Mechanical properties of isolated cardiac myocytes.

PHYSIOLOGICAL

REVIEWS

Vol. 71, No. 2, April 1991 Printed in U.S.A.

Mechanical

Properties

of Isolated ALLAN

Cardiac Myocytes

J. BRADY

Department of Physiology and Cardiovascular Research Laboratory, University of California, Los Angeles, School of Medicine, Center for Health Sciences, Los Angeles, Califwnia

........................................................................................... I. Introduction ......................................................... II. Development of Adult Myocyte Preparation .......................................................... III. Mechanical Properties of Cardiac Myocytes ............................................................................ A. Attachment procedures B. Passive mechanical properties .................................................................... C. Contractile responses in active cardiac myocytes ................................................. ............................................................................... IV. Indexes of Contractility ........................................................... A. Shortening as an index of contractility B. Shortening related to Frank-Starling relation ................................................... ............................................................................ V. Summary and Conclusions

I. INTRODUCTION

Viewed from the perspective of organ function, there has been a long-standing interest in the separability of cardiac muscle length or ventricular volumedependent effects (i.e., the Frank-Starling relation) from intrinsic inotropic mechanisms in the cardiac contractile response. Furthermore, at the cellular level there is continued interest in the mechanisms of passive and active force generation in the sarcomere. In fact, the resolution of both levels of interest has been severely limited in studies over the past decades by the complexity of multicellular cardiac preparations and our inability to measure or control a minimal number of the contractile-related parameters. Actually, the results of many of these studies strongly question the separability of geometrical and intrinsic factors of cardiac contraction (12, 71, 97, 99), but the issues are by no means closed. For example, attempts to deduce cross-bridge mechanical kinetics from multicellular preparations (including geometrically linear preparations such as trabeculae and papillary muscles) have led to ambiguous results because of the viscoelastic nature of these preparations (93) and because no clear representation of the relation between passive and active elements of the tissue is evident (20). On the one hand, for simplicity, resting mechanical properties of these preparations have been assumed to be in parallel with active properties. This arrangement has been represented as a Maxwell mechanical analogue. Then, again, series elasticity in excised preparations has been largely attributed to end compliance of the preparations that is related to the attachment of recording devices so that a Voigt analogue is suggested. Finally, tests of these assumptions reveal a consid0031-9333/91

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erable complexity of stress and strain distributions at the sarcomere level, reflecting significant structural and functional nonuniformity in both passive and actively expressed responses. Because contractile function is strongly sarcomere length and cross-bridge shortening dependent, this inhomogeneity further reduces the reliability of interpretations of cross-bridge function based on these global or whole tissue measurements. Added to these concerns is the growing evidence that some phase of the contractile activation process may be diminished at short sarcomere length or with the shortening necessary to achieve sarcomere lengths below unattached rest length. Hence it becomes even more critical to know or to control sarcomere length at the sarcomere level. On first impression, the isolated heart cell would seem to be ideal for mechanical studies. A preparation free of collagen and containing relatively few myofibrils in a single cohesive structure would allow almost direct access to the measurement of sarcomere length and cross-bridge contractile responses. At the present time, however, our ability to isolate a single heart cell for mechanical studies has simply reduced our problem from a state of megadimensional ambiguity to one of mere multidimensional ambiguity. Also, counterbalancing the structural simplification of the preparation are the inherent challenges of noninjurious cell attachment, the recording of microgram levels of force measurement, and individual sarcomere resolution. These challenges have kept our progress in studies of cardiac myocyte contraction at a slow pace; however, alternative mechanical measurements, such as shortening of unattached cells, auxotonic responses of cells attached to relatively compliant force transducers, stiffness measurements, steady-state activation of skinned cells, and labeled antibody staining of cytoskeletal and interme413

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diate filaments, are leading to more detailed concepts of the contractile process in cardiac muscle. These developments are discussed in some detail in this review.

II.

DEVELOPMENT

OF ADULT

MYOCYTE

PREPARATION

During the past 20 years numerous attempts have been made, using several experimental approaches, to develop an excised single cardiac myocyte preparation that would tolerate normal Ca” concentrations and that could be used to evaluate electrical, metabolic, and contractile function at the cellular level. The vast literature on the progress of this development has been extensively reviewed by Dow et al. (28, 29), and recent methods of myocyte isolation have been evaluated by Powell (100). During this period the isolation procedures have been modified such that myocytes can be isolated that remain quiescent and relaxed in normal Ca2+-containing perfusates and are electrically excitable. As noted by Haworth et al. (47), a primary step in producing Ca2+-tolerant cardiac myocytes was the recognition that a critical level of Ca2+ must be present in the digestion medium ( -20 PM) for the first few minutes of coronary perfusion in order for the enzymes to separate the cells and break up the extracellular collagen. The addition of a variety of substrates to assist the cells in handling the Ca2’ loading that occurs with the isolation procedure also seems to be beneficial (7, 47, 84, 96, 125, 144). Cell separation at the intercalated disks appears to be readily effected by collagenase so that the principal injury to the cells probably occurs in the separation of the cells from each other as they are freed from the collagen matrix. Gap junctional areas of the nexes may be particularly sensitive to mechanical damage, but electron micrographs of isolated cells show many intact gap junctions often with some adhering residue of an adjacent cell (38,82,85). The large number of cells that can be isolated from ventricular tissues [total yields of 6579% in 1 mM Ca2’ (143) and up to 95% in 1.8 mM Ca2’ (S)] indicates that cells from which a gap junction has been removed can reseal the injured area (85) and that, as reported by Severs et al. (llS), most gap junction .s are internalized by endocytosis soon after cell isolation. These preparations have been the subject of a wide variety of successful studies of cardiac cellular physiology, except that the cells, largely devoid of collagen, are extremely sensitive to external mechanical stress. These persisting attachment problems have resulted in a increasing number of studies that have utilized shortening in unattached cells as a measure of contractility.

III.

MECHANICAL

PROPERTIES

OF CARDIAC

MYOCYTES

One of the major objectives in studying the mechanical properties of the isolated cardiac myocyte, as in studies of whole cardiac tissue, is to deduce cross-

