Cardiac muscle shares similarities with skeletal muscle with regard to its striated appearance and contraction, with both differing significantly from smooth muscle cells. Coordinated contraction of cardiac muscle cells in the heart propel blood from the atria and ventricles to the blood vessels of the circulatory system. Cardiac muscle cells, like all tissues in the body, rely on an ample blood supply to deliver oxygen and nutrients and to remove waste products such as carbon dioxide. The coronary arteries fulfill this function.
Cardiac muscle is adapted to be highly resistant to fatigue: it has a large number of mitochondria, enabling continuous aerobic respiration via oxidative phosphorylation, numerous myoglobins and a good blood supply, which provides nutrients and oxygen. In contrast to skeletal muscle, cardiac muscle requires both extracellular calcium and sodium ions for contraction to occur. Like skeletal muscle, the initiation and upshoot of the action potential in cardiac muscle cells is derived from the entry of sodium ions across the sarcolemma in a positive feedback loop.
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