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Ca
+
Tropomyosin
alpha-1 chain
Tropomyosin
beta chain
Beta-1
adrenergic
receptor
Ryanodine
receptor 2
Voltage-
depenent L-type
calcium channel
Voltage-
depenent L-type
calcium channel
Voltage-
depenent L-type
calcium channel
cAMP-dependent
protein kinase
type I-alpha
regulatory
subunit
Sodium/calcium
exchanger 1
Voltage-gated
T-type calcium
channel (ICaT)
Voltage-gated
T-type calcium
channel (ICaT)
Sarcoplasmic/endoplasmic
reticulum
calcium ATPase
2
cAMP-dependent
protein kinase
catalytic
subunit alpha
Epinephrine
Enflurane
Ca
+
Ca
+
Ca
+
Na
+
Na
+
Ca
+
Ca
+
Ca
+
Enflurane
Enflurane
ATP
H
2
O
Ca
+
ADP
P
i
Ca
+
Ca
+
Troponin
Troponin
G-Protein
Signaling
Cascade
Muscle
Contraction
Cardiac Myocyte
Sarcoplasmic Reticulum
Low calcium is unable to
bind to troponin to displace
tropomyosin from the myosin
binding sites on the actin
filaments
Myosin and actin are unbound
allowing the filaments to
slide further apart,
resulting in muscle
relaxation
Actin Filament
Myosin Filament
The beta-1 adrenergic
receptor is coupled to and
activates the G-protein
signalling cascade.
The G-protein signalling
cascade activates protein
kinase which activates
calcium channels on the
membrane, resulting in
calcium influx.
Low calcium is unable to
activate the ryanodine
receptor on the sarcoplasmic
reticulum.
Cytosol
Since calcium is linked to
activation of muscle
contraction. Reducing
cytosolic calcium levels
reduces muscle contraction
Epinephrine stimulation
effect of the heart is
reduced as intracellular
calcium levels are lowered
by Enflurane blocking
channels on the sarcoplasmic
reticulum
T-tubule
Enflurane is administered
via respiratory inhalation
Enflurane inhibits calcium
release channels on the
sarcoplasmic reticulum
Calcium
TPM1
TPM2
ADRB1
RYR2
CACNA1C
CACNA2D2
CACNB1
PRKAR1A
SLC8A1
CACNA1H
CACNA1G
ATP2A2
PRKACA
Epinephrine
Enflurane
Calcium
Calcium
Calcium
Sodium
Sodium
Calcium
Calcium
Calcium
Enflurane
Enflurane
Adenosine
triphosphate
Water
Calcium
Adenosine
diphosphate
Phosphate
Calcium
Calcium
Troponin
Troponin
G-Protein
Signaling
Cascade
Muscle
Contraction