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bridge kinetics as a means of understanding the contractile process. However, our access to the cross bridges is still indirect. For example, to measure myocyte force or stiffness we must make some attachment to the cell, and this attachment may produce distorting strains or stresses that influence the contractile response. Also, to resolve the small forces developed by the isolated myocyte, the compliance of the force-sensing system may be appreciable relative to the length of the cell. Furthermore, the myocytes possess passive viscoelastic properties, the orientation of which with respect to the cross bridges is still unclear, so that the way in which these passive elements are represented in relation to the active contraction (series or parallel combinations) influences our interpretation of cross-bridge activity. On the other hand, when shortening in the unattached myocyte is measured, what is obtained is a measure of the maximum turnover rate of the cross bridges, but internal viscous loading and loading by longitudinal and radial elastic elements as well as external cell orienting or stabilizing forces against which the cycling cross bridges are working may not be well defined. In addition, the consequences of shortening on crossbridge activation are only beginning to be understood. These problems leave our interpretation of cross-bridge dynamics in active cells still rather clouded. It should be emphasized, however, that the variety of force-, stiffness-, and length-measuring techniques that have been utilized in isolated myocyte preparations in recent years has contributed substantially to our understanding of the myocardial contractile process. However, not unexpectedly, these studies have also extended the scope of parameters that must be dealt with in achieving this goal. The following discussion of these data attempts to put the definitive and ambiguous aspects of these studies in perspective. A. Attachment Procedures The major limitation in attachment to intact cells is that the sarcolemma, without the protective collagen, is extremely sensitive to applied stress. A variety of cements have been tried to bond the cell to the styli of mechanical transducers. Also, the cells will adhere to poly-L-lysine-coated surfaces to some extent, but cell damage or separation often occurs before maximum contractile activation occurs. Tarr et al. (131), using isolated frog atria1 cells, and Shepherd and Kavaler (121), using single guinea pig ventricular myocytes, have had success with this coating procedure. The studies with frog atria1 cells took advantage of the extreme length of frog atria1 cells (ZOO-300pm) such that they were able to wrap the ends of these narrow (~5 pm wide) myocytes around poly-L-lysine-coated glass supporting beams. The calibrated deflection of one beam served as the force transducer. Intact cells survived this procedure well and remained quiescent and electrically excitable. The major disadvantage of this method was the neces-


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sity to construct the glass beams such that a displacement of -5% of cell length was necessary to obtain adequate resolution of the force responses. In the guinea pig study the cell was simply placed on and thus adhered to the coated surface of the two supporting glass beams. Sarcomere uniformity in these cells has not been reported. Silicone rubber cements are useful, but a uniform stress distribution with attachment to the cell is difficult. A fibrin attachment procedure was reported to be successful by Copelas et al. (24). The compliance of the fibrin seemed to be tolerable (1 ,um/mg), but the method has not been widely used. Brady et al. (19) attached isolated cardiac myocytes of rats to a force transducer with single-barreled suction micropipettes and recorded electrically stimulated twitch tension as a function of cell length, external Ca2+ variations, and stimulus interval variations. They measured peak twitch forces of -4 pN, but the success rate of such recordings was extremely low because of the high stress on the sarcolemma at the tips of the micropipettes. Among the more promising attachment methods is a concentric double-barreled micropipette in which the inner pipette is recessed such that approximately four to five sarcomeres of each end of the cell can be drawn in against the inner pipette with mild suction. The glass surfaces are treated with a thin coat of a prototype barnacle cement (Biopolymers) that provides sufficient adhesion to support full Ca2’ -activated force development in detergent-skinned myocytes. This attachment applies more of the supporting stress to the intercalated disk surface where stress transfer normally occurs (17). This technique has not yet solved the sarcolemmal stress problem with intact myocytes perfused with normal levels of extracellular Ca2+. However, this method works well with detergent-skinned preparations and will support forces of maximal activation with sarcomere strain distribution only 12% in excess of that of unattached myocytes (K. P. Roos and A. J. Brady, unpublished observations). A major problem with attachment to highly sensitive force transducers is that in cases where the force detection system is not submersible, some part of the force-sensing system must pass through a liquid-air interface. The surface tension of the meniscus around the connecting element through this interface can be of -10 pN, whereas the myocyte forces of interest may be one to two orders of magnitude below this level. Thus extreme surface stability and reproducibility of the perfusate surface are required to measure myocyte forces with these transducers. Iwazumi (59) developed a flow controller system in which the chamber solution surface is monitored electronically and flow adjusted by means of servo-controlled solenoids to maintain a constant and reproducible solution level. This device, in conjunction with a novel electromagnetic force transducer, made possible the stable recording of tension from single myofibrils.

ISOLATED

CARDIAC

B. Passive

MYOCYTES

Mechanical

415

Properties

1. Comparative elastic properties of skeletal and cardiac

cells In attempts to determine whether the relatively high resting stiffness of cardiac muscle has an intracellular component, a number of studies have compared the stiffness of isolated cellular preparations of cardiac and skeletal muscle. Thus comparing the elastic properties of isolated cells of the hamster gracilis and ventricular myocytes at sarcomere lengths 2.20 and 2.6 pm, Fish et al. (36) showed that resting stress values were three to four times greater in the cardiac cells at each sarcomere length. Also, an exponential dependence of stress on sarcomere length was found in which the slope of the natural log stress-sarcomere length relation in the cardiac and skeletal muscle cells was 7.48 and 5.77 mN/ mm2, respectively [where strain was measured as the relative displacement from control length, (L - L,)/L,]. These values were significantly different at the 3% level. Thus passive mammalian isolated cardiac muscle cell stress is severalfold greater than skeletal muscle cells at similar lengths. These data are supported by the higher cytoskeleton protein content of cardiac cells; for example, Maruyama et al. (78) report that 18% of the total myofibrillar protein is connectin in bovine heart, which is threefold greater than in skeletal muscle. Price (101) found 2% desmin, also in bovine heart, compared with a report of 0.35% in skeletal muscle (90). In a study of frog (Rana catesbeiana) glycerinated semitendinosus and atria1 preparations in which the contractile filaments had been extracted in 0.6 M KCl, Matsubara and Maruyama (81) found that further treatment of the preparations with 1% NaOH or 2% sodium dodecyl sulfate to remove the remaining striated structures reduced the semitendinosus resting tension to t20%, but the atria1 preparation retained >50% of its resting tension at a sarcomere length of -2.75 pm. They concluded that because the primary structure remaining after these treatments was probably a network of the large cytoskeletal filament connectin, the higher content of connectin in heart muscle may be responsible for the difference in resting tension. 2. Relation of cellular to tissue elasticity in cardiac muscle In studies of the passive mechanical properties of single isolated frog (R. catesbeiana) atria1 fibers in which the cells were attached by wrapping around supporting glass rods, Tarr et al. (131) found that these cells had resting stresses 8- to 30-fold less than intact frog atria1 trabeculae and could be readily extended to sarcomere lengths of 3.45 pm. In contrast, the passive force recordings in isolated mammalian cardiac myocytes (19,


