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Mesa MH, Garcia GC, Hoerndli FJ, McCabe KJ, Rangamani P. Spine apparatus modulates Ca 2+ in spines through spatial localization of sources and sinks. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.22.558941. [PMID: 37790389 PMCID: PMC10542496 DOI: 10.1101/2023.09.22.558941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Dendritic spines are small protrusions on dendrites in neurons and serve as sites of postsynaptic activity. Some of these spines contain smooth endoplasmic reticulum (SER), and sometimes an even further specialized SER known as the spine apparatus (SA). In this work, we developed a stochastic spatial model to investigate the role of the SER and the SA in modulating Ca 2+ dynamics. Using this model, we investigated how ryanodine receptor (RyR) localization, spine membrane geometry, and SER geometry can impact Ca 2+ transients in the spine and in the dendrite. Our simulations found that RyR opening is dependent on where it is localized in the SER and on the SER geometry. In order to maximize Ca 2+ in the dendrites (for activating clusters of spines and spine-spine communication), a laminar SA was favorable with RyRs localized in the neck region, closer to the dendrite. We also found that the presence of the SER without the laminar structure, coupled with RyR localization at the head, leads to higher Ca 2+ presence in the spine. These predictions serve as design principles for understanding how spines with an ER can regulate Ca 2+ dynamics differently from spines without ER through a combination of geometry and receptor localization. Highlights 1RyR opening in dendritic spine ER is location dependent and spine geometry dependent. Ca 2+ buffers and SERCA can buffer against runaway potentiation of spines even when CICR is activated. RyRs located towards the ER neck allow for more Ca 2+ to reach the dendrites. RyRs located towards the spine head are favorable for increased Ca 2+ in spines.
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2
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Campos FO, Shiferaw Y, Whitaker J, Plank G, Bishop MJ. Subthreshold delayed afterdepolarizations provide an important arrhythmogenic substrate in the border zone of infarcted hearts. Heart Rhythm 2023; 20:299-306. [PMID: 36343889 DOI: 10.1016/j.hrthm.2022.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Fernando O Campos
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.
| | - Yohannes Shiferaw
- Department of Physics, University of California, Los Angeles, California
| | - John Whitaker
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gernot Plank
- Gottfried Schatz Research Center, Division of Biophysics, Medical University of Graz, Graz, Austria
| | - Martin J Bishop
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
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3
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Hutchings DC, Madders GWP, Niort BC, Bode EF, Waddell CA, Woods LS, Dibb KM, Eisner DA, Trafford AW. Interaction of background Ca 2+ influx, sarcoplasmic reticulum threshold and heart failure in determining propensity for Ca 2+ waves in sheep heart. J Physiol 2022; 600:2637-2650. [PMID: 35233776 PMCID: PMC9310721 DOI: 10.1113/jp282168] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/25/2022] [Indexed: 11/11/2022] Open
Abstract
Ventricular arrhythmias can cause death in heart failure (HF). A trigger is the occurrence of Ca2+ waves which activate a Na+ -Ca2+ exchange (NCX) current, leading to delayed after-depolarisations and triggered action potentials. Waves arise when sarcoplasmic reticulum (SR) Ca2+ content reaches a threshold and are commonly induced experimentally by raising external Ca2+ , although the mechanism by which this causes waves is unclear and was the focus of this study. Intracellular Ca2+ was measured in voltage-clamped ventricular myocytes from both control sheep and those subjected to rapid pacing to produce HF. Threshold SR Ca2+ content was determined by applying caffeine (10 mM) following a wave and integrating wave and caffeine-induced NCX currents. Raising external Ca2+ induced waves in a greater proportion of HF cells than control. The associated increase of SR Ca2+ content was smaller in HF due to a lower threshold. Raising external Ca2+ had no effect on total influx via the L-type Ca2+ current, ICa-L , and increased efflux on NCX. Analysis of sarcolemmal fluxes revealed substantial background Ca2+ entry which sustains Ca2+ efflux during waves in the steady state. Wave frequency and background Ca2+ entry were decreased by Gd3+ or the TRPC6 inhibitor BI 749327. These agents also blocked Mn2+ entry. Inhibiting connexin hemi-channels, TRPC1/4/5, L-type channels or NCX had no effect on background entry. In conclusion, raising external Ca2+ induces waves via a background Ca2+ influx through TRPC6 channels. The greater propensity to waves in HF results from increased background entry and decreased threshold SR content. KEY POINTS: Heart failure is a pro-arrhythmic state and arrhythmias are a major cause of death. At the cellular level, Ca2+ waves resulting in delayed after-depolarisations are a key trigger of arrhythmias. Ca2+ waves arise when the sarcoplasmic reticulum (SR) becomes overloaded with Ca2+ . We investigate the mechanism by which raising external Ca2+ causes waves, and how this is modified in heart failure. We demonstrate that a novel sarcolemmal background Ca2+ influx via the TRPC6 channel is responsible for SR Ca2+ overload and Ca2+ waves. The increased propensity for Ca2+ waves in heart failure results from an increase of background influx, and a lower threshold SR content. The results of the present study highlight a novel mechanism by which Ca2+ waves may arise in heart failure, providing a basis for future work and novel therapeutic targets.
