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Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited cardiac arrhythmia disorder that is characterized by emotion- and exercise-induced polymorphic ventricular arrhythmias and may lead to sudden cardiac death (SCD). CPVT plays an important role in SCD in the young and therefore recognition and adequate treatment of the disease are of vital importance. In the past years tremendous improvements have been made in the diagnostic methods and treatment of the disease. In this review, we summarize the clinical characteristics, genetics, and diagnostic and therapeutic strategies of CPVT and describe the most recent advances and some of the current challenges. (Circ J 2016; 80: 1285-1291).
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Affiliation(s)
- Krystien V Lieve
- Heart Centre, Department of Clinical and Experimental Cardiology, Academic Medical Centre
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102
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Willis BC, Pandit SV, Ponce-Balbuena D, Zarzoso M, Guerrero-Serna G, Limbu B, Deo M, Camors E, Ramirez RJ, Mironov S, Herron TJ, Valdivia HH, Jalife J. Constitutive Intracellular Na+ Excess in Purkinje Cells Promotes Arrhythmogenesis at Lower Levels of Stress Than Ventricular Myocytes From Mice With Catecholaminergic Polymorphic Ventricular Tachycardia. Circulation 2016; 133:2348-59. [PMID: 27169737 PMCID: PMC4902321 DOI: 10.1161/circulationaha.116.021936] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 05/03/2016] [Indexed: 11/18/2022]
Abstract
Supplemental Digital Content is available in the text. Background— In catecholaminergic polymorphic ventricular tachycardia (CPVT), cardiac Purkinje cells (PCs) appear more susceptible to Ca2+ dysfunction than ventricular myocytes (VMs). The underlying mechanisms remain unknown. Using a CPVT mouse (RyR2R4496C+/Cx40eGFP), we tested whether PC intracellular Ca2+ ([Ca2+]i) dysregulation results from a constitutive [Na+]i surplus relative to VMs. Methods and Results— Simultaneous optical mapping of voltage and [Ca2+]i in CPVT hearts showed that spontaneous Ca2+ release preceded pacing-induced triggered activity at subendocardial PCs. On simultaneous current-clamp and Ca2+ imaging, early and delayed afterdepolarizations trailed spontaneous Ca2+ release and were more frequent in CPVT PCs than CPVT VMs. As a result of increased activity of mutant ryanodine receptor type 2 channels, sarcoplasmic reticulum Ca2+ load, measured by caffeine-induced Ca2+ transients, was lower in CPVT VMs and PCs than respective controls, and sarcoplasmic reticulum fractional release was greater in both CPVT PCs and VMs than respective controls. [Na+]i was higher in both control and CPVT PCs than VMs, whereas the density of the Na+/Ca2+ exchanger current was not different between PCs and VMs. Computer simulations using a PC model predicted that the elevated [Na+]i of PCs promoted delayed afterdepolarizations, which were always preceded by spontaneous Ca2+ release events from hyperactive ryanodine receptor type 2 channels. Increasing [Na+]i monotonically increased delayed afterdepolarization frequency. Confocal imaging experiments showed that postpacing Ca2+ spark frequency was highest in intact CPVT PCs, but such differences were reversed on saponin-induced membrane permeabilization, indicating that differences in [Na+]i played a central role. Conclusions— In CPVT mice, the constitutive [Na+]i excess of PCs promotes triggered activity and arrhythmogenesis at lower levels of stress than VMs.
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Affiliation(s)
- B Cicero Willis
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Sandeep V Pandit
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Daniela Ponce-Balbuena
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Manuel Zarzoso
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Guadalupe Guerrero-Serna
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Bijay Limbu
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Makarand Deo
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Emmanuel Camors
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Rafael J Ramirez
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Sergey Mironov
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Todd J Herron
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - Héctor H Valdivia
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.)
| | - José Jalife
- From University of Michigan, Ann Arbor (B.C.W., S.V.P., D.P.-B., M.Z., G.G.-S., R.J.R., S.M., T.J.H., H.H.V., J.J.); Norfolk State University, VA (B.L., M.D.); University of Tennessee Health Science Center, Memphis (E.C.); and Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.).
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103
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Gray B, Bagnall RD, Lam L, Ingles J, Turner C, Haan E, Davis A, Yang PC, Clancy CE, Sy RW, Semsarian C. A novel heterozygous mutation in cardiac calsequestrin causes autosomal dominant catecholaminergic polymorphic ventricular tachycardia. Heart Rhythm 2016; 13:1652-60. [PMID: 27157848 DOI: 10.1016/j.hrthm.2016.05.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a lethal inherited arrhythmia syndrome characterized by adrenergically stimulated ventricular tachycardia. Mutations in the cardiac ryanodine receptor gene (RYR2) cause an autosomal dominant form of CPVT, while mutations in the cardiac calsequestrin 2 gene (CASQ2) cause an autosomal recessive form. OBJECTIVE The aim of this study was to clinically and genetically evaluate a large family with severe autosomal dominant CPVT. METHODS Clinical evaluation of family members was performed, including detailed history, physical examination, electrocardiogram, exercise stress test, and autopsy review of decedents. We performed genome-wide linkage analysis in 12 family members and exome sequencing in 2 affected family members. In silico models of mouse and rabbit myocyte electrophysiology were used to predict potential disease mechanisms. RESULTS Severe CPVT with dominant inheritance in 6 members was diagnosed in a large family with 2 sudden deaths, 2 resuscitated cardiac arrests, and multiple appropriate implantable cardioverter-defibrillator shocks. A comprehensive analysis of cardiac arrhythmia genes did not reveal a pathogenic variant. Exome sequencing identified a novel heterozygous missense variant in CASQ2 (Lys180Arg) affecting a highly conserved residue, which cosegregated with disease and was absent in unaffected family members. Genome-wide linkage analysis confirmed a single linkage peak at the CASQ2 locus (logarithm of odds ratio score 3.01; θ = 0). Computer simulations predicted that haploinsufficiency was unlikely to cause the severe CPVT phenotype and suggested a dominant negative mechanism. CONCLUSION We show for the first time that a variant in CASQ2 causes autosomal dominant CPVT. Genetic testing in dominant CPVT should include screening for heterozygous CASQ2 variants.
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Affiliation(s)
- Belinda Gray
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, New South Wales, Australia
| | - Richard D Bagnall
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, New South Wales, Australia
| | - Lien Lam
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, New South Wales, Australia
| | - Jodie Ingles
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, New South Wales, Australia
| | - Christian Turner
- Department of Cardiology, Westmead Children's Hospital, Sydney, New South Wales, Australia
| | - Eric Haan
- Adult Genetics Unit, South Australian Clinical Genetics Service, SA Pathology and School of Medicine, University of Adelaide, Adelaide, New South Wales, Australia
| | - Andrew Davis
- Department of Cardiology, The Royal Children's Hospital Melbourne, Melbourne, New South Wales, Victoria, Australia
| | - Pei-Chi Yang
- Department of Pharmacology, University of California, Davis, California, USA
| | - Colleen E Clancy
- Department of Pharmacology, University of California, Davis, California, USA
| | - Raymond W Sy
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Christopher Semsarian
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, New South Wales, Australia.
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104
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Yuchi Z, Van Petegem F. Ryanodine receptors under the magnifying lens: Insights and limitations of cryo-electron microscopy and X-ray crystallography studies. Cell Calcium 2016; 59:209-27. [DOI: 10.1016/j.ceca.2016.04.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/08/2016] [Accepted: 04/09/2016] [Indexed: 10/21/2022]
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105
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Bagur R, Tanguy S, Foriel S, Grichine A, Sanchez C, Pernet-Gallay K, Kaambre T, Kuznetsov AV, Usson Y, Boucher F, Guzun R. The impact of cardiac ischemia/reperfusion on the mitochondria-cytoskeleton interactions. Biochim Biophys Acta Mol Basis Dis 2016; 1862:1159-71. [PMID: 26976332 DOI: 10.1016/j.bbadis.2016.03.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 02/18/2016] [Accepted: 03/10/2016] [Indexed: 12/15/2022]
Abstract
Cardiac ischemia-reperfusion (IR) injury compromises mitochondrial oxidative phosphorylation (OxPhos) and compartmentalized intracellular energy transfer via the phosphocreatine/creatine kinase (CK) network. The restriction of ATP/ADP diffusion at the level of the mitochondrial outer membrane (MOM) is an essential element of compartmentalized energy transfer. In adult cardiomyocytes, the MOM permeability to ADP is regulated by the interaction of voltage-dependent anion channel with cytoskeletal proteins, particularly with β tubulin II. The IR-injury alters the expression and the intracellular arrangement of cytoskeletal proteins. The objective of the present study was to investigate the impact of IR on the intracellular arrangement of β tubulin II and its effect on the regulation of mitochondrial respiration. Perfused rat hearts were subjected to total ischemia (for 20min (I20) and 45min (I45)) or to ischemia followed by 30min of reperfusion (I20R and I45R groups). High resolution respirometry and fluorescent confocal microscopy were used to study respiration, β tubulin II and mitochondrial arrangements in cardiac fibers. The results of these experiments evidence a heterogeneous response of mitochondria to IR-induced damage. Moreover, the intracellular rearrangement of β tubulin II, which in the control group colocalized with mitochondria, was associated with increased apparent affinity of OxPhos for ADP, decreased regulation of respiration by creatine without altering mitochondrial CK activity and the ratio between octameric to dimeric isoenzymes. The results of this study allow us to highlight changes of mitochondrial interactions with cytoskeleton as one of the possible mechanisms underlying cardiac IR injury.