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32,35) indicate that substantial resting tension is apparent at sarcomere lengths of 2.0-2.2 pm, and the myocytes become extremely stiff at sarcomere lengths of 2.4-2.6 pm (l&35,36). Nag and Zak (85) report that some collagen fibrils may be attached to enzymatically dissociated rat cardiac myocytes and might be responsible for some of the resting tension. However, other studies showed that these enzymatically dissociated cells are nearly free of collagen (18, 104) so that, in contrast to frog atria1 tissue, the high resting tension of mammalian heart muscle must be, at least in part, a characteristic of the cardiac cell ultrastructure. The relative contribution of passive cellular elasticity to total tissue elasticity is of interest both in terms of resistance to stretch and resistance to shortening. In the latter case a restoring force would be established that may be responsible for some of the steepness of the active length-tension relation and for the rapid restoration of initial length in cells shortened below their unattached rest length (sarcomere length - 1.85-1.93 pm) (see sect. IvB). With regard to a resistance to stretch, Kentish et al. (62) measured the passive length-tension relation in intact and detergent-skinned rat trabeculae and found a substantial reduction in resting tension after 30 min of perfusion with 1% Triton X-100. In the skinned preparation at sarcomere length of 2.20 pm, resting stress was -40% of that of the intact preparation. These observations suggest that dissolution of the sarcolemma in detergent may isolate the intracellular elastic elements from the extracellular stroma. Comparing the length dependence of passive stress and stiffness of intact papillary muscle and trabeculae with excised single cardiac myocytes, Brady et al. (20) and Brady (16) found that at sarcomere lengths of -1.9 pm the passive stress in trabeculae and collagenase-isolated myocytes was similar. On the other hand, the slope of the natural log stiffness-length relation in trabeculae and papillary muscles was three to five times greater than in the excised myocytes. Similar conclusions were expressed by Fish et al. (36). In whole muscle preparations, Krueger (65) and Krueger and Tsujioka (70) report two phases of the resting tension-sarcomere length relation with a steep component beginning around a sarcomere length of 2.6 pm. They attribute much of the more compliant component below a sarcomere length of 2.69 pm to intrinsic cellular elements and the steeper portion to extracellular elements. These results suggest that the major component of passive stress in whole tissue is probably borne by the extracellular collagen at the longer sarcomere lengths (65,105). However, extrapolating these relations to sarcomere lengths < 1.9 pm suggests that at the shorter lengths a compressive stress or stiffness of the myocytes may become a significant or even the dominant factor in total tissue elasticity, particularly if the elements of the strutlike structure of the extracellular collagen matrix go slack below unstressed muscle length (13). This possibility is suggested by the fact that reextension after active shortening in isolated myocytes is as rapid or more rapid than in multicellular prepara-

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tions (64, 66,87,104,111,113). Krueger (66) emphasizes the fact that myocyte relengthening after active shortening occurs in a fast and a slower phase. The relative contributions of el astic recoil and cross -bridge detachment processes to these phases remain unclear, but as Krueger (66) points out, the magnitude of the restoring forces is sufficient to influence ventricular filling in the whole heart by a sucking action during early diastole. 3. Structural

basis of cardiac

myocyte

resting

tension

The relatively high resting stiffness of the cardiac cell has led to correlative mechanical and ultrastructural studies aimed at the identification of the cellular structures responsible for the high resting tension. Brady (16) and Brady and Farnsworth (18) found that the stiffness at a sarcomere length of 2.0 pm measured with ~-HZ sinusoidal length perturbation [and at 70 Hz (unpublished observations)] was relatively unchanged with membrane skinning in 1% Triton X-100 detergent but fell to -20% of control after nearly complete Aband extraction in 0.47 M KC1 (pH = 6.2). In 0.6 M KI, after I-band filament extraction, stiffness fell to -10% of the intact value. These data indicate that the A-band filaments are probably directly involved in bearing resting stress in cardiac muscle. Similar myosin disassembly st.udies in single skeletal muscle fibers (48, 49, 58) also gave results implicating A-band filaments in the support of resting stress. A recent study in detergent-skinned cardiac myocytes (110) showed that in attached cells stiffness declined as the A band was extracted in high salt, whereas in unattached cells, cell length shortened with A-band extraction. The studies with unattached cells indicate that in the intact cell some longitudinal elements of the cell must be normally stressed at rest length and that this stress is relieved as the A-ba nd fi laments are disassociated, i.e., the cell shortens as the A band disassembles. Th .e high-salt filament- extraction data strongly indicate that longitudinal elements, related to the integrity of the A band, are responsible for a major component of the relatively high resting tension characteristic of cardiac muscle. These data also point to differences in passive cytoskeletal elastic structure rather than membranous elements or contractile filament interactions, since all the membranous systems were disrupted in detergent and perfusate free Ca2+ was 8%) and a median skewed toward 2.6 pm (the number of sarcomeres measured was -500). This deviation compares to an SD of -6% in the unattached cell. In a cell at a mean sarcomere length = 2.23 pm, SD was >8%, sarcomere length range was 1.7-2.6 pm, and the median was 2.2 pm. In this cell, axial skewing was relatively minor, but sarcomere misalignments across the width of the cell (radial skewing) spanned the entire length of the cell. In these modes of attachment, uniform radial support is poor so that the isolated cardiac myocyte offers little advantage over multicellular preparations in

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terms of control of sarcomere length. On the other hand, attachment to detergent-skinned myocytes with doublebarreled micropipettes (18) distributes the applied stress much more evenly over the face of the intercalated disk. In preliminary studies in resting myocytes, sarcomere length SD values were *6-7%, with little radial or axial skewing at cell extensions 30% above rest length compared with a SD of *5-6% in unattached cells (l,OOO-2,000 sarcomeres) (K. P. Roos, personal communication). In any case, these observations indicate that in order to take advantage of the greater structural simplicity of single isolated heart cells in mechanical studies, appropriate attachment procedures must be employed to maintain the inherent sarcomere uniformity of the myocytes. C. Contractile Responses in Active Cardiac Myocytes I. Force measurements in skinned myocytes Early studies of Ca2’ activation of isolated cardiac myocytes made use of the fact that skinned myocytes adhere well to glass microtools. For example, Bloom (9, 10) and Bloom et al. (11) excised small clusters of cardiac cells (3-5 cells wide by 2-3 cells long) from the mouse ventricle by mechanical disaggregation and, in the latter work, measured contractile force by means of microtools impaling the preparations. These preparations were, in effect, skinned, and they responded with spontaneous contractions in micromolar levels of EGTA-buffered Ca2+ perfusates. The sarcoreticular network appeared to be intact as evidenced by a contracture response to 1 mM caffeine. Spontaneous irregular active contractions occurred in most preparations, and their amplitude increased with perfusate Ca2’ in the range of l-10 PM. Maximal steady-state contracture responses were ~4 pN, which is similar to tonic responses (3-4 pN) in mechanically skinned cells (35). Sarcomere length and uniformity were not reported in these studies. De Clerck et al. (25) measured force and shortening in mechanically skinned rat cardiac myocytes also using a microtool attachment. The cell did not tolerate normal Ca2’ levels, but contraction could be initiated by ionophoretically released Ca2+from an extracellular pipette. Loads could be electronically clamped at predetermined levels with a servo-controlled system, but a shortening of ~5 pm occurred during the clamping process. The contractile responses were limited by diffusion from the pipette, but “isometric” contractile forces also of ~4 PN and maximum unloaded shortening velocity averaged only 0.35 cell lengths/s. The resulting force-velocity relations resembled those of intact cardiac tissue but were too irregular to deduce the basic nature of the relation, possibly due to the nonuniformity of activation by the electrophoretic procedure. In studies of contractile responses in mechanically skinned rat ventricular cells. Fabiato and Fabiato (35)


