Cardiac Excitation-Contraction Coupling

D. M. Bers, S. Despa

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

9 Scopus citations


Contraction of the heart, required to pump the blood out of the left ventricle, is a complex process that involves electrical excitation of the cardiac muscle, finely tuned changes in the intracellular concentration of the ubiquitous second-messenger calcium (Ca), and activation of the contractile apparatus of cardiac myocytes. This process is called 'excitation-contraction (E-C) coupling'. The electrical impulse generated by the cardiac pacemaker cells propagates to the ventricle where it triggers cardiac myocyte depolarization. Depolarization opens voltage-dependent Ca channels, allowing Ca to enter cardiac myocytes and trigger Ca release from the sarcoplasmic reticulum. The combination of Ca entry and Ca release raises the intracellular Ca concentration, allowing Ca to bind to the myofilaments and activate contraction. Relaxation occurs when Ca is extruded from the cytosol. Defective E-C coupling leads to heart failure (HF), a syndrome that develops when the amount of blood pumped from the heart is inadequate to meet the metabolic demands of the body. HF is characterized by both contractile dysfunction and increased propensity for fatal arrhythmias. In this article, we review the E-C coupling process in healthy hearts and the main alterations that lead to reduced contractions and arrhythmias in HF.

Original languageEnglish
Title of host publicationEncyclopedia of Biological Chemistry
Subtitle of host publicationSecond Edition
Number of pages5
ISBN (Electronic)9780123786319
StatePublished - Feb 15 2013

Bibliographical note

Publisher Copyright:
© 2013 Elsevier Inc. All rights reserved.


  • Action potential
  • Arrhythmias
  • Contraction
  • Heart failure
  • Intracellular Ca
  • Ryanodine receptors
  • Sarcoplasmic reticulum
  • Sodium/calcium exchanger

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology


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