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Affiliation(s)
- Rafaela Bagur
- University Grenoble Alpes, Laboratory of Fundamental and Applied Bioenergetics, INSERM U1055, Grenoble, France; University Grenoble Alpes, TIMC-IMAG, CNRS, UMR5525, Grenoble, France
| | - Stéphane Tanguy
- University Grenoble Alpes, TIMC-IMAG, CNRS, UMR5525, Grenoble, France
| | - Sarah Foriel
- University Grenoble Alpes, Laboratory of Fundamental and Applied Bioenergetics, INSERM U1055, Grenoble, France
| | - Alexei Grichine
- University Grenoble Alpes, Life Science Imaging - In Vitro Platform, IAB, INSERM CRI U823, Grenoble, France
| | - Caroline Sanchez
- University Grenoble Alpes, TIMC-IMAG, CNRS, UMR5525, Grenoble, France
| | - Karin Pernet-Gallay
- INSERM, U836, F-38000, Grenoble, France; University Grenoble Alpes, GIN, F-38000 Grenoble, France
| | - Tuuli Kaambre
- National Institute of Chemical Physics and Biophysics, Laboratory of Bioenergetics, Tallinn, Estonia
| | - Andrey V Kuznetsov
- Innsbruck Medical University, Cardiac Surgery Research Laboratory, Innsbruck A-6020, Austria
| | - Yves Usson
- University Grenoble Alpes, TIMC-IMAG, CNRS, UMR5525, Grenoble, France
| | - François Boucher
- University Grenoble Alpes, TIMC-IMAG, CNRS, UMR5525, Grenoble, France
| | - Rita Guzun
- University Grenoble Alpes, Laboratory of Fundamental and Applied Bioenergetics, INSERM U1055, Grenoble, France; Hospital of the University Grenoble Alpes, Department Thorax (EFCR), France.
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106
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WALSH MARKA, STUART ALANG, SCHLECHT HELENEB, JAMES ANDREWF, HANCOX JULESC, NEWBURY-ECOB RUTHA. Compound Heterozygous Triadin Mutation Causing Cardiac Arrest in Two Siblings. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:497-501. [DOI: 10.1111/pace.12813] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 12/11/2015] [Accepted: 12/22/2015] [Indexed: 12/01/2022]
Affiliation(s)
- MARK A. WALSH
- Bristol Royal Hospital for Children; Bristol UK
- Bristol Heart Institute; Bristol UK
| | - ALAN G. STUART
- Bristol Royal Hospital for Children; Bristol UK
- Bristol Heart Institute; Bristol UK
| | - HELENE B. SCHLECHT
- Genomic Diagnostics laboratory; Manchester Centre for Genomic Medicine; Manchester UK
| | - ANDREW F. JAMES
- School of Physiology and Pharmacology, Cardiovascular Research Laboratories; University of Bristol; Bristol UK
| | - JULES C. HANCOX
- School of Physiology and Pharmacology, Cardiovascular Research Laboratories; University of Bristol; Bristol UK
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107
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Abstract
OPINION STATEMENT Ion channelopathies are a frequent cause of sudden cardiac death (SCD) in patients with structurally normal hearts. These are generally Mendelian inherited electrical disorders with variable penetrance and expressivity. The ability to predict the development of life threatening arrhythmias in these patients is challenging. This chapter will present an update on the genetics, the role of genetic testing, and management of the inherited cardiac channelopathies with a focus on the relatively more common syndromes associated with an increased risk of SCD.
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Affiliation(s)
- Gordon F Tomaselli
- Division of Cardiology, Johns Hopkins University, 720 N. Rutland Ave. Ross 844, Baltimore, MD, 21205, USA.
- Department of Medicine, Johns Hopkins University, 720 N. Rutland Ave. Ross 844, Baltimore, MD, 21205, USA.
| | - Andreas S Barth
- Division of Cardiology, Johns Hopkins University, 720 N. Rutland Ave. Ross 844, Baltimore, MD, 21205, USA
- Department of Medicine, Johns Hopkins University, 720 N. Rutland Ave. Ross 844, Baltimore, MD, 21205, USA
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108
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Ríos E, Figueroa L, Manno C, Kraeva N, Riazi S. The couplonopathies: A comparative approach to a class of diseases of skeletal and cardiac muscle. ACTA ACUST UNITED AC 2016; 145:459-74. [PMID: 26009541 PMCID: PMC4442791 DOI: 10.1085/jgp.201411321] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A novel category of diseases of striated muscle is proposed, the couplonopathies, as those that affect components of the couplon and thereby alter its operation. Couplons are the functional units of intracellular calcium release in excitation–contraction coupling. They comprise dihydropyridine receptors, ryanodine receptors (Ca2+ release channels), and a growing list of ancillary proteins whose alteration may lead to disease. Within a generally similar plan, the couplons of skeletal and cardiac muscle show, in a few places, marked structural divergence associated with critical differences in the mechanisms whereby they fulfill their signaling role. Most important among these are the presence of a mechanical or allosteric communication between voltage sensors and Ca2+ release channels, exclusive to the skeletal couplon, and the smaller capacity of the Ca stores in cardiac muscle, which results in greater swings of store concentration during physiological function. Consideration of these structural and functional differences affords insights into the pathogenesis of several couplonopathies. The exclusive mechanical connection of the skeletal couplon explains differences in pathogenesis between malignant hyperthermia (MH) and catecholaminergic polymorphic ventricular tachycardia (CPVT), conditions most commonly caused by mutations in homologous regions of the skeletal and cardiac Ca2+ release channels. Based on mechanistic considerations applicable to both couplons, we identify the plasmalemma as a site of secondary modifications, typically an increase in store-operated calcium entry, that are relevant in MH pathogenesis. Similar considerations help explain the different consequences that mutations in triadin and calsequestrin have in these two tissues. As more information is gathered on the composition of cardiac and skeletal couplons, this comparative and mechanistic approach to couplonopathies should be useful to understand pathogenesis, clarify diagnosis, and propose tissue-specific drug development.
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Affiliation(s)
- Eduardo Ríos
- Section of Cellular Signaling, Department of Molecular Biophysics and Physiology, Rush University, Chicago, IL 60612
| | - Lourdes Figueroa
- Section of Cellular Signaling, Department of Molecular Biophysics and Physiology, Rush University, Chicago, IL 60612
| | - Carlo Manno
- Section of Cellular Signaling, Department of Molecular Biophysics and Physiology, Rush University, Chicago, IL 60612
| | - Natalia Kraeva
- Malignant Hyperthermia Investigation Unit, University Health Network, Toronto General Hospital, Toronto, Ontario M5G 2C4, Canada
| | - Sheila Riazi
- Malignant Hyperthermia Investigation Unit, University Health Network, Toronto General Hospital, Toronto, Ontario M5G 2C4, Canada
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109
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Imberti JF, Underwood K, Mazzanti A, Priori SG. Clinical Challenges in Catecholaminergic Polymorphic Ventricular Tachycardia. Heart Lung Circ 2016; 25:777-83. [PMID: 26948768 DOI: 10.1016/j.hlc.2016.01.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inheritable cardiac disorder associated with exercise- and stress-induced sudden death in young individuals. Although important steps forward have been made in the comprehension and treatment of this disease, several aspects remain unclear. Firstly, from an epidemiological standpoint the actual prevalence of CPVT is still unknown and possibly underestimated. In addition, the diagnostic process remains very challenging and can be supported by genetic analysis in only about half of the cases. Finally, up to one third of CPVT patients continue to present complex arrhythmias despite beta blocker treatment; the role of newer therapeutic options, such as flecainide and left cardiac sympathetic denervation, needs to be further elucidated. All these points constitute challenges for the cardiologist in the management of CPVT patients and fuel research into new diagnostic, prognostic and therapeutic approaches.
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Affiliation(s)
- Jacopo F Imberti
- Molecular Cardiology, IRCCS Salvatore Maugeri Foundation, Pavia, Italy
| | | | - Andrea Mazzanti
- Molecular Cardiology, IRCCS Salvatore Maugeri Foundation, Pavia, Italy
| | - Silvia G Priori
- Molecular Cardiology, IRCCS Salvatore Maugeri Foundation, Pavia, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy.
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111
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The role of genetic testing in unexplained sudden death. Transl Res 2016; 168:59-73. [PMID: 26143861 DOI: 10.1016/j.trsl.2015.06.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 06/08/2015] [Accepted: 06/11/2015] [Indexed: 12/19/2022]
Abstract
Most sudden deaths are because of a cardiac etiology and are termed sudden cardiac death (SCD). In younger individuals coronary artery disease is less prevalent and cardiac genetic disorders are more common. If sudden death is unexplained despite an appropriate autopsy and toxicologic assessment the term sudden arrhythmic death syndrome (SADS) may be used. This is an umbrella term and common underlying etiologies are primary arrhythmia syndromes with a familial basis such as Brugada syndrome, long QT syndrome, and subtle forms of cardiomyopathy. The first clinical presentation of these conditions is often SCD, which makes identification, screening, and risk stratification crucial to avert further deaths. This review will focus on genetic testing in the context of family screening. It will address the role of the "molecular autopsy" alongside current postmortem practices in the evaluation of SADS deaths. We describe the current data underlying genetic testing in these conditions, explore the potential for next-generation sequencing, and discuss the inherent diagnostic problems in determination of pathogenicity.
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112
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Functional Impact of Ryanodine Receptor Oxidation on Intracellular Calcium Regulation in the Heart. Rev Physiol Biochem Pharmacol 2016; 171:39-62. [PMID: 27251471 DOI: 10.1007/112_2016_2] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Type 2 ryanodine receptor (RyR2) serves as the major intracellular Ca2+ release channel that drives heart contraction. RyR2 is activated by cytosolic Ca2+ via the process of Ca2+-induced Ca2+ release (CICR). To ensure stability of Ca2+ dynamics, the self-reinforcing CICR must be tightly controlled. Defects in this control cause sarcoplasmic reticulum (SR) Ca2+ mishandling, which manifests in a variety of cardiac pathologies that include myocardial infarction and heart failure. These pathologies are also associated with oxidative stress. Given that RyR2 contains a large number of cysteine residues, it is no surprise that RyR2 plays a key role in the cellular response to oxidative stress. RyR's many cysteine residues pose an experimental limitation in defining a specific target or mechanism of action for oxidative stress. As a result, the current understanding of redox-mediated RyR2 dysfunction remains incomplete. Several oxidative modifications, including S-glutathionylation and S-nitrosylation, have been suggested playing an important role in the regulation of RyR2 activity. Moreover, oxidative stress can increase RyR2 activity by forming disulfide bonds between two neighboring subunits (intersubunit cross-linking). Since intersubunit interactions within the RyR2 homotetramer complex dictate the channel gating, such posttranslational modification of RyR2 would have a significant impact on RyR2 function and Ca2+ regulation. This review summarizes recent findings on oxidative modifications of RyR2 and discusses contributions of these RyR2 modifications to SR Ca2+ mishandling during cardiac pathologies.
