Cardiac tropism

Cardiac tropism describes the effect of external stimuli on the heart.

So they produce different types of changes in heart activity.

These changes are broadly categorized into four types.

Chronotropic effects, inotropic effects, dromotropic effects and bathmotropic effects.

Here the meaning of the suffix 'tropic", which is common for all the words, is change.

chronotropic effects.
Chrono means time.
And of course, the most important cardiac parameter related to time is heart rate.
That is, how many times the heart beats every minute.
So the chronotropic means changes in heart rate.

Positive chronotropic means an increase in heart rate

and negative chronotropic means a decrease in heart rate.

Now we know that heart rate is controlled by the SA node, the pacemaker of the heart.

So the factors affecting heart rate acts through the SA node.

For example adrenaline speeds up the SA node and thereby increases heart rate.

So it is called a positive chronotropic agent.

On the other hand, acetylcholine slows down the SA node. So it decreases heart rate.

Or in other words, it produces negative chronotropic action.

So these were chronotropic actions.

inotropic effects.

"ino" means force. And tropic means change.

So the inotropic effect means a change in the force of contraction.

Positive inotropic means an increase in the force of contraction

and negative ionotropic means decrease in the force of contraction.

Now the main factor determining the contractility is Ca concentration in cardiac muscle.

So the factors affecting contractility acts by changing Ca levels in the cardiac muscles.

For example, cardiac glycosides like digitalis, cause Ca loading in the heart muscles. This
increases force of contraction, also called positive inotropic action.

On the other hand, Ca channel blockers decrease the Ca levels.

This leads to a decrease in the force of contraction, also called negative inotropic action.

So these were inotropic actions.

dromotropic actions.

Dromo means running.

Impulse.

We know that impulse generates at SA node passes through AV node to reach the ventricles.

Dromotropic means changes in the speed of this impulse conduction through the AV node.

Positive dromotropic means increase in velocity of conduction and negative dromotropic means
decrease in the velocity of the conduction.
Obviously dromotropic effects are produced by acting on the AV node.

For example, adrenaline increases the velocity of conduction through the AV node. Thus it
produces positive dromotropic action.

And cardiac glycosides decrease the velocity of conduction. Or in other words they have
negative dromotropic action.

So these were the dromotropic actions.

bathmotropic actions.

"bathmo" means threshold.

Here it's the threshold for action potential that we are talking about.

Thus bathmotropic action means changes in the excitability of cardiac muscle.

Positive bathmotropic means increased excitability

and negative bathmotropic means decreased excitability.

Now the excitability depends on the resting membrane potential. The closer it is to the threshold,
the easier it is to reach it and get excited.

The bathmotropic effects are produced by altering resting membrane potential.

For example, adrenaline brings the resting membrane potential close to the threshold.

This makes the cell easily excitable or in other words,

adrenaline produces positive bathmotropic action.

On the other hand, acetylcholine produces the opposite effect.

So it has negative bathmotropic action.