J Clin Med
Department of Chemical Science and Technology, Faculty of Bioscience and Applied Chemistry, Hosei University, 1-7-2 Kajino-Cho, Koganei-City 184-8584, Japan.
Published: April 2024
: Observational studies of intermittent hemodialysis therapy have reported that the excess decrease in K concentration in plasma (KP) during treatment is associated with the destabilization of cardiac function. Elucidating the mechanism by which the decrease in KP impairs myocardial excitation is indispensable for a deeper understanding of prescription design. : In this study, by using an electrophysiological mathematical model, we investigated the relationship between KP dynamics and cardiomyocyte excitability for the first time. : The excess decrease in KP during treatment destabilized cardiomyocyte excitability through the following events: (1) a decrease in KP led to the prolongation of the depolarization phase of ventricular cells due to the reduced potassium efflux rate of the Kr channel, temporarily enhancing contraction force; (2) an excess decrease in KP activated the transport of K and Na through the funny channel in sinoatrial nodal cells, disrupting automaticity; (3) the excess decrease in KP also resulted in a significant decrease in the resting membrane potential of ventricular cells, causing contractile dysfunction. Avoiding an excess decrease in KP during treatment contributed to the maintenance of cardiomyocyte excitability. : The results of these mathematical analyses showed that it is necessary to implement personal prescription or optimal control of K concentration in dialysis fluid based on predialysis KP from the perspective of regulatory science in dialysis treatment.
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http://dx.doi.org/10.3390/jcm13082289 | DOI Listing |
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