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113
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Sumitomo N. Current topics in catecholaminergic polymorphic ventricular tachycardia. J Arrhythm 2015; 32:344-351. [PMID: 27761157 PMCID: PMC5063269 DOI: 10.1016/j.joa.2015.09.008] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 09/02/2015] [Accepted: 09/07/2015] [Indexed: 10/25/2022] Open
Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is induced by emotions or exercise in patients without organic heart disease and may be polymorphic or bidirectional in nature. The prognosis of CPVT is not good, and therefore prevention of sudden death is of utmost importance. Genetic variants of CPVT include RyR2, CASQ2, CALM2, TRD, and possibly KCNJ2 and ANK2 gene mutations. Hypotheses that suggest the causes of CPVT include weakened binding of FKBP12.6 and RyR2, a store overload-induced Ca2+ release (SOICR), unzipping of intramolecular domain interactions in RyR2, and molecular and functional abnormalities caused by mutations in the CASQ2 gene. The incidence of an RyR2 anomaly in CPVTs is about 35-79%, whereas anomalies in the CASQ2 gene account for 3-5% CPVTs. The ping-pong theory, suggesting that reciprocating delayed after depolarization induces bigeminy of the right and left bundle branches, may explain the pathogenesis of bidirectional ventricular tachycardia. Flecainide, carvedilol, left sympathetic nerve denervation, and catheter ablation of the PVC may serve as new therapeutic strategies for CPVT while gene-therapy may be applied to some types of CPVT in the future. Although, not all sudden cardiac deaths in CPVT patients are currently preventable, new medical and interventional therapies may improve CPVT prognosis.
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Affiliation(s)
- Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-City, Saitama 350-1298, Japan
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Ehler E. Cardiac cytoarchitecture - why the "hardware" is important for heart function! BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2015; 1863:1857-63. [PMID: 26577135 PMCID: PMC5104690 DOI: 10.1016/j.bbamcr.2015.11.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/05/2015] [Accepted: 11/09/2015] [Indexed: 01/05/2023]
Abstract
Cells that constitute fully differentiated tissues are characterised by an architecture that makes them perfectly suited for the job they have to do. This is especially obvious for cardiomyocytes, which have an extremely regular shape and display a paracrystalline arrangement of their cytoplasmic components. This article will focus on the two major cytoskeletal multiprotein complexes that are found in cardiomyocytes, the myofibrils, which are responsible for contraction and the intercalated disc, which mediates mechanical and electrochemical contact between individual cardiomyocytes. Recent studies have revealed that these two sites are also crucial in sensing excessive mechanical strain. Signalling processes will be triggered that## lead to changes in gene expression and eventually lead to an altered cardiac cytoarchitecture in the diseased heart, which results in a compromised function. Thus, understanding these changes and the signals that lead to them is crucial to design treatment strategies that can attenuate these processes. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.
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Affiliation(s)
- Elisabeth Ehler
- BHF Centre of Research Excellence at King's College London, Cardiovascular Division and Randall Division of Cell and Molecular Biophysics, London, UK.
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115
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Campuzano O, Sarquella-Brugada G, Brugada R, Brugada J. Genetics of channelopathies associated with sudden cardiac death. Glob Cardiol Sci Pract 2015; 2015:39. [PMID: 26566530 PMCID: PMC4625210 DOI: 10.5339/gcsp.2015.39] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/30/2015] [Indexed: 12/19/2022] Open
Abstract
Recent technological advances in cardiology have resulted in new guidelines for the diagnosis, treatment and prevention of diseases. Despite these improvements, sudden death remains one of the main challenges to clinicians because the majority of diseases associated with sudden cardiac death are characterized by incomplete penetrance and variable expressivity. Hence, patients may be unaware of their illness, and physical activity can be the trigger for syncope as first symptom of the disease. Most common causes of sudden cardiac death are congenital alterations and structural heart diseases, although a significant number remain unexplained after comprehensive autopsy. In these unresolved cases, channelopathies are considered the first potential cause of death. Since all these diseases are of genetic origin, family members could be at risk, despite being asymptomatic. Genetics has also benefited from technological advances, and genetic testing has been incorporated into the sudden death field, identifying the cause in clinically affected patients, asymptomatic family members and post-mortem cases without conclusive diagnosis. This review focuses on recent advances in the genetics of channelopathies associated with sudden cardiac death.
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Affiliation(s)
- Oscar Campuzano
- Cardiovascular Genetics Center, University of Girona - IDIBGI, Spain ; Department of Medical Sciences, School of Medicine, University of Girona, Spain
| | | | - Ramon Brugada
- Cardiovascular Genetics Center, University of Girona - IDIBGI, Spain ; Department of Medical Sciences, School of Medicine, University of Girona, Spain
| | - Josep Brugada
- Unit of Arrhythmias, Hospital Sant Joan de Deu, University of Barcelona, Spain ; Unit of Arrhythmias, Hospital Clinic de Barcelona, University of Barcelona, Spain
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Bailey C, Blair E, Garratt C, Newman WG. Effective cascade screening through identification of a mutation in RYR2 in a large family with a history of sudden death. J Cardiol Cases 2015; 13:9-13. [PMID: 30546600 DOI: 10.1016/j.jccase.2015.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 08/13/2015] [Accepted: 08/26/2015] [Indexed: 11/16/2022] Open
Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited arrhythmogenic disorder which usually presents in the first or second decade of life with syncope, which is typically induced by emotional stress or exercise. We describe a large family with a history of three sudden unexpected deaths. Investigations in the sibling of a deceased individual affected by emotion-induced syncope revealed ventricular bigeminy. Molecular genetic testing was performed on one symptomatic individual and a missense mutation in RYR2 was identified consistent with a diagnosis of CPVT. Subsequent cascade testing of family members excluded 37 of 43 individuals from risk and facilitated preventative intervention. This case highlights the value of genotyping in sudden cardiac death by defining the precise diagnosis and through the identification and exclusion of at-risk individuals. <Learning objective: The diagnosis of CPVT should be considered in families with a history of sudden death in a previously asymptomatic young person. Cascade molecular genetic testing should be undertaken as, if a pathogenic mutation is found, this can distinguish it from other arrhythmogenic disorders and can identify at-risk individuals allowing treatment to be targeted at those in need, thus helping to reduce the mortality associated with the condition.>.
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Affiliation(s)
- Claire Bailey
- Manchester Centre for Genomic Medicine, University of Manchester, Manchester, UK.,Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Edward Blair
- Department of Clinical Genetics, Churchill Hospital, Old Road, Headington, Oxford, UK
| | - Clifford Garratt
- Manchester Heart Centre, Central Manchester University Hospitals NHS Foundation Trust, & Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK
| | - William G Newman
- Manchester Centre for Genomic Medicine, University of Manchester, Manchester, UK.,Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
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117
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Spears DA, Gollob MH. Genetics of inherited primary arrhythmia disorders. APPLICATION OF CLINICAL GENETICS 2015; 8:215-33. [PMID: 26425105 PMCID: PMC4583121 DOI: 10.2147/tacg.s55762] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A sudden unexplained death is felt to be due to a primary arrhythmic disorder when no structural heart disease is found on autopsy, and there is no preceding documentation of heart disease. In these cases, death is presumed to be secondary to a lethal and potentially heritable abnormality of cardiac ion channel function. These channelopathies include congenital long QT syndrome, catecholaminergic polymorphic ventricular tachycardia, Brugada syndrome, and short QT syndrome. In certain cases, genetic testing may have an important role in supporting a diagnosis of a primary arrhythmia disorder, and can also provide prognostic information, but by far the greatest strength of genetic testing lies in the screening of family members, who may be at risk. The purpose of this review is to describe the basic genetic and molecular pathophysiology of the primary inherited arrhythmia disorders, and to outline a rational approach to genetic testing, management, and family screening.
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Affiliation(s)
- Danna A Spears
- Division of Cardiology - Electrophysiology, University Health Network, Toronto General Hospital, Toronto, ON, Canada
| | - Michael H Gollob
- Division of Cardiology - Electrophysiology, University Health Network, Toronto General Hospital, Toronto, ON, Canada
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118
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Organization of junctional sarcoplasmic reticulum proteins in skeletal muscle fibers. J Muscle Res Cell Motil 2015; 36:501-15. [DOI: 10.1007/s10974-015-9421-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/08/2015] [Indexed: 01/24/2023]
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119
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ROORYCK CAROLINE, KYNDT FLORENCE, BOZON DOMINIQUE, ROUX-BUISSON NATHALIE, SACHER FREDERIC, PROBST VINCENT, THAMBO JEANBENOIT. New Family With Catecholaminergic Polymorphic Ventricular Tachycardia Linked to the Triadin Gene. J Cardiovasc Electrophysiol 2015. [DOI: 10.1111/jce.12763] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- CAROLINE ROORYCK
- Univ. Bordeaux; Maladies Rares: Génétique et Métabolisme (MRGM); Bordeaux France
- LIRYC, L'Institut de rythmologie et modélisation cardiaque; Université de Bordeaux INSERM; France
- Service des cardiopathies congénitales; Hôpital Cardiologique du Haut-Lévêque; CHU Bordeaux; Bordeaux France
| | - FLORENCE KYNDT
- Institut du thorax, Clinique Cardiologique Inserm; CHU de Nantes; France
| | - DOMINIQUE BOZON
- Laboratoire de Cardiogénétique Moléculaire, Centre de Biologie et Pathologie Est; Hospices Civils de Lyon; France
| | - NATHALIE ROUX-BUISSON
- INSERM U836, Grenoble Institut des Neurosciences; Equipe Muscle et Pathologies; Grenoble France
| | - FREDERIC SACHER
- LIRYC, L'Institut de rythmologie et modélisation cardiaque; Université de Bordeaux INSERM; France
| | - VINCENT PROBST
- Institut du thorax, Clinique Cardiologique Inserm; CHU de Nantes; France
| | - JEAN-BENOIT THAMBO
- LIRYC, L'Institut de rythmologie et modélisation cardiaque; Université de Bordeaux INSERM; France
- Service des cardiopathies congénitales; Hôpital Cardiologique du Haut-Lévêque; CHU Bordeaux; Bordeaux France
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120
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Søndergaard MT, Tian X, Liu Y, Wang R, Chazin WJ, Chen SRW, Overgaard MT. Arrhythmogenic Calmodulin Mutations Affect the Activation and Termination of Cardiac Ryanodine Receptor-mediated Ca2+ Release. J Biol Chem 2015; 290:26151-62. [PMID: 26309258 DOI: 10.1074/jbc.m115.676627] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Indexed: 11/06/2022] Open
Abstract
The intracellular Ca(2+) sensor calmodulin (CaM) regulates the cardiac Ca(2+) release channel/ryanodine receptor 2 (RyR2), and mutations in CaM cause arrhythmias such as catecholaminergic polymorphic ventricular tachycardia (CPVT) and long QT syndrome. Here, we investigated the effect of CaM mutations causing CPVT (N53I), long QT syndrome (D95V and D129G), or both (CaM N97S) on RyR2-mediated Ca(2+) release. All mutations increased Ca(2+) release and rendered RyR2 more susceptible to store overload-induced Ca(2+) release (SOICR) by lowering the threshold of store Ca(2+) content at which SOICR occurred and the threshold at which SOICR terminated. To obtain mechanistic insights, we investigated the Ca(2+) binding of the N- and C-terminal domains (N- and C-domain) of CaM in the presence of a peptide corresponding to the CaM-binding domain of RyR2. The N53I mutation decreased the affinity of Ca(2+) binding to the N-domain of CaM, relative to CaM WT, but did not affect the C-domain. Conversely, mutations N97S, D95V, and D129G had little or no effect on Ca(2+) binding to the N-domain but markedly decreased the affinity of the C-domain for Ca(2+). These results suggest that mutations D95V, N97S, and D129G alter the interaction between CaM and the CaMBD and thus RyR2 regulation. Because the N53I mutation minimally affected Ca(2+) binding to the C-domain, it must cause aberrant regulation via a different mechanism. These results support aberrant RyR2 regulation as the disease mechanism for CPVT associated with CaM mutations and shows that CaM mutations not associated with CPVT can also affect RyR2. A model for the CaM-RyR2 interaction, where the Ca(2+)-saturated C-domain is constitutively bound to RyR2 and the N-domain senses increases in Ca(2+) concentration, is proposed.