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Affiliation(s)
- David C Hutchings
- Unit of Cardiac Physiology, Division of Cardiovascular Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester, UK
| | - George W P Madders
- Unit of Cardiac Physiology, Division of Cardiovascular Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Barbara C Niort
- Unit of Cardiac Physiology, Division of Cardiovascular Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Elizabeth F Bode
- Unit of Cardiac Physiology, Division of Cardiovascular Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Caitlin A Waddell
- Unit of Cardiac Physiology, Division of Cardiovascular Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Lori S Woods
- Unit of Cardiac Physiology, Division of Cardiovascular Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Katharine M Dibb
- Unit of Cardiac Physiology, Division of Cardiovascular Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - David A Eisner
- Unit of Cardiac Physiology, Division of Cardiovascular Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Andrew W Trafford
- Unit of Cardiac Physiology, Division of Cardiovascular Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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4
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Borysova L, Ng YYH, Wragg ES, Wallis LE, Fay E, Ascione R, Dora KA. High spatial and temporal resolution Ca 2+ imaging of myocardial strips from human, pig and rat. Nat Protoc 2021; 16:4650-4675. [PMID: 34400840 DOI: 10.1038/s41596-021-00590-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/14/2021] [Indexed: 11/09/2022]
Abstract
Ca2+ handling within cardiac myocytes underpins coordinated contractile function within the beating heart. This protocol enables high spatial and temporal Ca2+ imaging of ex vivo multicellular myocardial strips. The endocardial surface is retained, and strips of 150-300-µm thickness are dissected, loaded with Ca2+ indicators and mounted within 1.5 h. A list of the equipment and reagents used and the key methodological aspects allowing the use of this technique on strips from any chamber of the mammalian heart are described. We have successfully used this protocol on human, pig and rat biopsy samples. On use of this protocol with intact endocardial endothelium, we demonstrated that the myocytes develop asynchronous spontaneous Ca2+ events, which can be ablated by electrically evoked Ca2+ transients, and subsequently redevelop spontaneously after cessation of stimulation. This protocol thus offers a rapid and reliable method for studying the Ca2+ signaling underpinning cardiomyocyte contraction, in both healthy and diseased tissue.
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Affiliation(s)
- Lyudmyla Borysova
- Vascular Pharmacology Group, Department of Pharmacology, University of Oxford, Oxford, UK
| | - Y Y Hanson Ng
- Vascular Pharmacology Group, Department of Pharmacology, University of Oxford, Oxford, UK
| | - Edward S Wragg
- Vascular Pharmacology Group, Department of Pharmacology, University of Oxford, Oxford, UK
| | - Lillian E Wallis
- Vascular Pharmacology Group, Department of Pharmacology, University of Oxford, Oxford, UK
| | - Emily Fay
- Vascular Pharmacology Group, Department of Pharmacology, University of Oxford, Oxford, UK
| | - Raimondo Ascione
- Bristol Heart Institute, Bristol Royal Infirmary, University of Bristol, Bristol, UK
| | - Kim A Dora
- Vascular Pharmacology Group, Department of Pharmacology, University of Oxford, Oxford, UK.