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M’fOCYTES

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found a damped series of contractile oscillations (0.1-l -1.6 pm. Earlier, Manring et al. (76) and later Nasser et Hz) occurred in partially activated myocytes in a critial. (87) found similar shortening characteristics in both cal range of Ca2+ concentrations (pCa 6.4-5.7) and at trabeculae and rabbit myocytes and referred to heart sarcomere lengths < 3.10 pm. These oscillations ap- muscle in this regard as a “shortening machine.” These peared on the rising phase of the contracture between data were explained as resulting from the balance of the 50-100% of the final tension response. They charactertime-dependent rise in contractile activation of the cell ized these oscillations as local stress-equilibrating ad- and the shortening-dependent deactivation of the conjustments of the force-sarcomere relations of the sarco- tractile process (12, 15, 31). meres such that longer sarcomeres stretch shorter or Using a similar frog atria1 myocyte preparation weaker sarcomeres in series and thus increase the and a high-velocity perfusion technique, Shepherd and weaker activation levels, whereas the stronger sarco- Kavaler (121) found contractile force and shortening to meres reduce their force by shortening. On the basis of a respond maximally to step changes in Na+, Ca2+, and caffeine in 300 ms and concluded that there is no eviviscoelastic model of these localized oscillations, they calculate a sarcomere maximum velocity of -10 pm/s dence for Ca2+-induced Ca2+ release in frog atria1 cells, (4-5 sarcomere lengths/s), which is similar to that of i.e., that the Ca2+ source must be external and that cafintact cardiac muscle (95) and that later reported in un- feine must have a sarcolemmal action because its augattached cells (-9 pm/s) by Krueger et al. (67), as well mentation of contraction is as fast as the contractile as 3.42 cell lengths/s reported by Roos et al. (109) and 3.6 effects of Na+ and Ca2+ changes. pm/s reported in cat myocytes (61). These damped oscilIn an isolated guinea pig myocyte preparation lations during the rise of tonic activation are distinct (120), a cell was stimulated with a patch-clamp elecfrom the oscillations that occur at much lower Ca2+ trode. The measured contractile forces at 35°C averaged (pCa = 7.4) (33) that are attributable to Ca2+-induced 5.3 mN/mm2 (1.2 ,uN) at a sarcomere length of 1.81-1.88 Ca2+release from the sarcoreticular network. ,urn with shortening up to 8% in the central region of the These studies show that the tonically activated cell. No measurement of sarcomere uniformity was reskinned cardiac myocyte is capable of force development ported in these experiments. In the measurements of and shortening comparable to twitch responses in intact shortening in unattached cells, using a Sr2+ perfusate tissue. (122), they concluded that, in contrast to the frog atria1 myocytes, activator Ca2+ must come from internal stores and that the sarcoreticular network Ca2+release 2. Active force development in intact cells requires Ca2+ entry through channels. If these measurements are put in perspective with In studies of isolated intact frog atria1 myocytes (R. respect to multicellular preparations, then the contraccatesbeiana) (127,131), contractile force was determined tile forces reported for the isolated guinea pig myocytes from the deflection of a force beam measured with a are somewhat disappointing. For example, Yeatman et video system and a calibration of the beam compliance. al. (146) reported a stress of 42 mN/mm2 in papillary This attachment procedure was possible because the muscle at 37°C. They reported a Q10of -0.9 so that at cells are ZOO-300pm long; however, only about a 50-pm 35°C the papillary force would be 43 mN/mm2. Thus the segment of the cell was used for sarcomere length mea- guinea pig myocyte (122) generated forces only 12% (5.3 surements. The cells averaged -5 pm wide and thus mN/mm2) of those of intact tissue, not compensating for contain only a few myofibrils in cross section. The cells extracellular space. If the extracellular space is aswere electrically excitable so that twitch responses sumed to be 20% of tissue volume, then the active force could be recorded along with a video record of sarcomere is only 10% (54 mN/mm2). In the guinea pig myocyte length. They found that frog intact atria1 cells develop study, the beam compliance was 0.88 prn/pN, giving a twitch contractile forces of -150-250 nN, depending on beam deflection of 0.62-2.9 pm or l.O-4.5% of the 65-pm the compliance of the supporting beams (132). Force cell length. The highest recorded force was 3.3 PN in beam compliance ranged from 0.028 to 0.128 pm/nN, re- contracture (120), which is comparable to the twitch sulting in sarcomere length changes of 1020% for con- tension recorded in isolated rat myocytes at room temtractions of this magnitude (128, 132). Contractile perature by Brady et al. (19). Although the cells did not strength and shortening velocity continuously increased have an appreciable preload (sarcomere length - 1.8 with length even to sarcomere lengths > 3 pm (129). The pm), it is doubtful that the small twitch contractions in strength of the twitch and the shortening velocity could the guinea pig preparation were entirely due to the also be graded by both the amplitude and the duration of short initial length and the high compliance of the supthe stimulus current, indicating a graded release of ac- porting beams. Another factor may relate to a low Ca2’ tivating Ca2+ in the cell (130). With the recording of load in the short cell. For example, Nichols (88) found contractile responses after a variety of quick releases, that in cat papillary muscle at 3O”C, changes in diastolic auxotonic force-sarcomere length relations could be length affected subsequent twitch tension. Because measured so that auxotonic force-velocity relations stretch enhanced subsequent twitches more than recould be deduced (129, 130). lease, Nichols suggested that the diastolic length phenomenon may be related to the surface-to-volume ratio At an initial length of 3.0-3.2 pm, these cells shortened at nearly constant velocity to a sarcomere length of of the cells and that ionic exchange sites may be more


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accessible in the stretched cell. Thus excised cells may be less Ca” loaded than intact preparations, perhaps because they tend to be shorter after being freed from the collagen matrix. Another concern is that the low contractility may be indicative of a major nonuniformity of sarcomere dimensions during active contraction. These observations indicate that there are still considerable reservations concerning the functional state of attached isolated cardiac myocytes. 3. Displacement cells

recordings

in unattached

stimulated

The measurement of shortening in electrically stimulated isolated cardiac myocytes has been successful, with considerable new information regarding relations between cell function and metabolism. A wide variety of methods have been devised to record myocyte contractions, including I) direct cell transmittance changes (32), 2) video recording of cell motion (32,45,46, 57, 68, 87), 3) laser diffraction (61, 89, 117, 149, 4 phase-lock detectors (26,27,64), 5) the more complex CCD and video imaging systems (109, 112), and 6) edge detectors in which the motion of a contracting isolated cell can be measured in a variety of contractile states (22,37,72-75, 123). The edge-detection methods rely on some adhesion of the isolated cell to a stable surface or a perfusion micropipette so that a constant reference of cell position is obtainable. Because sarcomere length uniformity appears to be well maintained during shortening in unattached myocytes, the problem of sarcomere length uniformity is of less concern than in attached preparations. On the other hand, the load, both internal and external, against which attached cells contract in all of these methods is not known. Thus even though shortening can be graded by the stimulus and environmental factors in these preparations, without a knowledge of the loading of the unattached cells the interpretation of the contractile state of these cells in relation to activating Ca2+ may be ambiguous or, at least, may require the measurement of a number of parameters to deduce the basis of changes in contractility. These concerns are outlined next. IV.