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Affiliation(s)
- Mads T Søndergaard
- From the Department of Chemistry and Bioscience, Aalborg University, 9220 Aalborg, Denmark, the Libin Cardiovascular Institute of Alberta, Department of Physiology and Pharmacology and Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta T2N 1N4, Canada, and
| | - Xixi Tian
- the Libin Cardiovascular Institute of Alberta, Department of Physiology and Pharmacology and Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta T2N 1N4, Canada, and
| | - Yingjie Liu
- the Libin Cardiovascular Institute of Alberta, Department of Physiology and Pharmacology and Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta T2N 1N4, Canada, and
| | - Ruiwu Wang
- the Libin Cardiovascular Institute of Alberta, Department of Physiology and Pharmacology and Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta T2N 1N4, Canada, and
| | - Walter J Chazin
- the Departments of Biochemistry and Chemistry, Center for Structural Biology, Vanderbilt University, Nashville, Tennessee 37235
| | - S R Wayne Chen
- the Libin Cardiovascular Institute of Alberta, Department of Physiology and Pharmacology and Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta T2N 1N4, Canada, and
| | - Michael T Overgaard
- From the Department of Chemistry and Bioscience, Aalborg University, 9220 Aalborg, Denmark,
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121
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Abstract
Sudden cardiac death occurs in a broad spectrum of cardiac pathologies and is an important cause of mortality in the general population. Genetic studies conducted during the past 20 years have markedly illuminated the genetic basis of the inherited cardiac disorders associated with sudden cardiac death. Here, we review the genetic basis of sudden cardiac death with a focus on the current knowledge on the genetics of the primary electric disorders caused primarily by mutations in genes encoding ion channels, and the cardiomyopathies, which have been attributed to mutations in genes encoding a broader category of proteins, including those of the sarcomere, the cytoskeleton, and desmosomes. We discuss the challenges currently faced in unraveling genetic factors that predispose to sudden cardiac death in the setting of sequela of coronary artery disease and present the genome-wide association studies conducted in recent years on electrocardiographic parameters, highlighting their potential in uncovering new biological insights into cardiac electric function.
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Affiliation(s)
- Connie R Bezzina
- From the Department of Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands (C.R.B., N.L.); Molecular Cardiology, Fondazione Salvatore Maugeri, Pavia, Italy (S.G.P.); and Department of Molecular Medicine, University of Pavia, Pavia Italy (S.G.P.)
| | - Najim Lahrouchi
- From the Department of Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands (C.R.B., N.L.); Molecular Cardiology, Fondazione Salvatore Maugeri, Pavia, Italy (S.G.P.); and Department of Molecular Medicine, University of Pavia, Pavia Italy (S.G.P.)
| | - Silvia G Priori
- From the Department of Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands (C.R.B., N.L.); Molecular Cardiology, Fondazione Salvatore Maugeri, Pavia, Italy (S.G.P.); and Department of Molecular Medicine, University of Pavia, Pavia Italy (S.G.P.).
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122
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Abstract
Despite improvements in the therapy of underlying heart disease, sudden cardiac death is a major cause of death worldwide. Disturbed Na and Ca handling is known to be a major predisposing factor for life-threatening tachyarrhythmias. In cardiomyocytes, many ion channels and transporters, including voltage-gated Na and Ca channels, cardiac ryanodine receptors, Na/Ca-exchanger, and SR Ca-ATPase are involved in this regulation. We have learned a lot about the pathophysiological relevance of disturbed ion channel function from monogenetic disorders. Changes in the gating of a single ion channel and the activity of an ion pump suffice to dramatically increase the propensity for arrhythmias even in structurally normal hearts. Nevertheless, patients with heart failure with acquired dysfunction in many ion channels and transporters exhibit profound dysregulation of Na and Ca handling and Ca/calmodulin-dependent protein kinase and are especially prone to arrhythmias. A deeper understanding of the underlying arrhythmic principles is mandatory if we are to improve their outcome. This review addresses basic tachyarrhythmic mechanisms, the underlying ionic mechanisms and the consequences for ion homeostasis, and the situation in complex diseases like heart failure.
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Affiliation(s)
- Stefan Wagner
- From the Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany (S.W., L.S.M.); and Department of Pharmacology, University of California, Davis, CA (D.M.B.)
| | - Lars S Maier
- From the Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany (S.W., L.S.M.); and Department of Pharmacology, University of California, Davis, CA (D.M.B.).
| | - Donald M Bers
- From the Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany (S.W., L.S.M.); and Department of Pharmacology, University of California, Davis, CA (D.M.B.)
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123
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Sitsapesan R. A new look at structures and mechanisms regulating endoplasmic/sarcoplasmic reticulum Ca(2+) release in health and disease. J Physiol 2015; 593:3239-40. [PMID: 26228552 DOI: 10.1113/jphysiol.2014.281907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 09/03/2014] [Accepted: 10/05/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
- Rebecca Sitsapesan
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, OX1 3QT, UK
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124
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Liu Z, Liu X, Yu H, Pei J, Zhang Y, Gong J, Pu J. Common Variants in TRDN and CALM1 Are Associated with Risk of Sudden Cardiac Death in Chronic Heart Failure Patients in Chinese Han Population. PLoS One 2015. [PMID: 26196381 PMCID: PMC4510877 DOI: 10.1371/journal.pone.0132459] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Recent studies suggest that variants in two calcium handling genes (RyR2 and CASQ2) associated with sudden cardiac death (SCD) and non-sudden cardiac death (NSCD) in subjects with heart failure and coronary artery disease, respectively. The purpose of this study was to identify other calcium handling genes associated with SCD in the long-term of chronic heart failure (CHF) in Chinese Han population. Methods and Results We investigated 20 SNPs representing 10 genes that regulated calcium handling in 1429 patients with CHF, and the genetic association with SCD and all-cause death was analysed. During a median follow-up period of 63 months, 538 patients (37.65%) died from CHF, of whom 185 (34.38%) had SCD and the others were NSCD. SNPs that pass a P value cut-off of 0.0025 were considered as significant. We found that patients carrying the CC genotype of rs3814843 on CALM1 gene had greater risks of SCD (HR 5.542, 95% CI 2.054–14.948, P = .001) and all cause death (HR 3.484, 95% CI 1.651–7.350, P = .001). After adjusting for other risk factors, significant associations remained. Moreover, patients carrying G allele of rs361508 on TRDN gene also had increased risk of SCD. Conclusions Common variants in TRDN and CALM1 are associated with increased risk of SCD in patients with CHF. These findings provide further evidence for association of variants in calcium handling regulating proteins and SCD in chronic heart failure.
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Affiliation(s)
- Zhouying Liu
- State Key Laboratory of Cardiovascular Disease, Physiology and Pathophysiology Laboratory, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei-Li-Shi Road, Xi-Cheng District, Beijing, 100037, P. R. China
| | - Xiaoyan Liu
- State Key Laboratory of Cardiovascular Disease, Physiology and Pathophysiology Laboratory, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei-Li-Shi Road, Xi-Cheng District, Beijing, 100037, P. R. China
| | - Haiyun Yu
- State Key Laboratory of Cardiovascular Disease, Physiology and Pathophysiology Laboratory, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei-Li-Shi Road, Xi-Cheng District, Beijing, 100037, P. R. China
| | - Juanhui Pei
- State Key Laboratory of Cardiovascular Disease, Physiology and Pathophysiology Laboratory, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei-Li-Shi Road, Xi-Cheng District, Beijing, 100037, P. R. China
| | - Yinhui Zhang
- State Key Laboratory of Cardiovascular Disease, Physiology and Pathophysiology Laboratory, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei-Li-Shi Road, Xi-Cheng District, Beijing, 100037, P. R. China
| | - Jing Gong
- State Key Laboratory of Cardiovascular Disease, Physiology and Pathophysiology Laboratory, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei-Li-Shi Road, Xi-Cheng District, Beijing, 100037, P. R. China
| | - Jielin Pu
- State Key Laboratory of Cardiovascular Disease, Physiology and Pathophysiology Laboratory, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei-Li-Shi Road, Xi-Cheng District, Beijing, 100037, P. R. China
- * E-mail:
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Distinctive malfunctions of calmodulin mutations associated with heart RyR2-mediated arrhythmic disease. Biochim Biophys Acta Gen Subj 2015; 1850:2168-76. [PMID: 26164367 DOI: 10.1016/j.bbagen.2015.07.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/22/2015] [Accepted: 07/02/2015] [Indexed: 01/11/2023]
Abstract
Calmodulin (CaM) is a cytoplasmic calcium sensor that interacts with the cardiac ryanodine receptor (RyR2), a large Ca(2+) channel complex that mediates Ca(2+) efflux from the sarcoplasmic reticulum (SR) to activate cardiac muscle contraction. Direct CaM association with RyR2 is an important physiological regulator of cardiac muscle excitation-contraction coupling and defective CaM-RyR2 protein interaction has been reported in cases of heart failure. Recent genetic studies have identified CaM missense mutations in patients with a history of severe cardiac arrhythmogenic disorders that present divergent clinical features, including catecholaminergic polymorphic ventricular tachycardia (CPVT), long QT syndrome (LQTS) and idiopathic ventricular fibrillation (IVF). Herein, we describe how two CPVT- (N54I & N98S) and three LQTS-associated (D96V, D130G & F142L) CaM mutations result in alteration of their biochemical and biophysical properties. Ca(2+)-binding studies indicate that the CPVT-associated CaM mutations, N54I & N98S, exhibit the same or a 3-fold reduced Ca(2+)-binding affinity, respectively, versus wild-type CaM, whereas the LQTS-associated CaM mutants, D96V, D130G & F142L, display more profoundly reduced Ca(2+)-binding affinity. In contrast, all five CaM mutations confer a disparate RyR2 interaction and modulation of [(3)H]ryanodine binding to RyR2, regardless of CPVT or LQTS association. Our findings suggest that the clinical presentation of CPVT or LQTS associated with these five CaM mutations may involve both altered intrinsic Ca(2+)-binding as well as defective interaction with RyR2.
