Influence of glycosides on myocardial potassium and sodium concentration in acute and chronic potassium deficiency.

The analytical assay of intracellular potassium ([Ki]) and sodium ([Nai]) concentration of guinea pig papillary muscle measured in in vitro experiments shows that: 1) 5 X 10(-7) M g-strophanthin causes a decrease of [Ki] under control conditions, in acute as well as in chronic potassium deficiency, 2) a more marked glycoside effect is seen when the extracellular potassium concentration is reduced from 4.7 to 2mEq/1; this finding, therefore, is in good agreement with the observation that glucoside binding to its receptor at the cellular membrane is enhanced when potassium concentration is decreased, 3) whereas in chronic potassium deficiency normal [Ki] and [Nai] are maintained, acute potassium deficiency is accompanied by a loss of cellular K and gain of cellular Na. Under the influence of cardioactive glycosides, in chronic potassium depletion higher intracellular potassium and lower intracellular sodium concentrations are maintained than in acute potassium depletion. It is supposed tha t the net changes which are caused by a reduction of [Ke] in acute potassium deficiency in contrast to chronical potassium deficiency predispose to glycoside toxicity. These changes may therefore be the cause of the clinical observation that acute hypokalemia is associated with a greater glycoside sensitivity than chronic potassium deficiency.