INDEXES

OF CONTRACTILITY

A complete description of the mechanical component of the contractile process with which to relate the underlying biochemical processes requires measurements of force, stiffness, and shortening characteristics under a variety of loading and perturbational conditions. With the currently available techniques there is a limitation in the extent of these parameters that can be monitored. Problems with attachment of isolated cardiac myocytes to recording and control devices puts a constraint on any characterization of the myocardial contractile process such that the most extensive data at

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hand have come from shortening responses. The limited information that is available regarding force development indicates that isolated cardiac myocytes retain at least some of the relatively high passive stiffness characteristic of cardiac muscle and that they are capable of active stress generation, both in tonic and in twitch responses, comparable to intact preparations. However, the sensitivity of the collagen-free sarcolemmal membrane to applied stress and the absence of adequate cell attachment methods that maintain the inherent sarcomere uniformity during stress development leave little more than a few, more or less, auxotonic force recordings under very limited experimental conditions. Certainly a sarcomeric force-velocity relation that is necessary to relate the contractile process to biochemical kinetics cannot be characterized. The recording of isometric and afterloaded force responses and the establishment of the functional relation between active and passive forces as a function of sarcomere length remain among the most important experimental challenges. In the face of such limitations in contractile force measurement, a great deal of progress has been made in quantifying the shortening responses of the isolated myocytes under a wide variety of conditions. The more opportune challenge, then, is to understand the intrinsic factors that control myocyte shortening in terms of externally applied parameters, such as Ca2+ levels, stimulus patterns, and pharmacological agents. Some of the advances and concerns related to the measurement of shortening in unattached cells are discussed in the next section. A. Shortening

as an Index

of Contractility

The active shortening response of an unattached myocyte reveals the maximum degree of shortening and the shortening velocity of the minimally loaded cell manifested under the conditions extant in the internal and external environment of the cell. Both myocyte shortening and shortening velocity are readily measurable with current techniques. Thus, to the extent that these two parameters are indicative of the state of the contractile process, there is a measure of functional parameters that can be modified by experimental conditions. The parallels that have been demonstrated between myocyte shortening responses and those of intact tissue confirm that the isolated myocyte is a useful model of cardiac tissue. These features have been recently reviewed by Allen and Kentish (1). A number of major concerns need emphasis in the use of unattached cell responses as an index of contractility and, in particular, in the use of this index to infer cytosolic and sarcoreticular network Ca2+. In this regard, Krueger (66) emphasizes the point that myocyte shortening and relengthening reflect different components of internal loading and contractile processes so that a measure of maximum shortening alone may not be a sufficient measure of contractility. Krueger indi-


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cates that the ratio of the rates of shortening to relengthening provides additional information that may help to differentiate between passive and active components of the shortening event. For example, interventions that increase the elastic loading of the shortening cell, e.g., compression of cross bridges or increased stress in the cytoskeleton, as may occur in anoxic heart tissue (39,124), would slow the shortening rate but accelerate relengthening. In contrast, isoproterenol increases both shortening and relaxation rates in rat and rabbit myocytes (45) as well as increasing the extent of shortening. Thus in assessing the mechanism of an intervention the rate of cell length change should be included along with the measurement of maximum length change. There are further concerns when the basis of shortening is examined in terms of the Frank-Starling length-tension relation. The steep ascending limb of the length-tension curve, relative to skeletal muscle, implies that the ability of the cell to generate force must be affected by some property of cardiac contraction at short sarcomere length or by the shortening process itself, which is required to achieve a sarcomere length below rest length (-1851.90 pm) (42). A question is, What characteristics of the contractile process do measurements of maximum unloaded shortening and maximum shortening velocity reveal in altered contractile states relative to changes in cross bridges and/or Ca2+ kinetics? To put some of these questions in perspective, the next section reviews some of the issues relative to the functional basis of the ascending limb of the cardiac length-tension relation. B. Shortening

Related to Frank-Starling

Relation

Because isolated unattached myocyte preparations are not normally preloaded, except by possible adhesion to the supporting surface and by the viscous loading of the perfusion media, initial length factors affecting contractility may not be a variable parameter. Exceptions might appear where Ca2+ loading or unloading affects the initial cell length; however, these variations could be monitored during the interventions under study. On the other hand, when a muscle shortens in a twitch from an initial length near the peak of the ascending limb of the length-tension relation, its capacity to manifest external force declines as the muscle becomes shorter. Consequently, when shortening in unattached cardiac myocytes is used as an indicator of contractility, the underlying length-dependent factors may affect the interpretation of the mechanism of an intervention, depending on which process or processes are responsible for the ascending limb. There are consistent data indicating that the ascending limb of the length-tension relation in cardiac muscle is significantly steeper than in skeletal muscle (for reviews see Refs. 1, 60, 133). The higher resting tension, restoring forces, the absence of tetanization, the relatively low level of Ca2+ activation during a twitch in cardiac muscle. ~, and -.~~-~ an --~~ atmarent --L-~--

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length dependence of activation all are factors that may affect the determination of this steep length-tension curve. Therefore it is helpful to consider what is known about the basis of force-length relations in cardiac muscle. Specifically, the following are some of the mechanisms that have been proposed to influence the ascending limb of muscle: 1) interference with cross-bridge attachment from thin filaments passing through the M zone of the sarcomere at short sarcomere lengths (41, 56); 2) internal passive elastic restoring forces that increase with cell shortening or with an increase in cell diameter (41); 3) buckling of the ends of thin filaments of the adjacent halves of the sarcomere as they meet in the M region (21); 4) compression of attached cross bridge as sarcomere shortening occurs, thus creating a cross-bridge-dependent restoring force [in skeletal muscle (4)]; 5) shortening deactivation that may occur as a result of quick releases during activation or from the necessary shortening required to reach sarcomere lengths less than rest length (sarcomere length = 1.801.85 pm) before the isometric phase of contraction (12, 14, 30); 6) a length-dependent activation process in which Ca2+ bound to troponin C (TnC) is released when a cross bridge becomes detached during active shortening with a consequent reduction in the number of activation sites as shortening occurs (2,3,52); and 7) the influence of diastolic length on intracellular Ca2+ levels (88). These mechanisms are considered in some detail. I. Thin jZament

interference

of cross-bridge

attachment

The early suggestion that the ascending limb of the length-tension relation might be due to the interference of cross-bridge attachment from thin filaments of opposite ends of the sarcomere (41, 56) has been discussed extensively by Jewel1 (60), Gordon and Pollack (42), and Allen (5). The conclusion is that in maximally activated muscle fibers the plateau of tension development extends down to nearly 1.6 pm where the thick filaments begin to interact with the Z lines. Indeed Fabiato and Fabiato (33) showed a decline to only 85% maximum force development in tonically activated skinned cardiac myocytes at a sarcomere length of 1.6 pm compared with 40% in phasic Ca2+-induced Ca2’ release responses. Thus this portion of the ascending limb appears to be due more to incomplete activation or to the development of internal forces that resist sarcomere shortening rather than an interference with cross-bridge attachment. 2. Restoring

forces

The fact that neither cardiac muscle nor isolated myocytes will retain a sarcomere length less than -1.8 pm after active shortening indicates that some restoring force must be developed with shortening that restores the rest length during relaxation. The source and