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126
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Tzimas C, Terrovitis J, Lehnart SE, Kranias EG, Sanoudou D. Calcium/calmodulin-dependent protein kinase II (CaMKII) inhibition ameliorates arrhythmias elicited by junctin ablation under stress conditions. Heart Rhythm 2015; 12:1599-610. [PMID: 25814413 PMCID: PMC4485547 DOI: 10.1016/j.hrthm.2015.03.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Indexed: 01/01/2023]
Abstract
BACKGROUND Aberrant calcium signaling is considered one of the key mechanisms contributing to arrhythmias, especially in the context of heart failure. In human heart failure, there is significant down-regulation of the sarcoplasmic reticulum (SR) protein junctin, and junctin deficiency in mice is associated with stress-induced arrhythmias. OBJECTIVE The purpose of this study was to determine whether the increased SR Ca(2+) leak and arrhythmias associated with junctin ablation may be associated with increased calcium/calmodulin-dependent protein kinase II (CaMKII) activity and phosphorylation of the cardiac ryanodine receptor (RyR2) and whether pharmacologic inhibition of CaMKII activity may prevent these arrhythmias. METHODS Using a combination of biochemical, cellular, and in vivo approaches, we tested the ability of KN-93 to reverse aberrant CaMKII phosphorylation of RyR2. Specifically, we performed protein phosphorylation analysis, in vitro cardiomyocyte contractility and Ca(2+) kinetics, and in vivo ECG analysis in junctin-deficient mice. RESULTS In the absence of junctin, RyR2 channels displayed CaMKII-dependent hyperphosphorylation. Notably, CaMKII inhibition by KN-93 reduced the in vivo incidence of stress-induced ventricular tachycardia by 65% in junctin null mice. At the cardiomyocyte level, KN-93 reduced the percentage of junctin null cells exhibiting spontaneous Ca(2+) aftertransients and aftercontractions under stress conditions by 35% and 37%, respectively. At the molecular level, KN-93 blunted the CaMKII-mediated hyperphosphorylation of RyR2 and phospholamban under stress conditions. CONCLUSION Our data suggest that CaMKII inhibition is effective in preventing arrhythmogenesis in the setting of junctin ablation through modulation of both SR Ca(2+) release and uptake. Thus, it merits further investigation as promising molecular therapy.
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Affiliation(s)
- Christos Tzimas
- Molecular Biology Division, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - John Terrovitis
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stephan E Lehnart
- Clinic of Cardiology & Pulmonology, University Medical Center Goettingen, Goettingen, Germany
| | - Evangelia G Kranias
- Molecular Biology Division, Biomedical Research Foundation of the Academy of Athens, Athens, Greece; Department of Pharmacology and Cell Biophysics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Despina Sanoudou
- Molecular Biology Division, Biomedical Research Foundation of the Academy of Athens, Athens, Greece; Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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127
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Abstract
Optimal cardiac function depends on proper timing of excitation and contraction in various regions of the heart, as well as on appropriate heart rate. This is accomplished via specialized electrical properties of various components of the system, including the sinoatrial node, atria, atrioventricular node, His-Purkinje system, and ventricles. Here we review the major regionally determined electrical properties of these cardiac regions and present the available data regarding the molecular and ionic bases of regional cardiac function and dysfunction. Understanding these differences is of fundamental importance for the investigation of arrhythmia mechanisms and pharmacotherapy.
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Affiliation(s)
- Daniel C Bartos
- Department of Pharmacology, University of California Davis, Davis, California, USA
| | - Eleonora Grandi
- Department of Pharmacology, University of California Davis, Davis, California, USA
| | - Crystal M Ripplinger
- Department of Pharmacology, University of California Davis, Davis, California, USA
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128
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Savio-Galimberti E, Knollmann BC. Channel Activity of Cardiac Ryanodine Receptors (RyR2) Determines Potency and Efficacy of Flecainide and R-Propafenone against Arrhythmogenic Calcium Waves in Ventricular Cardiomyocytes. PLoS One 2015; 10:e0131179. [PMID: 26121139 PMCID: PMC4488248 DOI: 10.1371/journal.pone.0131179] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 05/31/2015] [Indexed: 11/18/2022] Open
Abstract
Flecainide blocks ryanodine receptor type 2 (RyR2) channels in the open state, suppresses arrhythmogenic Ca2+ waves and prevents catecholaminergic polymorphic ventricular tachycardia (CPVT) in mice and humans. We hypothesized that differences in RyR2 activity induced by CPVT mutations determines the potency of open-state RyR2 blockers like flecainide (FLEC) and R-propafenone (RPROP) against Ca2+ waves in cardiomyocytes. Using confocal microscopy, we studied Ca2+ sparks and waves in isolated saponin-permeabilized ventricular myocytes from two CPVT mouse models (Casq2-/-, RyR2-R4496C+/-), wild-type (c57bl/6, WT) mice, and WT rabbits (New Zealand white rabbits). Consistent with increased RyR2 activity, Ca2+ spark and wave frequencies were significantly higher in CPVT compared to WT mouse myocytes. We next obtained concentration-response curves of Ca2+ wave inhibition for FLEC, RPROP (another open-state RyR2 blocker), and tetracaine (TET) (a state-independent RyR2 blocker). Both FLEC and RPROP inhibited Ca2+ waves with significantly higher potency (lower IC50) and efficacy in CPVT compared to WT. In contrast, TET had similar potency in all groups studied. Increasing RyR2 activity of permeabilized WT myocytes by exposure to caffeine (150 µM) increased the potency of FLEC and RPROP but not of TET. RPROP and FLEC were also significantly more potent in rabbit ventricular myocytes that intrinsically exhibit higher Ca2+ spark rates than WT mouse ventricular myocytes. In conclusion, RyR2 activity determines the potency of open-state blockers FLEC and RPROP for suppressing arrhythmogenic Ca2+ waves in cardiomyocytes, a mechanism likely relevant to antiarrhythmic drug efficacy in CPVT.
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Affiliation(s)
- Eleonora Savio-Galimberti
- Division of Clinical Pharmacology and Oates Institute for Experimental Therapeutics, Department of Medicine, Vanderbilt University School of Medicine, Nashville, United States of America
- Division of Cardiovascular Medicine. Department of Medicine, Vanderbilt University School of Medicine, Nashville, United States of America
| | - Björn C. Knollmann
- Division of Clinical Pharmacology and Oates Institute for Experimental Therapeutics, Department of Medicine, Vanderbilt University School of Medicine, Nashville, United States of America
- * E-mail:
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Gender Differences in the Inheritance Mode of RYR2 Mutations in Catecholaminergic Polymorphic Ventricular Tachycardia Patients. PLoS One 2015; 10:e0131517. [PMID: 26114861 PMCID: PMC4482545 DOI: 10.1371/journal.pone.0131517] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/03/2015] [Indexed: 11/19/2022] Open
Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is one of the causes of sudden cardiac death in young people and results from RYR2 mutations in ~60% of CPVT patients. The inheritance of the RYR2 mutations follows an autosomal dominant trait, however, de novo mutations are often identified during familial analysis. In 36 symptomatic CPVT probands with RYR2 mutations, we genotyped their parents and confirmed the origin of the respective mutation. In 26 sets of proband and both parents (trio), we identified 17 de novo mutations (65.4%), seven from their mothers and only two mutations were inherited from their fathers. Among nine sets of proband and mother, five mutations were inherited from mothers. Four other mutations were of unknown origin. The inheritance of RYR2 mutations was significantly more frequent from mothers (n = 12, 34.3%) than fathers (n = 2, 5.7%) (P = 0.013). The mean ages of onset were not significantly different in probands between de novo mutations and those from mothers. Thus, half of the RYR2 mutations in our cohort were de novo, and most of the remaining mutations were inherited from mothers. These data would be useful for family analysis and risk stratification of the disease.
