The Modulated Receptor Hypothesis Revisited from the Viewpoint of Myocardial Interstitial Potential.
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Time- and voltage-dependent interaction of antiarrhythmic agents with target cardiac ion channels is termed the modulated receptor hypothesis. Actuaily class I agents suppress the maximum upstroke rate (V<SUB>m</SUB>ax) of intracellular potential (V<SUB>i</SUB>c) depending on the pacing cycle length (PCL) and external potassium concentration ([K<SUP>+</SUP>]<SUB>e</SUB>). We examined this concept from the aspect of interstitial potential (V<SUB>i</SUB>s), since V<SUB>i</SUB>s reflects the second time derivative of V<SUB>i</SUB>c. V<SUB>i</SUB>c. and V<SUB>i</SUB>s were recorded sequentially using standard microelectrode applied to the paced and superfused guinea pig papillary muscles. In the steady state, the greatest negative deflection of V<SUB>i</SUB>s (V<SUB>m</SUB>in) was suppressed by qumldine (10 μM) In both PCL and [K<SUP>+</SUP>]<SUB>e</SUB>-dependent manner just like V<SUB>m</SUB>ax. However, quinidine-induced greater inhibition of V<SUB>m</SUB>in than V<SUB>m</SUB>ax was evident at shorter PCL and greater [K<SUP>+</SUP>]<SUB>e</SUB>. Based on the sequential alteration of PCL and exposure to ouabain (10 μM), different quinidine sensitivity between V<SUB>m</SUB>in and V<SUB>m</SUB>ax is most likely accounted for by the activity-dependent K<SUP>+</SUP> efflux and Na<SUP>+</SUP>-K<SUP>+</SUP> pump-mediated K<SUP>+</SUP> uptake (i. e., [K<SUP>+</SUP>]<SUB>e</SUB> fluctuation). Thus, the modulated receptor hypothesis is concluded to be valid in terms of V<SUB>i</SUB>s.
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