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Suppression of ventricular arrhythmias by targeting late L-type Ca2+ current
Univ Calif Los Angeles, CA 90095 USA.
Univ Calif Los Angeles, CA 90095 USA.
Univ Calif Los Angeles, CA 90095 USA.
Harvard Med Sch, MA 02115 USA.
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2021 (English)In: The Journal of General Physiology, ISSN 0022-1295, E-ISSN 1540-7748, Vol. 153, no 12, article id e202012584Article in journal (Refereed) Published
Abstract [en]

Ventricular arrhythmias, a leading cause of sudden cardiac death, can be triggered by cardiomyocyte early afterdepolarizations (EADs). EADs can result from an abnormal late activation of L-type Ca2+ channels (LTCCs). Current LTCC blockers (class IV antiarrhythmics), while effective at suppressing EADs, block both early and late components of I-Ca,I-L, compromising inotropy. However, computational studies have recently demonstrated that selective reduction of late I-Ca,I-L (Ca2+ influx during late phases of the action potential) is sufficient to potently suppress EADs, suggesting that effective antiarrhythmic action can be achieved without blocking the early peak I-Ca,I-L, which is essential for proper excitation-contraction coupling. We tested this new strategy using a purine analogue, roscovitine, which reduces late I-Ca,I-L with minimal effect on peak current. Scaling our investigation from a human Ca(V)1.2 channel clone to rabbit ventricular myocytes and rat and rabbit perfused hearts, we demonstrate that (1) roscovitine selectively reduces I-Ca,I-L noninactivating component in a human Ca(V)1.2 channel clone and in ventricular myocytes native current, (2) the pharmacological reduction of late I-Ca,I-L suppresses EADs and EATs (early after Ca2+ transients) induced by oxidative stress and hypokalemia in isolated myocytes, largely preserving cell shortening and normal Ca2+ transient, and (3) late I-Ca,I-L reduction prevents/suppresses ventricular tachycardia/fibrillation in ex vivo rabbit and rat hearts subjected to hypokalemia and/or oxidative stress. These results support the value of an antiarrhythmic strategy based on the selective reduction of late I-Ca,I-L to suppress EAD-mediated arrhythmias. Antiarrhythmic therapies based on this idea would modify the gating properties of Ca(V)1.2 channels rather than blocking their pore, largely preserving contractility.

Place, publisher, year, edition, pages
ROCKEFELLER UNIV PRESS , 2021. Vol. 153, no 12, article id e202012584
National Category
Physiology
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URN: urn:nbn:se:liu:diva-181016DOI: 10.1085/jgp.202012584ISI: 000715557200001PubMedID: 34698805OAI: oai:DiVA.org:liu-181016DiVA, id: diva2:1612162
Note

Funding Agencies|National Institutes of Health/National Heart, Lung, and Blood InstituteUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Heart Lung & Blood Institute (NHLBI) [1R01HL134346, P01HL078931, R01HL152296]; American Heart AssociationAmerican Heart Association [14SDG20300018, 17POST33670046]; Knut and Alice Wallenberg FoundationKnut & Alice Wallenberg Foundation; Kawata and Laubisch Endowments

Available from: 2021-11-17 Created: 2021-11-17 Last updated: 2021-11-17

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