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130
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Domingo D, Neco P, Fernández-Pons E, Zissimopoulos S, Molina P, Olagüe J, Suárez-Mier MP, Lai FA, Gómez AM, Zorio E. Rasgos no ventriculares, clínicos y funcionales de la mutación RyR2R420Q causante de taquicardia ventricular polimórfica catecolaminérgica. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.04.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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131
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Altmann HM, Tester DJ, Will ML, Middha S, Evans JM, Eckloff BW, Ackerman MJ. Homozygous/Compound Heterozygous Triadin Mutations Associated With Autosomal-Recessive Long-QT Syndrome and Pediatric Sudden Cardiac Arrest: Elucidation of the Triadin Knockout Syndrome. Circulation 2015; 131:2051-60. [PMID: 25922419 DOI: 10.1161/circulationaha.115.015397] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 04/17/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Long-QT syndrome (LQTS) may result in syncope, seizures, or sudden cardiac arrest. Although 16 LQTS-susceptibility genes have been discovered, 20% to 25% of LQTS remains genetically elusive. METHODS AND RESULTS We performed whole-exome sequencing child-parent trio analysis followed by recessive and sporadic inheritance modeling and disease-network candidate analysis gene ranking to identify a novel underlying genetic mechanism for LQTS. Subsequent mutational analysis of the candidate gene was performed with polymerase chain reaction, denaturing high-performance liquid chromatography, and DNA sequencing on a cohort of 33 additional unrelated patients with genetically elusive LQTS. After whole-exome sequencing and variant filtration, a homozygous p.D18fs*13 TRDN-encoded triadin frameshift mutation was discovered in a 10-year-old female patient with LQTS with a QTc of 500 milliseconds who experienced recurrent exertion-induced syncope/cardiac arrest beginning at 1 year of age. Subsequent mutational analysis of TRDN revealed either homozygous or compound heterozygous frameshift mutations in 4 of 33 unrelated cases of LQTS (12%). All 5 TRDN-null patients displayed extensive T-wave inversions in precordial leads V1 through V4, with either persistent or transient QT prolongation and severe disease expression of exercise-induced cardiac arrest in early childhood (≤3 years of age) and required aggressive therapy. The overall yield of TRDN mutations was significantly greater in patients ≤10 years of age (5 of 10, 50%) compared with older patients (0 of 24, 0%; P=0.0009). CONCLUSIONS We identified TRDN as a novel underlying genetic basis for recessively inherited LQTS. All TRDN-null patients had strikingly similar phenotypes. Given the recurrent nature of potential lethal arrhythmias, patients fitting this phenotypic profile should undergo cardiac TRDN genetic testing.
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Affiliation(s)
- Helene M Altmann
- From Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (H.M.A., D.J.T., M.L.W., M.J.A.), Department of Medicine/Division of Cardiovascular Diseases (D.J.T., M.L.W., M.J.A.), Medical Genome Facility (B.W.E.), and Department of Pediatrics/Division of Pediatric Cardiology (M.J.A.), Mayo Clinic, Rochester, MN; and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo College of Medicine, Rochester, MN (S.M., J.M.E.)
| | - David J Tester
- From Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (H.M.A., D.J.T., M.L.W., M.J.A.), Department of Medicine/Division of Cardiovascular Diseases (D.J.T., M.L.W., M.J.A.), Medical Genome Facility (B.W.E.), and Department of Pediatrics/Division of Pediatric Cardiology (M.J.A.), Mayo Clinic, Rochester, MN; and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo College of Medicine, Rochester, MN (S.M., J.M.E.)
| | - Melissa L Will
- From Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (H.M.A., D.J.T., M.L.W., M.J.A.), Department of Medicine/Division of Cardiovascular Diseases (D.J.T., M.L.W., M.J.A.), Medical Genome Facility (B.W.E.), and Department of Pediatrics/Division of Pediatric Cardiology (M.J.A.), Mayo Clinic, Rochester, MN; and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo College of Medicine, Rochester, MN (S.M., J.M.E.)
| | - Sumit Middha
- From Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (H.M.A., D.J.T., M.L.W., M.J.A.), Department of Medicine/Division of Cardiovascular Diseases (D.J.T., M.L.W., M.J.A.), Medical Genome Facility (B.W.E.), and Department of Pediatrics/Division of Pediatric Cardiology (M.J.A.), Mayo Clinic, Rochester, MN; and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo College of Medicine, Rochester, MN (S.M., J.M.E.)
| | - Jared M Evans
- From Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (H.M.A., D.J.T., M.L.W., M.J.A.), Department of Medicine/Division of Cardiovascular Diseases (D.J.T., M.L.W., M.J.A.), Medical Genome Facility (B.W.E.), and Department of Pediatrics/Division of Pediatric Cardiology (M.J.A.), Mayo Clinic, Rochester, MN; and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo College of Medicine, Rochester, MN (S.M., J.M.E.)
| | - Bruce W Eckloff
- From Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (H.M.A., D.J.T., M.L.W., M.J.A.), Department of Medicine/Division of Cardiovascular Diseases (D.J.T., M.L.W., M.J.A.), Medical Genome Facility (B.W.E.), and Department of Pediatrics/Division of Pediatric Cardiology (M.J.A.), Mayo Clinic, Rochester, MN; and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo College of Medicine, Rochester, MN (S.M., J.M.E.)
| | - Michael J Ackerman
- From Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (H.M.A., D.J.T., M.L.W., M.J.A.), Department of Medicine/Division of Cardiovascular Diseases (D.J.T., M.L.W., M.J.A.), Medical Genome Facility (B.W.E.), and Department of Pediatrics/Division of Pediatric Cardiology (M.J.A.), Mayo Clinic, Rochester, MN; and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo College of Medicine, Rochester, MN (S.M., J.M.E.).
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Refaat MM, Hotait M, Tseng ZH. Utility of the exercise electrocardiogram testing in sudden cardiac death risk stratification. Ann Noninvasive Electrocardiol 2015; 19:311-8. [PMID: 25040480 DOI: 10.1111/anec.12191] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Sudden cardiac death (SCD) remains a major public health problem. Current established criteria identifying those at risk of sudden arrhythmic death, and likely to benefit from implantable cardioverter defibrillators (ICDs), are neither sensitive nor specific. Exercise electrocardiogram (ECG) testing was traditionally used for information concerning patients' symptoms, exercise capacity, cardiovascular function, myocardial ischemia detection, and hemodynamic responses during activity in patients with hypertrophic cardiomyopathy. METHODS We conducted a systematic review of MEDLINE on the utility of exercise ECG testing in SCD risk stratification. RESULTS Exercise testing can unmask suspected primary electrical diseases in certain patients (catecholaminergic polymorphic ventricular tachycardia or concealed long QT syndrome) and can be effectively utilized to risk stratify patients at an increased (such as early repolarization syndrome and Brugada syndrome) or decreased risk of SCD, such as the loss of preexcitation on exercise testing in asymptomatic Wolff-Parkinson-White syndrome. CONCLUSIONS Exercise ECG testing helps in SCD risk stratification in patients with and without arrhythmogenic hereditary syndromes.
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Affiliation(s)
- Marwan M Refaat
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, American University of Beirut Faculty of Medicine and Medical Center, Beirut, Lebanon
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Vatta M, Spoonamore KG. Use of genetic testing to identify sudden cardiac death syndromes. Trends Cardiovasc Med 2015; 25:738-48. [PMID: 25864170 DOI: 10.1016/j.tcm.2015.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 03/06/2015] [Accepted: 03/07/2015] [Indexed: 01/25/2023]
Abstract
Sudden cardiac death (SCD) is a leading cause of mortality worldwide. Although coronary artery disease remains the most common substrate for SCD, primary cardiac genetic diseases, presenting with or without structural heart abnormalities, play a significant role. In the last 30 years, the study of large family pedigrees allowed the discovery of causative genes unveiling the genetic basis of diseases such as primary cardiomyopathies and arrhythmia syndromes, which are known to increase the risk of SCD. However, recent technological advancement with the ability to perform massive parallel sequencing and analyze the entire genome has uncovered a higher level of complexity in the genetic predisposition for cardiac diseases, which are usually characterized by Mendelian inheritance patterns. Clinical genetic testing, historically shaped around a monogenic Mendelian disorder paradigm, is now facing the challenge to adopt and adapt to a more complex model in which a significant portion of subjects may present with multi-allelic inheritance involving additional genes that could modulate the severity and type of disease-related phenotypes. Here, we will try to provide a viewpoint that will hopefully foster further debate in the field.
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Affiliation(s)
- Matteo Vatta
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN; Department of Medicine, Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN.
| | - Katherine G Spoonamore
- Department of Medicine, Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN
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134
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Beard NA, Dulhunty AF. C-terminal residues of skeletal muscle calsequestrin are essential for calcium binding and for skeletal ryanodine receptor inhibition. Skelet Muscle 2015; 5:6. [PMID: 25861445 PMCID: PMC4389316 DOI: 10.1186/s13395-015-0029-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 01/14/2015] [Indexed: 02/05/2023] Open
Abstract
Background Skeletal muscle function depends on calcium signaling proteins in the sarcoplasmic reticulum (SR), including the calcium-binding protein calsequestrin (CSQ), the ryanodine receptor (RyR) calcium release channel, and skeletal triadin 95 kDa (trisk95) and junctin, proteins that bind to calsequestrin type 1 (CSQ1) and ryanodine receptor type 1 (RyR1). CSQ1 inhibits RyR1 and communicates store calcium load to RyR1 channels via trisk95 and/or junctin. Methods In this manuscript, we test predictions that CSQ1’s acidic C-terminus contains binding sites for trisk95 and junctin, the major calcium binding domain, and that it determines CSQ1’s ability to regulate RyR1 activity. Results Progressive alanine substitution of C-terminal acidic residues of CSQ1 caused a parallel reduction in the calcium binding capacity but did not significantly alter CSQ1’s association with trisk95/junctin or influence its inhibition of RyR1 activity. Deletion of the final seven residues in the C-terminus significantly hampered calcium binding, significantly reduced CSQ’s association with trisk95/junctin and decreased its inhibition of RyR1. Deletion of the full C-terminus further reduced calcium binding to CSQ1 altered its association with trisk95 and junctin and abolished its inhibition of RyR1. Conclusions The correlation between the number of residues mutated/deleted and binding of calcium, trisk95, and junctin suggests that binding of each depends on diffuse ionic interactions with several C-terminal residues and that these interactions may be required for CSQ1 to maintain normal muscle function.
