why does hypokalemia increase phase 4 slope?

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ocean11

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I know that during phase 4, Na and Ca come into the cell (making it more positive) and K comes out (although less) but if one had hypokalemia woulnd't the K in the cell 'want' to come out even MORE ... and thus DECREASE the phase 4 slope?!? so why does it 'increase' the slope?!? maybe it does something to the Na/Ca channels?!?!? arghghghg HELP...

thanks

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ocean11 said:
I know that during phase 4, Na and Ca come into the cell (making it more positive) and K comes out (although less) but if one had hypokalemia woulnd't the K in the cell 'want' to come out even MORE ... and thus DECREASE the phase 4 slope?!? so why does it 'increase' the slope?!? maybe it does something to the Na/Ca channels?!?!? arghghghg HELP...

thanks

coming out faster means a more vertical line which means a greater slope -- closer to a value of one (whether or up down). Remember that slopes are fractions of rise/run or run/rise either way it's a fraction.
 
Soup said:
coming out faster means a more vertical line which means a greater slope -- closer to a value of one (whether or up down). Remember that slopes are fractions of rise/run or run/rise either way it's a fraction.

thanx but thats not the issue I just don't understand why hypokalemia would INCREASE phase 4 shouldn't it decrease it? because less K+ means that K+ would rush out of cells and thus DECREASE the slope....
 
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ocean11 said:
thanx but thats not the issue I just don't understand why hypokalemia would INCREASE phase 4 shouldn't it decrease it? because less K+ means that K+ would rush out of cells and thus DECREASE the slope....

I think what is throwing you is that "hypokalemia" means low blood K+...but the cause of the increase in slope is less k+ inside the cell, which also results from hypokalemia. Its not as if the cell just retains the same amount of K+ and the gradient increases, like your logic. The out/in chemical gradient is the same under hypokalemia, there is just less overall K+ both outside and in...

ie.. 10 outside 100 inside normally, hypokalemia: 1 outside 10 inside.

You have to remember that K+ channels are always open and K+ ions are constantly re-establishing the outer/inner gradient.

So, "hypokalemia" means low blood K+ which means lower intracellular k+ (since some from inside rushes out to the blood, leaving less inside overall, but same gradient)

Then, with less K+ in the cell, and the same gradient, im sure you can see how the slope increases (less opposition to inflow due to less K+ outflow)

Hope that makes some sense for you
 
ocean11 said:
I know that during phase 4, Na and Ca come into the cell (making it more positive) and K comes out (although less) but if one had hypokalemia woulnd't the K in the cell 'want' to come out even MORE ... and thus DECREASE the phase 4 slope?!? so why does it 'increase' the slope?!? maybe it does something to the Na/Ca channels?!?!? arghghghg HELP...

thanks

Remember that phase 4 slope is depolarization related to pacemaker automaticity. It seems like some are talking about phase 3 repolarization. Since you're talking about phase four slope, I assume you're talking about pacemaker cells, the only ones with auto depolarization. Those in the SA node have fewer IK1 channels, which are the channels affected (closed) by extracellular K+ concentration... so their slope doesn't change much. Latent pacemakers, on the other hand, have more IK1 channels and therefore their slope does increase. This is because one of the factors increasing slope is deactivation of potassium channels, which couples with funny Na current to depolarize the membrane. Low extracellular [K+] means more closed channels.

Let me know if I got anything wrong or I didn't understand the question. The key point is that a decrease in K+ permeability occures with any increase in electrochemical gradient.

peace... -dope-
 
I was actually wondering the same thing, my reasoning is as follows (be it right or wrong is another issue): Hypokalemia, is a condition of low potassium in the blood, while several mechanisms may contribute to this from a electrochemical standpoint (loss of GI and kidney regulation), one mechanism is transcellular shifting of potassium ions from extracellular space (serum) into intracellular sapce. This increase in intracellular concentration would shift the normal equilibrium point (inside to outside) in the reverse, so on the phase 4 slope (where the depolarizing effects of the NA and Ca channels contibute to spontaneous depolarization of the SA Node) the normal outward flow of K would be reversed and therefore with another source of positive ion influx, cause the slope to increase (i.e depolarize quicker).

Alternatively, like a previous poster replied, if the loss of serum K is due to renal disease, there will be less of gradient estabished between extracellular and intracelluar K concentrations, this in effect will decrease the repolarizing effect of K ions in opposition to the depolarizing curents of NA and Ca in phase 4. With less of a negative influence ( by way of decreased loss of positive ions), the cell will depolarize quicker.
 
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