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magnitude of this restoring force is of considerable interest not only in regard to the ascending limb of the cardiac length-tension relation but also because its character might give some clue to the functional organization of passive and active elements of the contractile system. However, Jewel1 (60) concluded that the strong Ca2+ dependence of the ascending limb of the lengthtension relation indicated that a passive elastic restoring force was probably not the primary basis for the fall in developed tension at short sarcomere lengths. Similarly, Fabiato and Fabiato (34) measured the force of myocyte extension by pressing a force transducer against a contracted cell during the relaxation process. They measured a force of ~4% active force as an estimate of the restoring force of the relaxing cell. Also by applying small loads to a relaxing trabecular preparation, ter Keurs and co-workers (134,135) concluded that the restoring force developed during shortening of the preparation could not be greater than a few percent of maximum isometric tension. Strauer (126) found that in the absence of an external load relengthening becomes slower with greater shortening. Krueger (64) concluded that the force of relengthening arises from within the cells but that in local asynchronous contractions the relengthening force (AP) from a sarcomere length of 1.6 pm is probably only a few percent of maximum isometric tension (-0.4 mN/mm2). In synchronous contractions the restoring forces are estimated to be, at most, l-2 mN/mm2 (34, 66). The latter conclusion is based on Krueger’s estimation of the restoring force using data from the resting stiffness (AP/AZ) of isolated myocytes (16,36) and the extent of segmental shortening (AZ) in a portion of an unattached myocyte caused by the asynchronous segmental contraction of the cell. The argument for a low restoring force is also supported by the idea that during shortening at maximal rates relatively few cross bridges are attached so that the restoring force must be less than the contractile force producing the shortening. The location of some of the elements responsible for the restoring force is suggested by the observations of Fabiato and Fabiato (35), who report that detergenttreated isolated single myofibrils do not relengthen after active shortening to a sarcomere length of 1.6 pm, whereas similarly activated mechanically skinned myocytes do relengthen to 1.9 pm. These data indicate that the major intracellular restoring force probably is related to stress in the interfibrillar structures that are destroyed by the detergent. At present it is unclear whether the longitudinal cytoskeletal filament systems (titin, desmin) are compressible or whether they simply go slack as the sarcomeres shorten. Because these filaments appear to survive detergent treatment, i.e., the high resistance to stretch remains (18), the absence of relengthening suggests that they do indeed go slack. However, the possibility must not be overlooked that the restoring force is not simply a passive property of the elastic structure of the sarcomere. It is possible that in the intact cell the restoring force is related, in

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part, to the active force generation process such as the compression of attached cross bridges. In this regard, it would be helpful to have a measurement of stiffness during controlled shortening and relengthening to evaluate the nature of the stressed elements (cross bridges and elastic structures) extant during the shortening and relengthening states.

3. Buckling

of thin &laments

Brown et al. (21) observed the appearance of waves in the contractile filaments of passive semitendinosus fibers of R. pipens compressed in gelatin. Krueger et al. (67) saw similar wavy patterns in isolated ventricular myocytes under similar compressed conditions. In the skeletal muscle study, Brown et al. (21) found that rather than forming a double-overlap pattern in the M zone in the compressed fiber, the ends of the thin filaments appeared to abut together, forcing the sarcomere to bend laterally and causing the wavy appearance. They suggested that a repulsive force due to the charges on the thick and/or thin filaments in the resting state may resist thin filament entrance into the M-zone region, whereas with activation thin filaments can be drawn past each other. On the other hand, the implication may be that in the passive sarcomere thin filament alignment between the two halves of the sarcomere is sufficiently precise to orient the end of the filaments into a relatively rigid end-to-end encounter. With active shortening, force exceeds the repulsive force or with cross-bridge attachment the thin filaments become misaligned enough to allow them to pass. Evidence for this process might be seen in a careful analysis of the slope of the myocyte shortening record in the vicinity of sarcomere length = 1.6 pm. On the other hand, the varied thin filament length in cardiac muscle (106) might smooth this transition such that only a subtle change in slope would occur.

4. Compressed

cross bridges

From another point of view, the steep ascending limb of the length-tension relation may reflect a component due to compressed cross bridge during shortening. In active skeletal muscle, Allen and Moss (4) found that the stiffness-to-force ratio increased at short sarcomere lengths, indicating that an increasing number of cross bridges must be in compression as sarcomere length decreased. If substantial cross-bridge compression does occur in shortening myocytes, then inotropic interventions that change the metabolic state of the cell, and thus the cross-bridge cycling rate by way of pH or adenosinetriphosphatase changes, might be expressed differently between the isometric and isotonic modes of contraction. The additional measurement of stiffness during shortening would help resolve this issue.


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5. Shortening

MECHANICAL

PROPERTIES

OF

deactivation

When active muscle is allowed to shorten, its ability to generate force is diminished even though the initial length is restored. In skinned cells in which activation can be maintained, the original force can be regenerated at the initial length but the redevelopment of force is relatively slow [half time = 410 and 230 ms in 8 and 15 PM Ca’+, respectively (Z)]. This shortening deactivation has been well demonstrated in both intact cardiac and skeletal muscle (12, 14, 30). However, shortening in unloaded cells to ~1.6 pm can occur even in low-Ca2+-perfused experiments. The shortening rate is Ca2+ dependent, but the Ca” level does not determine the extent of shortening in skinned cells (62). Therefore the deactivation process is not a simple function of length change or activating Ca2+. 6. Length-dependent activation

Along similar lines, there is a growing body of evidence that contractile activation is length dependent, particularly in twitch contractions of intact muscle. These data indicate that Ca” binding to TnC is reduced at short sarcomere lengths. Questions that arise are whether there is a common mechanism between shortening deactivation and the length sensitivity of Ca2+activation and how this deactivation and length-dependent activation relate to the steep ascending limb of the length-tension relation and, with regard to all these factors, what state of contractility is measured by unattached cell shortening when contractile states are changed by various inotropic agents. From studies in glycerinated cardiac muscle of cows, in detergent-skinned trabeculae preparations of rats, and from the substitution of skeletal muscle TnC for cardiac TnC in skinned trabeculae of hamsters, the following points concerning myocyte shortening and Ca2+activation are evident. I) Calcium is released from TnC when cross bridges detach with shortening steps (2, 50, 55). 2) In heart muscle the released Ca2+ correlates best with the force change rather than with the magnitude of the length change as in skeletal muscle (2,51). 3) With relengthening the Ca2+may rebind to TnC at least in steady-state activations as in skinned or glycerinated preparations (52). 4) Calcium is bound to TnC in rigor states, and the amount bound varies with sarcomere length (50). 5) Substitution of skeletal muscle TnC for cardiac TnC increases force development at short sarcomere lengths, indicating that the cardiac TnC regulation of contractile force is more length dependent than skeletal TnC regulation (6). With regard to deactivation, then, these data indicate that as unattached myocytes shorten, Ca2+binding to TnC is likely to be much reduced relative to an isometric state at each length, since in shortening muscle few cross bridges are attached and thus TnC activation would be low. These effects may have several important