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Affiliation(s)
- Nicole A Beard
- John Curtin School of Medical Research, Australian National University, Garran Road, Canberra, ACT 2601 Australia ; Discipline of Biomedical Sciences, Centre for Research in Therapeutic Solutions, Faculty of Education Science, Technology and Maths, University of Canberra, Kirinari Street, Bruce, ACT 2601 Australia
| | - Angela F Dulhunty
- John Curtin School of Medical Research, Australian National University, Garran Road, Canberra, ACT 2601 Australia
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135
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Van Petegem F. Ryanodine Receptors: Allosteric Ion Channel Giants. J Mol Biol 2015; 427:31-53. [DOI: 10.1016/j.jmb.2014.08.004] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 08/02/2014] [Accepted: 08/05/2014] [Indexed: 01/27/2023]
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ZHAO YT, VALDIVIA CR, GURROLA GB, HERNÁNDEZ JJ, VALDIVIA HH. Arrhythmogenic mechanisms in ryanodine receptor channelopathies. SCIENCE CHINA-LIFE SCIENCES 2014; 58:54-8. [PMID: 25480325 PMCID: PMC6309702 DOI: 10.1007/s11427-014-4778-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/10/2014] [Indexed: 11/27/2022]
Abstract
Ryanodine receptors (RyRs) are the calcium release channels of sarcoplasmic reticulum (SR) that provide the majority of cal-cium ions (Ca2+) necessary to induce contraction of cardiac and skeletal muscle cells. In their intracellular environment, RyR channels are regulated by a variety of cytosolic and luminal factors so that their output signal (Ca2+) induces finely-graded cell contraction without igniting cellular processes that may lead to aberrant electrical activity (ventricular arrhythmias) or cellular remodeling. The importance of RyR dysfunction has been recently highlighted with the demonstration that point mutations in RYR2, the gene encoding for the cardiac isoform of the RyR (RyR2), are associated with catecholaminergic polymorphic ventricular tachycardia (CPVT), an arrhythmogenic syndrome characterized by the development of adrenergically-mediated ventricular tachycardia in individuals with an apparently normal heart. Here we summarize the state of the field in regards to the main arrhythmogenic mechanisms triggered by RyR2 channels harboring mutations linked to CPVT. Most CPVT mutations characterized to date endow RyR2 channels with a gain of function, resulting in hyperactive channels that release Ca2+ spontaneously, especially during diastole. The spontaneous Ca2+ release is extruded by the electrogenic Na+/Ca2+ exchanger, which depolarizes the external membrane (delayed afterdepolarization or DAD) and may trigger untimely action potentials. However, a rare set of CPVT mutations yield RyR2 channels that are intrinsically hypo-active and hypo-responsive to stimuli, and it is unclear whether these channels release Ca2+ spontaneously during diastole. We discuss novel cellular mechanisms that appear more suitable to explain ventricular arrhythmias due to RyR2 loss-of-function mutations.
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137
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Domingo D, Neco P, Fernández-Pons E, Zissimopoulos S, Molina P, Olagüe J, Suárez-Mier MP, Lai FA, Gómez AM, Zorio E. Non-ventricular, Clinical, and Functional Features of the RyR2(R420Q) Mutation Causing Catecholaminergic Polymorphic Ventricular Tachycardia. ACTA ACUST UNITED AC 2014; 68:398-407. [PMID: 25440180 DOI: 10.1016/j.rec.2014.04.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 04/28/2014] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVES Catecholaminergic polymorphic ventricular tachycardia is a malignant disease, due to mutations in proteins controlling Ca(2+) homeostasis. While the phenotype is characterized by polymorphic ventricular arrhythmias under stress, supraventricular arrhythmias may occur and are not fully characterized. METHODS Twenty-five relatives from a Spanish family with several sudden deaths were evaluated with electrocardiogram, exercise testing, and optional epinephrine challenge. Selective RyR2 sequencing in an affected individual and cascade screening in the rest of the family was offered. The RyR2(R420Q) mutation was generated in HEK-293 cells using site-directed mutagenesis to conduct in vitro functional studies. RESULTS The exercise testing unmasked catecholaminergic polymorphic ventricular tachycardia in 8 relatives (sensitivity = 89%; positive predictive value = 100%; negative predictive value = 93%), all of them carrying the heterozygous RyR2(R420Q) mutation, which was also present in the proband and a young girl without exercise testing, a 91% penetrance at the end of the follow-up. Remarkably, sinus bradycardia, atrial and junctional arrhythmias, and/or giant post-effort U-waves were identified in patients. Upon permeabilization and in intact cells, the RyR2(R420Q) expressing cells showed a smaller peak of Ca(2+) release than RyR2 wild-type cells. However, at physiologic intracellular Ca(2+) concentration, equivalent to the diastolic cytosolic concentration, the RyR2(R420Q) released more Ca(2+) and oscillated faster than RyR2 wild-type cells. CONCLUSIONS The missense RyR2(R420Q) mutation was identified in the N-terminus of the RyR2 gene in this highly symptomatic family. Remarkably, this mutation is associated with sinus bradycardia, atrial and junctional arrhythmias, and giant U-waves. Collectively, functional heterologous expression studies suggest that the RyR2(R420Q) behaves as an aberrant channel, as a loss- or gain-of-function mutation depending on cytosolic intracellular Ca(2+) concentration.
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Affiliation(s)
- Diana Domingo
- Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Patricia Neco
- Inserm, U769, Université de Paris Sud, IFR141, LabEx Lermit, Châtenay-Malabry, France
| | - Elena Fernández-Pons
- Grupo de Investigación acreditado de Hemostasia, Trombosis, Arteriosclerosis y Biología Vascular, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Spyros Zissimopoulos
- Wales Heart Research Institute, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Pilar Molina
- Servicio de Histopatología, Instituto de Medicina Legal, Valencia, Spain
| | - José Olagüe
- Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M Paz Suárez-Mier
- Servicio de Histopatología, Instituto Nacional de Toxicología y Ciencias Forenses, Madrid, Spain
| | - F Anthony Lai
- Wales Heart Research Institute, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Ana M Gómez
- Inserm, U769, Université de Paris Sud, IFR141, LabEx Lermit, Châtenay-Malabry, France
| | - Esther Zorio
- Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
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Marty I. Triadin regulation of the ryanodine receptor complex. J Physiol 2014; 593:3261-6. [PMID: 26228554 DOI: 10.1113/jphysiol.2014.281147] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 09/19/2014] [Indexed: 11/08/2022] Open
Abstract
The calcium release complex is the major player in excitation-contraction coupling, both in cardiac and skeletal muscle. The core of the complex is the ryanodine receptor, and triadin is a regulating protein. Nevertheless, the precise function of triadin is only partially understood. Besides its function in the anchoring of calsequestrin at the triad/dyad, our recent results allow us to propose hypotheses on new triadin scaffolding functions, based on the studies performed using different models, from triadin knockout mice to human patients, and expression in non-muscle cells, taking into account the presence of multiple triadin isoforms.
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Affiliation(s)
- Isabelle Marty
- Grenoble Institut des Neurosciences, Inserm U836, Université Joseph Fourier-Bat EJ Safra, Chemin Fortuné Ferrini, 38700, La Tronche, France
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139
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Faggioni M, van der Werf C, Knollmann BC. Sinus node dysfunction in catecholaminergic polymorphic ventricular tachycardia: risk factor and potential therapeutic target? Trends Cardiovasc Med 2014; 24:273-8. [PMID: 25112803 DOI: 10.1016/j.tcm.2014.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/01/2014] [Accepted: 07/03/2014] [Indexed: 01/28/2023]
Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited heart rhythm disorder characterized by the occurrence of potentially life-threatening polymorphic ventricular tachyarrhythmias in conditions of physical or emotional stress. The underlying cause is a dysregulation in intracellular Ca handling due to mutations in the sarcoplasmic reticulum Ca release unit. Recent experimental work suggests that sinus bradycardia, which is sometimes observed in CPVT patients, may be another primary defect caused by CPVT mutations. Herein, we review the pathophysiology of CPVT and discuss the role of sinus node dysfunction as a modulator of arrhythmia risk and potential therapeutic target.
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Affiliation(s)
- Michela Faggioni
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical School, Medical Research Building IV, Rm. 1265, 2215B Garland Ave, Nashville, TN 37232-0575; Department of Cardiology, University of Pisa, Pisa, Italy
| | - Christian van der Werf
- Heart Center, Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Bjorn C Knollmann
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical School, Medical Research Building IV, Rm. 1265, 2215B Garland Ave, Nashville, TN 37232-0575.
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Denegri M, Bongianino R, Lodola F, Boncompagni S, De Giusti VC, Avelino-Cruz JE, Liu N, Persampieri S, Curcio A, Esposito F, Pietrangelo L, Marty I, Villani L, Moyaho A, Baiardi P, Auricchio A, Protasi F, Napolitano C, Priori SG. Single delivery of an adeno-associated viral construct to transfer the CASQ2 gene to knock-in mice affected by catecholaminergic polymorphic ventricular tachycardia is able to cure the disease from birth to advanced age. Circulation 2014; 129:2673-81. [PMID: 24888331 DOI: 10.1161/circulationaha.113.006901] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Catecholaminergic polymorphic ventricular tachycardia is an inherited arrhythmogenic disorder characterized by sudden cardiac death in children. Drug therapy is still insufficient to provide full protection against cardiac arrest, and the use of implantable defibrillators in the pediatric population is limited by side effects. There is therefore a need to explore the curative potential of gene therapy for this disease. We investigated the efficacy and durability of viral gene transfer of the calsequestrin 2 (CASQ2) wild-type gene in a catecholaminergic polymorphic ventricular tachycardia knock-in mouse model carrying the CASQ2(R33Q/R33Q) (R33Q) mutation. METHODS AND RESULTS We engineered an adeno-associated viral vector serotype 9 (AAV9) containing cDNA of CASQ2 wild-type (AAV9-CASQ2) plus the green fluorescent protein (GFP) gene to infect newborn R33Q mice studied by in vivo and in vitro protocols at 6, 9, and 12 months to investigate the ability of the infection to prevent the disease and adult R33Q mice studied after 2 months to assess whether the AAV9-CASQ2 delivery could revert the catecholaminergic polymorphic ventricular tachycardia phenotype. In both protocols, we observed the restoration of physiological expression and interaction of CASQ2, junctin, and triadin; the rescue of electrophysiological and ultrastructural abnormalities in calcium release units present in R33Q mice; and the lack of life-threatening arrhythmias. CONCLUSIONS Our data demonstrate that viral gene transfer of wild-type CASQ2 into the heart of R33Q mice prevents and reverts severe manifestations of catecholaminergic polymorphic ventricular tachycardia and that this curative effect lasts for 1 year after a single injection of the vector, thus posing the rationale for the design of a clinical trial.