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5
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Dries E, Bardi I, Nunez-Toldra R, Meijlink B, Terracciano CM. CaMKII inhibition reduces arrhythmogenic Ca2+ events in subendocardial cryoinjured rat living myocardial slices. J Gen Physiol 2021; 153:212078. [PMID: 33956073 PMCID: PMC8105719 DOI: 10.1085/jgp.202012737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 04/13/2021] [Indexed: 01/08/2023] Open
Abstract
Spontaneous Ca2+ release (SCR) can cause triggered activity and initiate arrhythmias. Intrinsic transmural heterogeneities in Ca2+ handling and their propensity to disease remodeling may differentially modulate SCR throughout the left ventricular (LV) wall and cause transmural differences in arrhythmia susceptibility. Here, we aimed to dissect the effect of cardiac injury on SCR in different regions in the intact LV myocardium using cryoinjury on rat living myocardial slices (LMS). We studied SCR under proarrhythmic conditions using a fluorescent Ca2+ indicator and high-resolution imaging in LMS from the subendocardium (ENDO) and subepicardium (EPI). Cryoinjury caused structural remodeling, with loss in T-tubule density and an increased time of Ca2+ transients to peak after injury. In ENDO LMS, the Ca2+ transient amplitude and decay phase were reduced, while these were not affected in EPI LMS after cryoinjury. The frequency of spontaneous whole-slice contractions increased in ENDO LMS without affecting EPI LMS after injury. Cryoinjury caused an increase in foci that generates SCR in both ENDO and EPI LMS. In ENDO LMS, SCRs were more closely distributed and had reduced latencies after cryoinjury, whereas this was not affected in EPI LMS. Inhibition of CaMKII reduced the number, distribution, and latencies of SCR, as well as whole-slice contractions in ENDO LMS, but not in EPI LMS after cryoinjury. Furthermore, CaMKII inhibition did not affect the excitation–contraction coupling in cryoinjured ENDO or EPI LMS. In conclusion, we demonstrate increased arrhythmogenic susceptibility in the injured ENDO. Our findings show involvement of CaMKII and highlight the need for region-specific targeting in cardiac therapies.
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Affiliation(s)
- Eef Dries
- National Heart and Lung Institute, Imperial College London, London, UK.,Lab of Experimental Cardiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Ifigeneia Bardi
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Bram Meijlink
- National Heart and Lung Institute, Imperial College London, London, UK
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6
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Liu Z, Zhang Y, Pan S, Qiu C, Jia H, Wang Y, Zhu H. Activation of RAGE-dependent endoplasmic reticulum stress associates with exacerbated postmyocardial infarction ventricular arrhythmias in diabetes. Am J Physiol Endocrinol Metab 2021; 320:E539-E550. [PMID: 33459180 DOI: 10.1152/ajpendo.00450.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Association between receptor for advanced glycation end products (RAGE) and postmyocardial infarction (MI) ventricular arrhythmias (VAs) in diabetes was investigated. Correlation between premature ventricular contractions (PVCs) and serum advanced glycation end products (AGEs) content was analyzed in a cohort consisting of 101 patients with ST-segment elevated MI (STEMI). MI diabetic rats were treated with anti-receptor for AGE (RAGE) antibody. Electrocardiography was used to record VAs. Myocytes were isolated from adjacent area around infracted region. Immunofluorescent stains were used to evaluate the association between FKBP12.6 (FK506-bindingprotein 12.6) and ryanodine receptor 2 (RyR2). Calcium sparks were evaluated by confocal microscope. Protein expression and phosphorylation were assessed by Western blotting. Calcineurin (CaN) enzymatic activity and RyR2 channel activity were also determined. In the cohort study, significantly increased amount of PVC was found in STEMI patients with diabetes (P < 0.05). Serum AGE concentration was significantly positively correlated with PVC amount in patients with STEMI (r = 0.416, P < 0.001). Multivariate analysis showed that serum AGE concentration was independently and positively related to frequent PVCs (adjusted hazard ratio, 1.86; 95% CI, 1.09-3.18, P = 0.022). In the animal study, increased glucose-regulated protein 78 (GRP78) expression, protein kinase RNA-like ER kinase (PERK) phosphorylation, CaN enzymatic activity, FKBP12.6-RyR2 disassociation, RyR2 channel opening, and endoplasmic reticulum (ER) calcium releasing were found in diabetic MI animals, which were attenuated by anti-RAGE antibody treatment. This RAGE blocking also significantly lowered the VA amount in diabetic MI animals. Activation of RAGE-dependent ER stress-mediated PERK/CaN/RyR2 signaling participated in post-MI VAs in diabetes.NEW & NOTEWORTHY In this study, we proposed a possible mechanism interpreting the clinical scenario that after myocardial infarction (MI) patients were more vulnerable to ventricular arrhythmias (VAs) when complicated with diabetes. A cohort study revealed that advanced glycation end products (AGEs) accumulated in patients with diabetes and closely associated post-MI VAs. In vivo and in vitro studies indicated that receptor for AGEs (RAGE)-dependent endoplasmic reticulum (ER) stress protein kinase RNA-like ER kinase (PERK) pathway triggered VAs, via ER calcium releasing, through calcineurin/RyR2 mechanism.