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consequences relative to the method of assessment of cardiac contractility. First, cytosolic Ca2+ would be expected to be higher in unattached shortening, as cross bridges detach during sarcomere shortening causing the release of Ca2+ from TnC. Second, the contraction may be of shorter duration, since sequestering by the sarcoreticular network would be faster. Third, if the cell becomes afterloaded at some point during the shortening process, then the developed tension would be reduced, since some of the Ca2+ released from TnC would be sequestered by the sarcoreticular network. Indeed, the latter process may be the primary basis for the steep ascending limb of the cardiac length-tension relation as measured by contractile force after shortening to a preset length or by the final sarcomere length after active shortening with various afterloads from an initial nonslack rest length. Thus the ascending limb of the FrankStarling relation may be predominantly determined by the loss of activating Ca2+ bound to TnC as shortening occurs (I). With regard to the question of what aspect of contractility unloaded shortening measures, the relation of unloaded shortening responses to cytosolic Ca2+during inotropic interventions becomes complex to interpret. For example, Allen and Kentish (2) showed that free Ca” increased with shortening in skinned cardiac myocytes, which is consistent with the hypothesis that binding of Ca2+ to TnC is reduced after detachment of cross bridges from an actin sites. However, increased buffering of the free Ca2+under these conditions did not alter the development of force after shortening. Furthermore, Hofmann and Fuchs (52) showed that, indeed, Ca2+ binding to TnC in glycerinated heart fibers was reversibly dependent on sarcomere length, i.e., Ca” binding to TnC decreased with shortening but increased again with relengthening. Thus with alteration of the inotropic state of a cell, the measurement only of unattached cell shortening may not accurately reflect either sarcoreticular network Ca2+ or cytoplasmic Ca2+, i.e., considerably more Ca” might be released by the sarcoreticular network and cytosolic Ca” might be greater than indicated by the magnitude of shortening. An independent measure of cellular Ca” is still necessary to evaluate the activation processes. 7. Contractility

related to diastolic length

In cat papillary muscle, Nichols (88) found twitch force to vary with time after a diastolic length change. Also, the increment in twitch force was greater in response to diastolic length increases than the decrement with similar decreases in diastolic length. This protracted dependence of force development on stepwise length changes suggests that contractile activation can be altered by diastolic length by mechanisms other than simple changes in myofilament overlap. In fact, Allen and Kentish (2) measured intracellular Ca2+transients as a function of diastolic length in ferret ventricular


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muscle and found that the transient responses underwent a slow decline after a reduction in diastolic length, paralleling the slow decline in tension. They attribute this length dependence to possible stretch-dependent conductance channels that may influence diastolic intracellular Ca2+ levels. These observations emphasize the extreme lability of Ca2+ levels in the cardiac myocyte relative to both length and time. Hence interpretations of activation kinetics based on shortening must include these variables.

V.

SUMMARY

AND

CONCLUSIONS

A wide variety of techniques have been developed to monitor the mechanical responses of isolated cardiac myocytes. The most successful are those that measure shortening in unattached cells. Because of their relative ease of implementation, edge-detector methods of following cell displacement have become most widespread. Laser diffraction techniques have been applied to the single heart cells, and sophisticated sarcomere imaging systems capable of 2-ms time resolution of shortening responses have also been developed. Active force has been recorded in intact single cells from frog atria; however, the compliance of the force transducers was relatively high (-5% L,). (There is an obvious trade-off between transducer sensitivity, which affects noise and drift and compliance.) Some success has been reported with the use of intact rat myocytes supported by suction micropipettes and in guinea pig ventricular myocytes adhering to poly-L-lysine-coated glass beams. With the rat preparation, contractile stress was comparable to that of ventricular muscle, but few cells survived the attachment. In guinea pig myocytes, contractile stress in electrically induced twitches was only ~10% of the active stress developed by mammalian trabeculae or papillary muscles at the same temperature (35”C), but, as with the frog atria1 transducer, the compliance of the supporting beams was relatively high. Sarcomere uniformity has not been evaluated in these intact preparations. For attachment to the relatively short mammalian cardiac myocytes, the more promising methods that better preserve sarcomere uniformity include doublebarreled micropipettes coated with a barnacle adhesive; however, for nonsubmersible transducers, a continuing limitation is the problem of solution surface stability. Unfortunately, the more severe limitation to effective attachment to intact cells is still the extreme sensitivity of the sarcolemma to mechanical stress. The challenge remains to develop an attachment to the intercalated disk such that cell stress can be transferred to the supporting transducers along the normal stress-bearing cellular interface. The ultrastructural and passive mechanical data strongly indicate that although the extracellular collagen limits the extension of cardiac muscle beyond the peak of the active length-tension relation, there is also a substantial cellular component of resistance to exten-

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sion. Furthermore, this cellular component is related to the cytoskeleton rather than to membranous elements in the cell. The more likely candidates for the longitudinal resting stress-bearing element are titin (connectin) and desmin. Titin is the most likely candidate, since it is present in both skeletal and cardiac muscle in relative large quantities, and immunolabeling and stiffness data show that titin extends from the M line to the Z band. These data also show that there is a close association of titin with the thick filaments in both cardiac and skeletal muscle and that passive stiffness falls as myosin is extracted and the titin attachment to myosin is disrupted in high salt. It remains to be established whether the influence of passive stress applied to the thick filaments by titin has any regulatory effect on active force development. It is apparent that the basis of the ascending limb of the Frank-Starling length-tension relation may be a composite of several factors, each of which may influence the magnitude of shortening in unattached cells when contractility is changed. The sensitivity of activating Ca2’ bound to TnC on cross-bridge attachment may play a predominant role in the length-tension relation. The development of restoring forces with cell shortening appears to be significant, but their effect may be more in restoring diastolic length than in influencing the length-tension relation. The relative contributions of other factors (cytosolic viscosity, cross-bridge compression, diastolic Ca2+) remain to be evaluated. Obviously, contractility during varied inotropic interventions measured by shortening does not measure the same properties of the contractile system as determined by isometric force development. A complete definition of the contractile process requires measurements of both modes of contraction and a determination of their complex interaction. With these data, an understanding of the basis of the steep ascending limb of the length-tension relation and its relation to inotropically altered Ca2+ activation may be forthcoming. The isolated cardiac myocyte represents the most promising preparation available at the present time to aid in the understanding of the cardiac contractile process. The isolation procedures have been sufficiently refined to provide an actively contractile unit that seems reasonably representative of intact tissue. The challenge now is to further develop attachment methods, force transducers, and sarcomere monitoring and control devices with which to relate the mechanical parameters of contraction to the myofilament components of the cell and biochemical kinetics. Among these challenges is the necessity to understand the functional relation between the passive stress-bearing elements of the cytoskeleton and the contractile filament system. I thank Leota Green and Dr. Kenneth Roos for assistance in the preparation of this review. This work was supported by the National Heart, Lung, and Blood Institute Grant HL-30828 and by the Laubisch Endowment.


