Title: Action Potentials in Cardiac Muscle - Medical Physiology
Headings: Action Potentials in Cardiac Muscle
Action Potentials in Cardiac Muscle
Figure 9-4

Content: Thus far, this mechanism of excitation-contraction coupling is the same as that for skeletal muscle, but there is a second effect that is quite different. In addition to the calcium ions that are released into the sarcoplasm from the cisternae of the sarcoplasmic reticulum, a large quantity of extra calcium ions also diffuses into the sarcoplasm from the T tubules themselves at the time of the action potential. Indeed, without this extra calcium from the T tubules, the strength of cardiac muscle contraction would be reduced considerably because the sarcoplasmic re-ticulum of cardiac muscle is less well developed than that of skeletal muscle and does not store enough calcium to provide full contraction. Conversely, the T tubules of cardiac muscle have a diameter 5 times as great as that of the skeletal muscle tubules, which means a volume 25 times as great. Also, inside the T tubules is a large quantity of mucopolysaccharides that are electronegatively charged and bind an abundant store of calcium ions, keeping these always available for diffusion to the interior of the cardiac muscle fiber when a T tubule action potential appears. The strength of contraction of cardiac muscle depends to a great extent on the concentration of calcium ions in the extracellular fluids. The reason for this is that the openings of the T tubules pass directly through the cardiac muscle cell membrane into the extracellular spaces surrounding the cells, allowing the same extracellular fluid that is in the cardiac muscle interstitium to percolate through the T tubules as well. Consequently, the quantity of calcium ions in the T
tubule system—that is, the availability of calcium ions to cause cardiac muscle contraction—depends to a great extent on the extracellular fluid calcium ion concentration. (By way of contrast, the strength of skeletal muscle contraction is hardly affected by moderate changes in extracellular fluid calcium concentration because skeletal muscle contraction is caused almost entirely by calcium ions released from the sarcoplasmic reticulum inside the skeletal muscle fiber itself.) At the end of the plateau of the cardiac action potential, the influx of calcium ions to the interior of the muscle fiber is suddenly cut off, and the calcium ions in the sarcoplasm are rapidly pumped back out of the muscle fibers into both the sarcoplasmic reticulum and the T tubule-extracellular fluid space.