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Affiliation(s)
- Marco Denegri
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Rossana Bongianino
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Francesco Lodola
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Simona Boncompagni
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Verónica C De Giusti
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - José E Avelino-Cruz
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Nian Liu
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Simone Persampieri
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Antonio Curcio
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Francesca Esposito
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Laura Pietrangelo
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Isabelle Marty
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Laura Villani
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Alejandro Moyaho
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Paola Baiardi
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Alberto Auricchio
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Feliciano Protasi
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Carlo Napolitano
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.)
| | - Silvia G Priori
- From Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (M.D., R.B., F.L., V.C.D.G., J.E.A.-C., S.P., A.C., F.E., P.B., C.N., S.G.P.); CeSI-Center for Research on Ageing & DNI-Department of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy (S.B., L.P., F.P.); Facultad de Ciencias Médicas, Centro de Investigaciones Cardiovasculares, UNLP-CONICET, La Plata, Argentina (V.C.D.G.); Laboratorio de Cardiología Molecular, Insituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (J.E.A.-C.); Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (N.L.); Division of Cardiology, Department of Medical and Surgical Science, University of "Magna Graecia," Catanzaro, Italy (A.C.); Federico II University of Naples, Cardiology, Naples, Italy (F.E.); INSERM U836, Grenoble Institut des Neurosciences, Equipe Muscle et Pathologies, Grenoble, France (I.M.); Université Joseph Fourier, Grenoble, France (I.M.); Pathology Division, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy (L.V.); Laboratorio de Ecología de la Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México (A.M.); Telethon Institute of Genetics and Medicine, Naples, Italy (A.A.); Medical Genetics, Department of Translational Medicine, "Federico II" University, Naples, Italy (A.A.); and Department of Molecular Medicine, University of Pavia, Pavia, Italy (S.G.P.).
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141
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Acimovic I, Vilotic A, Pesl M, Lacampagne A, Dvorak P, Rotrekl V, Meli AC. Human pluripotent stem cell-derived cardiomyocytes as research and therapeutic tools. BIOMED RESEARCH INTERNATIONAL 2014; 2014:512831. [PMID: 24800237 PMCID: PMC3996932 DOI: 10.1155/2014/512831] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 02/04/2014] [Indexed: 02/07/2023]
Abstract
Human pluripotent stem cells (hPSCs), namely, embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), with their ability of indefinite self-renewal and capability to differentiate into cell types derivatives of all three germ layers, represent a powerful research tool in developmental biology, for drug screening, disease modelling, and potentially cell replacement therapy. Efficient differentiation protocols that would result in the cell type of our interest are needed for maximal exploitation of these cells. In the present work, we aim at focusing on the protocols for differentiation of hPSCs into functional cardiomyocytes in vitro as well as achievements in the heart disease modelling and drug testing on the patient-specific iPSC-derived cardiomyocytes (iPSC-CMs).
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Affiliation(s)
- Ivana Acimovic
- Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5/A3, 62500 Brno, Czech Republic
| | - Aleksandra Vilotic
- Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5/A3, 62500 Brno, Czech Republic
| | - Martin Pesl
- Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5/A3, 62500 Brno, Czech Republic
- ICRC, St. Anne's University Hospital, 60200 Brno, Czech Republic
| | - Alain Lacampagne
- INSERM U1046, University of Montpellier I, University of Montpellier II, 34295 Montpellier, France
| | - Petr Dvorak
- Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5/A3, 62500 Brno, Czech Republic
- ICRC, St. Anne's University Hospital, 60200 Brno, Czech Republic
| | - Vladimir Rotrekl
- Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5/A3, 62500 Brno, Czech Republic
| | - Albano C. Meli
- Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5/A3, 62500 Brno, Czech Republic
- INSERM U1046, University of Montpellier I, University of Montpellier II, 34295 Montpellier, France
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142
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Wong LCH, Behr ER. Sudden unexplained death in infants and children: the role of undiagnosed inherited cardiac conditions. Europace 2014; 16:1706-13. [PMID: 24585884 DOI: 10.1093/europace/euu037] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Sudden unexplained death in childhood is a traumatic event for both the immediate family and medical professionals. This is termed sudden unexplained or arrhythmic death syndrome (SUDS/SADS) for children over 1 year of age while sudden unexplained death in infancy or sudden infant death syndrome (SUDI/SIDS) refers to unexplained deaths in the first year of life. There is increasing evidence for the role of undiagnosed inherited cardiac conditions, particularly channelopathies, as the cause of these deaths. This has far-reaching implications for the family regarding the potential risk to other family members and future pregnancies, providing a challenge not only in the counselling but also in the structured assessment and management of immediate relatives. This review will discuss the cardiac risk involved in sudden unexplained deaths of infants and children, the role of molecular autopsy, family cardiological screening, current management strategies, and future directions in this area.
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Affiliation(s)
- Leonie C H Wong
- Cardiovascular Sciences Research Centre, Division of Clinical Sciences, St George's University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Elijah R Behr
- Cardiovascular Sciences Research Centre, Division of Clinical Sciences, St George's University of London, Cranmer Terrace, London SW17 0RE, UK
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143
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Campuzano O, Allegue C, Partemi S, Iglesias A, Oliva A, Brugada R. Negative autopsy and sudden cardiac death. Int J Legal Med 2014; 128:599-606. [PMID: 24532175 DOI: 10.1007/s00414-014-0966-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 01/15/2014] [Indexed: 12/20/2022]
Abstract
Forensic medicine defines the unexplained sudden death as a death with a non-conclusive diagnosis after autopsy. Molecular diagnosis is being progressively incorporated in forensics, mainly due to improvement in genetics. New genetic technologies may help to identify the genetic cause of death, despite clinical interpretation of genetic data remains the current challenge. The identification of an inheritable defect responsible for arrhythmogenic syndromes could help to adopt preventive measures in family members, many of them asymptomatic but at risk of sudden death. This multidisciplinary translational research requires a specialized team.
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Affiliation(s)
- Oscar Campuzano
- Cardiovascular Genetic Center, University of Girona-IDIBGI, Girona, Spain
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144
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Hwang J, Pallas DC. STRIPAK complexes: structure, biological function, and involvement in human diseases. Int J Biochem Cell Biol 2014; 47:118-48. [PMID: 24333164 PMCID: PMC3927685 DOI: 10.1016/j.biocel.2013.11.021] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Revised: 11/18/2013] [Accepted: 11/28/2013] [Indexed: 12/31/2022]
Abstract
The mammalian striatin family consists of three proteins, striatin, S/G2 nuclear autoantigen, and zinedin. Striatin family members have no intrinsic catalytic activity, but rather function as scaffolding proteins. Remarkably, they organize multiple diverse, large signaling complexes that participate in a variety of cellular processes. Moreover, they appear to be regulatory/targeting subunits for the major eukaryotic serine/threonine protein phosphatase 2A. In addition, striatin family members associate with germinal center kinase III kinases as well as other novel components, earning these assemblies the name striatin-interacting phosphatase and kinase (STRIPAK) complexes. Recently, there has been a great increase in functional and mechanistic studies aimed at identifying and understanding the roles of STRIPAK and STRIPAK-like complexes in cellular processes of multiple organisms. These studies have identified novel STRIPAK and STRIPAK-like complexes and have explored their roles in specific signaling pathways. Together, the results of these studies have sparked increased interest in striatin family complexes because they have revealed roles in signaling, cell cycle control, apoptosis, vesicular trafficking, Golgi assembly, cell polarity, cell migration, neural and vascular development, and cardiac function. Moreover, STRIPAK complexes have been connected to clinical conditions, including cardiac disease, diabetes, autism, and cerebral cavernous malformation. In this review, we discuss the expression, localization, and protein domain structure of striatin family members. Then we consider the diverse complexes these proteins and their homologs form in various organisms, emphasizing what is known regarding function and regulation. Finally, we explore possible roles of striatin family complexes in disease, especially cerebral cavernous malformation.
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Affiliation(s)
- Juyeon Hwang
- Department of Biochemistry and Winship Cancer Institute, and Biochemistry, Cell, Developmental Biology Graduate Program, Emory University School of Medicine, 1510 Clifton Road, Atlanta, GA 30322, USA.
| | - David C Pallas
- Department of Biochemistry and Winship Cancer Institute, and Biochemistry, Cell, Developmental Biology Graduate Program, Emory University School of Medicine, 1510 Clifton Road, Atlanta, GA 30322, USA.
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145
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HRS/EHRA/APHRS Expert Consensus Statement on the Diagnosis and Management of Patients with Inherited Primary Arrhythmia Syndromes. J Arrhythm 2014. [DOI: 10.1016/j.joa.2013.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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146
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Priori SG, Wilde AA, Horie M, Cho Y, Behr ER, Berul C, Blom N, Brugada J, Chiang CE, Huikuri H, Kannankeril P, Krahn A, Leenhardt A, Moss A, Schwartz PJ, Shimizu W, Tomaselli G, Tracy C. Executive Summary: HRS/EHRA/APHRS Expert Consensus Statement on the Diagnosis and Management of Patients with Inherited Primary Arrhythmia Syndromes. J Arrhythm 2014. [DOI: 10.1016/j.joa.2013.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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147
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Outcomes of defibrillator therapy in catecholaminergic polymorphic ventricular tachycardia. Heart Rhythm 2014; 11:58-66. [DOI: 10.1016/j.hrthm.2013.10.027] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Indexed: 11/20/2022]
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148
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149
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Priori SG, Wilde AA, Horie M, Cho Y, Behr ER, Berul C, Blom N, Brugada J, Chiang CE, Huikuri H, Kannankeril P, Krahn A, Leenhardt A, Moss A, Schwartz PJ, Shimizu W, Tomaselli G, Tracy C. HRS/EHRA/APHRS Expert Consensus Statement on the Diagnosis and Management of Patients with Inherited Primary Arrhythmia Syndromes. Heart Rhythm 2013; 10:1932-63. [DOI: 10.1016/j.hrthm.2013.05.014] [Citation(s) in RCA: 1341] [Impact Index Per Article: 121.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Indexed: 12/15/2022]
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150
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Abstract
Ca²⁺ plays a crucial role in connecting membrane excitability with contraction in myocardium. The hallmark features of heart failure are mechanical dysfunction and arrhythmias; defective intracellular Ca²⁺ homeostasis is a central cause of contractile dysfunction and arrhythmias in failing myocardium. Defective Ca²⁺ homeostasis in heart failure can result from pathological alteration in the expression and activity of an increasingly understood collection of Ca²⁺ homeostatic and structural proteins, ion channels, and enzymes. This review focuses on the molecular mechanisms of defective Ca²⁺ cycling in heart failure and considers how fundamental understanding of these pathways may translate into novel and innovative therapies.
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Affiliation(s)
- Min Luo
- Division of Cardiovascular Medicine, Department of Internal Medicine, Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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