in patients with diabetes mellitus (DM). The present study was designed to investigate the effects of trimetazidine (TMZ), an anti-angina drug, on transient outward potassium current (I_to) remodeling in ventricular myocytes and the plasma contents of free fatty acid (FFA) and glucose in DM. Sprague-Dawley rats, 8 weeks old and weighing 200-250 g, were randomly divided into three groups of 20 animals each. The control group was injected with vehicle (1 mM citrate buffer), the DM group was injected with 65 mg/kg streptozotocin (STZ) for induction of type 1 DM, and the DM+TMZ group was injected with the same dose of STZ followed by a 4-week treatment with TMZ (60 mg·kg⁻¹·day⁻¹). All animals were then euthanized and their hearts excised and subjected to electrophysiological measurements or gene expression analyses. TMZ exposure significantly reversed the increased plasma FFA level in diabetic rats, but failed to change the plasma glucose level. The amplitude of I_to was significantly decreased in left ventricular myocytes from diabetic rats relative to control animals (6.25 ± 1.45 vs 20.72 ± 2.93 pA/pF at +40 mV). The DM-associated I_to reduction was attenuated by TMZ. Moreover, TMZ treatment reversed the increased expression of the channel-forming alpha subunit Kv1.4 and the decreased expression of Kv4.2 and Kv4.3 in diabetic rat hearts. These data demonstrate that TMZ can normalize, or partially normalize, the increased plasma FFA content, the reduced I_to of ventricular myocytes, and the altered expression Kv1.4, Kv4.2, and Kv4.3 in type 1 DM.     

Actions of myristyl-FRCRCFa, a cell-permeant blocker of the cardiac sarcolemmal Na-Ca exchanger, tested in rabbit ventricular myocytes

 In cardiac muscle, the electrogenic Na-Ca exchanger plays important roles in determining action potential shape and in the beat-to-beat homeostasis of intracellular calcium. In this study we tested the actions of a putative cell-permeant blocker of the cardiac sarcolemmal Na-Ca exchange, ”Myristyl- (Myr-) FRCRCFa”. Experiments were performed using isolated rabbit right ventricular myocytes and whole-cell patch-clamp at 35–37°C. The Na-Ca exchange current (I _Na-Ca), L-type calcium current (I _Ca,L), inward rectifier potassium current (I _K1) and delayed rectifier potassium current (I _K) were compared in untreated cells and cells incubated in a solution containing N-myristylated FRCRCFa. With other major currents blocked, I _Na-Ca was measured as the Ni-sensitive component of current during a voltage ramp applied from the holding potential of –40 mV, between +80 and –120 mV (ramp velocity 0.1 V s^–1). In untreated cells, I _Na-Ca at +60 mV was 7.1±0.6 pA/pF and at –100 mV was –2.7±0.3 pA/pF (n=9). After a 15-min pre-incubation with 20 μM Myr-FRCRCFa, I _Na-Ca was reduced to 4.2±0.3 pA/pF at +60 mV and –1.5±0.2 pA/pF at –100 mV (P<0.02; n=7). After incubation with 20 μM Myr-FRCRCFa for 1 h, I _Na-Ca at both potentials was further reduced (2.3±0.8 pA/pF at +60 mV; –0.9±0.3 pA/pF at –100 mV; P<0.008 compared with control; n=4). Under selective recording conditions for I _Ca,L, there was little difference in I _Ca,L density between untreated and cells incubated with Myr-FRCRCFa. A Boltzmann fit to the I _Ca,L/V relation showed no significant alteration of half-maximal activation potential or slope factor of activation. I _K1 was also largely unaffected by pre-incubation of cells with Myr-FRCRCFa. I _K, measured as deactivating tail current following 1-s test depolarisations to a range of test potentials, was also not significantly altered by Myr-FRCRCFa. The suppression of I _Na-Ca in cells incubated in Myr-FRCRCFa suggests that addition of the myristyl group to FRCRCFa peptide conveys cell permeancy to the peptide and that Myr-FRCRCFa applied externally to rabbit ventricular myocytes is moderately effective as an I _Na-Ca blocker. I _Ca,L, I _K1 and I _K were largely unaffected by Myr-FRCRCFa. N-Myristylation of such conformationally constrained hexapeptides may, therefore, provide a means of producing cell-permeant inhibitors of the cardiac Na-Ca exchanger. Received: 6 February 1997 / Received after revision: 8 April 1998 / Accepted: 9 April 1998     

高胆固醇血症对大鼠心室肌细胞离子电流的作用

目的：观察高胆固醇血症对大鼠心室肌细胞离子电流的作用。方法： 通过全细胞膜片钳技术记录用酶解法分离的正常和高胆固醇饮食的大鼠心室肌细胞离子电流。结果： 高胆固醇组（组Ⅱ）血清总胆固醇水平明显高于正常组（组Ⅰ）［（3.10±0.62)mmol·L-1 vs (1.18±0.37)mmol·L-1, P<0.01, n=20］。组Ⅱ血清甘油三酯也明显高于组Ⅰ［（1.51±0.30)mmol·L-1 vs (0.43±0.15)mmol·L-1, P<0.01, n=20］。组Ⅱ大鼠心室肌细胞动作电位时程（APD）与组I相比明显延长，APD50从(70.86±8.12)ms延长至(116.16±6.90)ms (n=10, P<0.01); APD90 从(95.10±7.27)ms延长至(144.04±7.39)ms (n=10, P<0.01)；在实验电压 -120 mV， Ik1从(-16.98±4.54) pA/pF（组I）增加到(-19.92±4.08) pA/pF（组Ⅱ）(n=12, P<0.05)；在实验电压 0 mV， ICa-L从(-8.56±1.29) pA/pF（组Ⅰ）减少到(-5.24±0.90) pA/pF（组Ⅱ）(n=10, P<0.01)；在实验电压 +60 mV，Ito从(13.20±1.97) pA/pF（组I）减少到(10.30±1.97) pA/pF（组Ⅱ）(n=8, P<0.05)。结论： 高胆固醇血症可显著改变心肌细胞离子电流密度的大小，对心脏具有毒性作用。     

KATP channel current increases in postinfarction remodeled cardiomyocytes

Adenosintriphosphate-sensitive potassium channels (K_ATP channels) are an important linkage between the metabolic state of a cell and electrophysiological membrane properties. In this study, K_ATP channels were studied in myocytes of normal and remodeled myocardium of the rat. Myocardial infarction was induced by ligature of the left anterior descending artery. Remodeled myocytes were obtained from the hypertrophied posterior left ventricular wall and interventricular septum 3 months after infarction. The current through K_ATP channels was measured in whole-cell and inside-out patches by using the patch-clamp technique. After myocardial infarction, the heart weight/body weight ratio was doubled and the myocytes were hypertrophied yielding a cell capacitance of 266±16 pF compared to 122±12 pF in control cells. The amount of Kir6.2 protein was indistinguishable in corresponding regions of control and remodeled hearts. The ATP sensitivity of K_ATP channels in remodeled cells was significantly lower than in control cells (half maximum block at 115 μmol/l ATP in remodeled and at 71 μmol/l ATP in control cells). The maximum I _KATP density induced by metabolic inhibition was higher in small remodeled (176±15 pA/pF) than in control cells (127±11 pA/pF), but was unchanged in large remodeled cells. Both, the higher I _KATP density and the lower sensitivity of the K_ATP channels to ATP suggest that remodeled cardiomyocytes develop an improved tolerance to ischemia by stabilizing the resting potential and decreasing excitability.