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Affiliation(s)
- Zhongwei Liu
- Department of Cardiology, Affiliated Shaanxi Provincial People's Hospital, Northwestern Polytechnical University, Xi'an, People's Republic of China
| | - Yong Zhang
- Department of Cardiology, Affiliated Shaanxi Provincial People's Hospital, Northwestern Polytechnical University, Xi'an, People's Republic of China
| | - Shuo Pan
- Department of Cardiology, Affiliated Shaanxi Provincial People's Hospital, Northwestern Polytechnical University, Xi'an, People's Republic of China
| | - Chuan Qiu
- Department of Global Biostatistics and Data Science, School of Public Health and Tropical Medicine, Center for Bioinformatics and Genomics, Tulane University, New Orleans, Louisiana
| | - Hao Jia
- International Medical Services, Affiliated Hospital of Northwest University, Northwest University, Xi'an, People's Republic of China
| | - Yuan Wang
- Department of Medical Prevention, Affiliated Shaanxi Provincial People's Hospital, Northwestern Polytechnical University, Xi'an, People's Republic of China
| | - Haitao Zhu
- Department of Pediatrics, Northwest Women's and Children's Hospital, Xi'an, People's Republic of China
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7
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Greene D, Shiferaw Y. Mechanistic link between CaM-RyR2 interactions and the genesis of cardiac arrhythmia. Biophys J 2021; 120:1469-1482. [PMID: 33617831 DOI: 10.1016/j.bpj.2021.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/13/2021] [Accepted: 02/08/2021] [Indexed: 12/01/2022] Open
Abstract
In this study, we develop a computational model of the interaction between ryanodine receptor type 2 (RyR2) and calmodulin (CaM) to explore the mechanistic link between CaM-RyR2 interactions and cardiac arrhythmia. Our starting point is a biophysically based computational model of CaM binding to a single RyR2 subunit, which reproduces single-channel RyR2 measurements in lipid bilayers. We then integrate this CaM-RyR2 model into a spatially distributed whole-cell model of Ca cycling, which is used to investigate the relationship between CaM and Ca cycling homeostasis. We show that a reduction in CaM concentration leads to a substantial increase in the rate of spontaneous Ca sparks, and this induces a marked reduction in sarcoplasmic reticulum Ca load during steady-state pacing. Also, we show that a reduction in CaM modifies the RyR2 open probability, which makes the cell more prone to Ca wave propagation. These results indicate that aberrant Ca cycling activity during pacing is determined by the interplay between sarcoplasmic reticulum load reduction and the threshold for Ca wave propagation. Based on these results, we show that when CaM is reduced, Ca waves can occur in a cell and induce action potential perturbations that are arrhythmogenic. Thus, this study outlines a novel, to our knowledge, mechanistic link between CaM-RyR2 binding kinetics and the induction of arrhythmias in the heart.
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Affiliation(s)
- D'Artagnan Greene
- Department of Physics, California State University Northridge, Los Angeles, California
| | - Yohannes Shiferaw
- Department of Physics, California State University Northridge, Los Angeles, California.
