Decreased inward rectifying K+current and increased ryanodine receptor sensitivity synergistically contribute to sustained focal arrhythmia in the intact rabbit heart

Myles, R. C. , Wang, L., Bers, D. M. and Ripplinger, C. M. (2015) Decreased inward rectifying K+current and increased ryanodine receptor sensitivity synergistically contribute to sustained focal arrhythmia in the intact rabbit heart. Journal of Physiology, 593(6), pp. 1479-1493. (doi: 10.1113/jphysiol.2014.279638) (PMID:25772297)

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Abstract

Heart failure (HF) results in dramatic electrophysiological remodelling, including increased sensitivity of ryanodine receptors (RyRs) and decreased inward rectifying K+ current (IK1), which predisposes HF myocytes to delayed afterdepolarizations and triggered activity. Therefore, we sought to determine the role of increased RyR sensitivity and decreased IK1 in contributing to focal arrhythmia in the intact non-failing heart. Optical mapping of transmembrane potential and intracellular Ca2+ was performed in Langendorff-perfused rabbit hearts (n = 15). Local β-adrenergic receptor stimulation with noradrenaline (norepinephrine; NA, 50 μl, 250 μm) was applied to elicit focal activity (premature ventricular complexes (PVCs) or ventricular tachycardia (VT ≥ 3 beats)). NA was administered under control conditions (CTL) and following pretreatment with 50 μm BaCl2 to reduce IK1, or 200 μm caffeine (Caff) to sensitize RyRs, both alone and in combination. Local NA injection resulted in Ca2+-driven PVCs arising from the injection site in all hearts studied. No increase in NA-mediated PVCs was observed following pretreatment with either BaCl2 or Caff alone (CTL: 1.1 ± 0.7, BaCl2: 1.0 ± 0.7, Caff: 1.3 ± 0.8 PVCs/injection, P not significant). However, pretreatment with the combination of BaCl2 + Caff resulted in a significant increase in PVCs (2.3 ± 2.8 PVCs/injection, P < 0.05 vs. CTL, BaCl2, Caff). Additionally, pretreatment with BaCl2 + Caff led to sustained monomorphic VT arising from the NA application site in all hearts studied, which lasted up to 6 min following a single NA injection. VT was never observed under any other condition suggesting synergism between increased RyR sensitivity and decreased IK1 in contributing to focal activity. These findings may have important implications for the understanding and prevention of focal arrhythmia in HF.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Myles, Dr Rachel
Authors: Myles, R. C., Wang, L., Bers, D. M., and Ripplinger, C. M.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Journal of Physiology
Publisher:Wiley
ISSN:0022-3751
ISSN (Online):1469-7793

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
550231Electrophysiological remodelling and mechanisms of ventricular arrhythmia in dilated cardiomyopathy.Rachel MylesBritish Heart Foundation (BHF)FS/10/64/28532RI CARDIOVASCULAR & MEDICAL SCIENCES