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isolated adult rat and rabbit cardiac myocytes to isoproterenol and calcium. J. MoZ. Cell. Cardiol. 20: 635-647, 1988. HARRIS, P. J., D. STEWART, M. C. CULLINAN, L. M. DELBRIDGE, L. DALLY, AND P. GRINWALD. Rapid measurement of isolated cardiac muscle cell length using a line-scan camera. IEEE Trans. Biomed. Eng. 34: 463-467,1987. HAWORTH, R. A., A. B. GOKNUR, T. F. WARNER, AND H. A. BERKOFF. Some determinants of quality and yield in the isolation of adult heart cells from rat. Cell Cakium 10: 57-62, 1989. HIGUCHI, H., AND S. ISHIWATA. Disassembly kinetics of thick filaments in rabbit skeletal muscle fibers. Effects of ionic strength, Ca2+ concentration, pH, temperature. Biophys. J. 47: 267-275,1985. HIGUCHI, H., AND Y. UMAZUME. Localization of the parallel elastic components in frog skinned muscle fibers studied by the dissociation of the A- and I-bands. Biophys. J 48: 137-147,1985. HOFMANN, P. A., AND F. FUCHS. Effect of length and crossbridge attachment on Ca2+ binding to cardiac troponin C. Am. J Physiol. 253 (CeLZ Physiol. 22): C90-C96, 1987. HOFMANN, P. A., AND F. FUCHS. Evidence for a force-dependent component of calcium binding to cardiac troponin C. Am. J Physiol. 253 (Cell Physiol. 22): C541-C546, 1987. HOFMANN, P. A., AND F. FUCHS. Bound calcium and force development in skinned cardiac muscle bundles: effects of sarcomere length. J. MoZ. CeZC Cardiol. 20: 667-677, 1988. HOROWITS, R., K. MARUYAMA, AND R. J. PODOLSKY. Elastic behavior of connectin filaments during thick filament movement in activated skeletal muscle. J. CeZL BioZ. 109: 2169-2176, 1989. HOROWITS, R., AND R. J. PODOLSKY. The positional stability of thick filaments in activated skeletal muscle depends on sarcomere length: evidence for the role of titin filaments. J. Cell BioZ. 105: 2217-2223,1987. HOUSMANS, P. K., H. K. LEE, AND J. R. BLINKS. Active shortening retards the decline of the intracellular calcium transient in mammalian heart muscle. Science Wash. DC 221: 159-161, 1983. HUXLEY, H. E. The mechanism of muscular contraction. Science Wash. DC 213: 18-27, 1965. ISENBERG, G. Ca entry and contraction as studied in isolated bovine ventricular myocytes. 2. Naturfbrsch. Teil C Biochem. Biophyys. Biol. Viral. 37: 502-512, 1982. ISHIWATA, S., K. MURAMATSU, AND H. HIGUCHI. Disassembly from both ends of thick filaments in rabbit skeletal muscle fibers. An optical diffraction study. Biophys. J. 47: 257-266,1985. IWAZUMI, T. High-speed untrasensitive instrumentation for myofibril mechanics measurements. Am. J Physiol. 252 (Cell Physiol. 21): C253-C262, 1987. JEWELL, B. R. A reexamination of the influence of muscle length on myocardial performance. Circ. Res. 40: 221-230, 1977. KENT, R. L., D. L. MANN, Y. URABE, R. HISANO, K. W. HEWETT, M. LOUGHNANE, AND G. COOPER IV. Contractile function of isolated feline cardiocytes in response to viscous loading. Am. J. Physiol. 257 (Heart Circ. Physiol. 26): H1717-H1727, 1989. KENTISH, J. C., H. E. D. J. TER KEURS, L. RICCIARDI, J. J. J. BUCX, AND M. I. M. NOBLE. Comparison between the sarcomere length-force relations of intact and skinned trabeculae from rat right ventricle. Influence of calcium concentrations on these relations. Circ. Res. 58: 755-768, 1986. KOTELIANSKY, V. E., M. A. GLUKHOVA, G. N. GNEUSHEV, J. L. SAMUEL, AND L. RAPPAPORT. Isolation and localization of filamin in heart muscle. Eur. J. Biochem. 156: 619-623,1986. KRUEGER, J. W. Measurement and interpretation of contraction in isolated cardiac cells. In: Biology ofIsolated Ad&t Cardiac Myocytes, edited by W. A. Clark, R. S. Decker, and T. K. Borg. Amsterdam: Elsevier, 1988, p. 172-186. KRUEGER, J. W. Fundamental mechanisms that govern cardiac function: A short review of cardiac sarcomere mechanics. Heart FaiZure 4: 137-153, 1988. KRUEGER, J. Rapid relengthening in isolated cardiac cells and the origin of diastolic recoil. In: Cardiac Mechanics and Function in the Normal and Diseased Heart, edited by M. Hori, H. Suga, J. Baan, and E. L. Yellin. Tokyo: Springer-Verlag, 1989, p. 23-34.

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Mechanical properties of the isolated equine trachea.

Calcium current measurements in acutely isolated neonatal cardiac myocytes.

Neutrophil adherence to isolated adult cardiac myocytes. Induction by cardiac lymph collected during ischemia and reperfusion.

Mechanical and vasomotor properties of piglet isolated middle cerebral artery.

Mechanical properties of isolated human oesophageal submucosal veins.

Nuclear calcium in cardiac myocytes.

Superoxide-dependent and superoxide-independent pathways for reduction of nitroblue tetrazolium in isolated rat cardiac myocytes.

Properties of L-type calcium channel gating current in isolated guinea pig ventricular myocytes.

Effects of oxygen free radicals on isolated cardiac myocytes from guinea-pig ventricle: electrophysiological studies.

Gene transfer into cardiac myocytes.

Effect of palmitoylcarnitine on the passive electrical properties of isolated guinea pig ventricular myocytes.

The effect of anoxia on lipid metabolism in isolated adult rat cardiac myocytes.

G-protein-mediated regulation of the insulin-responsive glucose transporter in isolated cardiac myocytes.

Kinetics, stoichiometry and role of the Na-Ca exchange mechanism in isolated cardiac myocytes.

Preparation and some properties of isolated beating myocytes from adult rabbit heart.

Alpha-adrenoceptor-mediated increase in cytosolic free calcium in isolated cardiac myocytes.

Calcium transients in isolated cardiac myocytes are altered by 1,1,1-trichloroethane.

Ca2+ ionophores are not suitable for inducing mPTP opening in murine isolated adult cardiac myocytes.

Free fatty acids do not release lipoprotein lipase from isolated cardiac myocytes or perfused hearts.

Identification of cardiac stem cells within mature cardiac myocytes.

Arrhythmogenic transient dynamics in cardiac myocytes.

Nuclear ion channels in cardiac myocytes.

High-efficiency gene transfer into cardiac myocytes.

Gαq-mediated activation of GRK2 by mechanical stretch in cardiac myocytes. THE ROLE OF PROTEIN KINASE C.