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8
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Savi M, Bocchi L, Cacciani F, Vilella R, Buschini A, Perotti A, Galati S, Montalbano S, Pinelli S, Frati C, Corradini E, Quaini F, Ruotolo R, Stilli D, Zaniboni M. Cobalt oxide nanoparticles induce oxidative stress and alter electromechanical function in rat ventricular myocytes. Part Fibre Toxicol 2021; 18:1. [PMID: 33407654 PMCID: PMC7788732 DOI: 10.1186/s12989-020-00396-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/21/2020] [Indexed: 02/08/2023] Open
Abstract
Background Nanotoxicology is an increasingly relevant field and sound paradigms on how inhaled nanoparticles (NPs) interact with organs at the cellular level, causing harmful conditions, have yet to be established. This is particularly true in the case of the cardiovascular system, where experimental and clinical evidence shows morphological and functional damage associated with NP exposure. Giving the increasing interest on cobalt oxide (Co3O4) NPs applications in industrial and bio-medical fields, a detailed knowledge of the involved toxicological effects is required, in view of assessing health risk for subjects/workers daily exposed to nanomaterials. Specifically, it is of interest to evaluate whether NPs enter cardiac cells and interact with cell function. We addressed this issue by investigating the effect of acute exposure to Co3O4-NPs on excitation-contraction coupling in freshly isolated rat ventricular myocytes. Results Patch clamp analysis showed instability of resting membrane potential, decrease in membrane electrical capacitance, and dose-dependent decrease in action potential duration in cardiomyocytes acutely exposed to Co3O4-NPs. Motion detection and intracellular calcium fluorescence highlighted a parallel impairment of cell contractility in comparison with controls. Specifically, NP-treated cardiomyocytes exhibited a dose-dependent decrease in the fraction of shortening and in the maximal rate of shortening and re-lengthening, as well as a less efficient cytosolic calcium clearing and an increased tendency to develop spontaneous twitches. In addition, treatment with Co3O4-NPs strongly increased ROS accumulation and induced nuclear DNA damage in a dose dependent manner. Finally, transmission electron microscopy analysis demonstrated that acute exposure did lead to cellular internalization of NPs. Conclusions Taken together, our observations indicate that Co3O4-NPs alter cardiomyocyte electromechanical efficiency and intracellular calcium handling, and induce ROS production resulting in oxidative stress that can be related to DNA damage and adverse effects on cardiomyocyte functionality. Supplementary Information The online version contains supplementary material available at 10.1186/s12989-020-00396-6.
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Affiliation(s)
- Monia Savi
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/a, 43124, Parma, Italy.
| | - Leonardo Bocchi
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/a, 43124, Parma, Italy
| | - Francesca Cacciani
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/a, 43124, Parma, Italy
| | - Rocchina Vilella
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/a, 43124, Parma, Italy
| | - Annamaria Buschini
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/a, 43124, Parma, Italy
| | - Alessio Perotti
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/a, 43124, Parma, Italy
| | - Serena Galati
- Centre for Molecular and Translational Oncology (COMT), University of Parma, Parma, Italy
| | - Serena Montalbano
- Centre for Molecular and Translational Oncology (COMT), University of Parma, Parma, Italy
| | - Silvana Pinelli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Caterina Frati
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Emilia Corradini
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Federico Quaini
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberta Ruotolo
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/a, 43124, Parma, Italy
| | - Donatella Stilli
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/a, 43124, Parma, Italy
| | - Massimiliano Zaniboni
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/a, 43124, Parma, Italy.
