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Regulation of muscle potassium: exercise performance, fatigue and health implications
Abstract
This review integrates from the single muscle fibre to exercising human the current understanding of the role of skeletal muscle for whole-body potassium (K+) regulation, and specifically the regulation of skeletal muscle [K+]. We describe the K+ transport proteins in skeletal muscle and how they contribute to, or modulate, K+ disturbances during exercise. Muscle and plasma K+ balance are markedly altered during and after high-intensity dynamic exercise (including sports), static contractions and ischaemia, which have implications for skeletal and cardiac muscle contractile performance. Moderate elevations of plasma and interstitial [K+] during exercise have beneficial effects on multiple physiological systems. Severe reductions of the trans-sarcolemmal K+ gradient likely contributes to muscle and whole-body fatigue, i.e. impaired exercise performance. Chronic or acute changes of arterial plasma [K+] (hyperkalaemia or hypokalaemia) have dangerous health implications for cardiac function. The current mechanisms to explain how raised extracellular [K+] impairs cardiac and skeletal muscle function are discussed, along with the latest cell physiology research explaining how calcium, β-adrenergic agonists, insulin or glucose act as clinical treatments for hyperkalaemia to protect the heart and skeletal muscle in vivo. Finally, whether these agents can also modulate K+-induced muscle fatigue are evaluated.
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“Additionally, extracellular potassium levels, which rise during intense exercise, can further disrupt muscle excitation and contraction processes, contributing to muscle fatigue17,39.”
From Evaluating bioenergetic pathway contributions from single to multiple sprints (2024) · cites this paper as [39]
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Cites
Basic anatomical and physiological data for use in radiological protection: reference values
Valentin, J. (2002) · Annals of the ICRP · doi:10.1016/s0146-6453(03)00002-2 · Cited by 2,024
Reflex cardiovascular and respiratory responses originating in exercising muscle
McCloskey, D. I., & Mitchell, J. H. (1972) · The Journal of Physiology · doi:10.1113/jphysiol.1972.sp009887 · Cited by 1,105
Wei, A. D., Gutman, G. A., Aldrich, R. W., Chandy, K. G., Grissmer, S., & Wulff, H. (2005) · Pharmacological Reviews · doi:10.1124/pr.57.4.9 · Cited by 990
Gutman, G. A., Chandy, K. G., Grissmer, S., Lazdunski, M., McKinnon, D. H., Pardo, L. A., Robertson, G. A., Rudy, B., Sanguinetti, M. C., Stühmer, W., et al. (2005) · Pharmacological Reviews · doi:10.1124/pr.57.4.10 · Cited by 888
Joyner, M. J., & Casey, D. P. (2015) · Physiological Reviews · doi:10.1152/physrev.00035.2013 · Cited by 833
Muscle and Blood Metabolites during a Soccer Game: Implications for Sprint Performance
KRUSTRUP, P., MOHR, M., STEENSBERG, A., BENCKE, J., KJÆR, M., & BANGSBO, J. (2006) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000222845.89262.cd · Cited by 742
The Spectrum of Epidemiology Underlying Sudden Cardiac Death
Hayashi, M., Shimizu, W., & Albert, C. M. (2015) · Circulation Research · doi:10.1161/circresaha.116.304521 · Cited by 741
Mancinelli, R., Botti, A., Bruni, F., Ricci, M. A., & Soper, A. K. (2007) · The Journal of Physical Chemistry B · doi:10.1021/jp075913v · Cited by 731
Na + -K + Pump Regulation and Skeletal Muscle Contractility
Clausen, T. (2003) · Physiological Reviews · doi:10.1152/physrev.00011.2003 · Cited by 582
Dynamics and consequences of potassium shifts in skeletal muscle and heart during exercise.
Sejersted, O., & Sjøgaard, G. (2000) · Physiological Reviews · doi:10.1152/physrev.2000.80.4.1411 · Cited by 526
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Metadata
- Authors
- Lindinger, M. I., & Cairns, S. P.
- Affiliations
- Auckland University of Technology (NZ)
- Corresponding author
- Cairns, Simeon P.
- Venue
- European Journal of Applied Physiology
- Published
- 2021-01-04
- Volume
- 121
- Issue
- 3
- Pages
- 721-748
- ISSN
- 0020-9376 (ISSN-L)
- 1439-6319
- 1439-6327
- OpenAlex
- W3119220887
- Cited by
- 78
- References
- 262
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 17 · 2023: 11 · 2022: 15 · 2021: 6
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Applied Physiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Potassium and Related Disorders
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
- Keywords
- physical activity, muscle fatigue, hyperkalemia, hypokalemia, plasma potassium, ischemia, cardiac function, exercise performance, calcium, beta-adrenergic agonists, insulin, glucose
- MeSH terms
- Humans, Potassium, Exercise, Muscle, Skeletal, Muscle Fatigue
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