Physiology, Bowditch Effect

Excerpt

The Bowditch effect is also known as the Treppe phenomenon, staircase phenomenon, or frequency-dependent activation. It refers to the idea that an increase in heart rate increases the force of contraction generated by the myocardial cells with each heartbeat despite accounting for all other influences. This concept of a frequency-based positive inotropic response of the heart was first explained in 1871 by the physiologist Henry Pickering Bowditch after he stimulated a resting frog’s ventricular apex. The basis of the phenomenon has associations with calcium ion handling and mishandling in cardiac cells. It involves proteins that participate in the excitation-contraction coupling, like the sarcoplasmic endoplasmic reticulum calcium-ATPase (SERCA). A direct correlation between decreased SERCA expression and reduced levels of sarcoplasmic reticulum (SR) Ca uptake, leading to a diminished force-frequency response, is coined as the hallmark of heart failure. Furthermore, there are also implications of mutations in SERCA in Darier disease - an autosomal dominant skin disease.