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9
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Liu MB, Priori SG, Qu Z, Weiss JN. Stabilizer Cell Gene Therapy: A Less-Is-More Strategy to Prevent Cardiac Arrhythmias. Circ Arrhythm Electrophysiol 2020; 13:e008420. [PMID: 32718183 DOI: 10.1161/circep.120.008420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In cardiac gene therapy to improve contractile function, achieving gene expression in the majority of cardiac myocytes is essential. In preventing cardiac arrhythmias, however, this goal may not be as important since transduction efficiencies as low as 40% suppressed ventricular arrhythmias in genetically modified mice with catecholaminergic polymorphic ventricular tachycardia. METHODS Using computational modeling, we simulated 1-, 2-, and 3-dimensional tissue under a variety of conditions to test the ability of genetically engineered nonarrhythmogenic stabilizer cells to suppress triggered activity due to delayed or early afterdepolarizations. RESULTS Due to source-sink relationships in cardiac tissue, a minority (20%-50%) of randomly distributed stabilizer cells engineered to be nonarrhythmogenic can suppress the ability of arrhythmogenic cells to generate delayed and early afterdepolarizations-related arrhythmias. Stabilizer cell gene therapy strategy can be designed to correct a specific arrhythmogenic mutation, as in the catecholaminergic polymorphic ventricular tachycardia mice studies, or more generally to suppress delayed or early afterdepolarizations from any cause by overexpressing the inward rectifier K channel Kir2.1 in stabilizer cells. CONCLUSIONS This promising antiarrhythmic strategy warrants further testing in experimental models to evaluate its clinical potential.
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Affiliation(s)
- Michael B Liu
- Departments of Medicine/Cardiology (M.B.L., Z.Q., J.N.W.), David Geffen School of Medicine, University of California, Los Angeles.,Physiology (M.B.L., J.N.W.), David Geffen School of Medicine, University of California, Los Angeles
| | - Silvia G Priori
- Department of Molecular Medicine, University of Pavia, Italy (S.G.P.).,Istituti Clinici Scientifici Maugeri, IRCCS, Pavia Italy (S.G.P.).,Centro de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (S.G.P.)
| | - Zhilin Qu
- Departments of Medicine/Cardiology (M.B.L., Z.Q., J.N.W.), David Geffen School of Medicine, University of California, Los Angeles.,Computational Medicine (Z.Q.), David Geffen School of Medicine, University of California, Los Angeles
| | - James N Weiss
- Departments of Medicine/Cardiology (M.B.L., Z.Q., J.N.W.), David Geffen School of Medicine, University of California, Los Angeles.,Physiology (M.B.L., J.N.W.), David Geffen School of Medicine, University of California, Los Angeles
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10
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Colman MA. Arrhythmia mechanisms and spontaneous calcium release: Bi-directional coupling between re-entrant and focal excitation. PLoS Comput Biol 2019; 15:e1007260. [PMID: 31393876 PMCID: PMC6687119 DOI: 10.1371/journal.pcbi.1007260] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/09/2019] [Indexed: 12/14/2022] Open
Abstract
Spontaneous sub-cellular calcium release events (SCRE) are conjectured to promote rapid arrhythmias associated with conditions such as heart failure and atrial fibrillation: they can underlie the emergence of spontaneous action potentials in single cells which can lead to arrhythmogenic triggers in tissue. The multi-scale mechanisms of the development of SCRE into arrhythmia triggers, and their dynamic interaction with the tissue substrate, remain elusive; rigorous and simultaneous study of dynamics from the nanometre to the centimetre scale is a major challenge. The aim of this study was to develop a computational approach to overcome this challenge and study potential bi-directional coupling between sub-cellular and tissue-scale arrhythmia phenomena. A framework comprising a hierarchy of computational models was developed, which includes detailed single-cell models describing spatio-temporal calcium dynamics in 3D, efficient non-spatial cell models, and both idealised and realistic tissue models. A phenomenological approach was implemented to reproduce SCRE morphology and variability in the efficient cell models, comprising the definition of analytical Spontaneous Release Functions (SRF) whose parameters may be randomly sampled from appropriate distributions in order to match either the 3D cell models or experimental data. Pro-arrhythmogenic pacing protocols were applied to initiate re-entry and promote calcium overload, leading to the emergence of SCRE. The SRF accurately reproduced the dynamics of SCRE and its dependence on environment variables under multiple different conditions. Sustained re-entrant excitation promoted calcium overload, and led to the emergence of focal excitations after termination. A purely functional mechanism of re-entry and focal activity localisation was demonstrated, related to the unexcited spiral wave core. In conclusion, a novel approach has been developed to dynamically model SCRE at the tissue scale, which facilitates novel, detailed multi-scale mechanistic analysis. It was revealed that complex re-entrant excitation patterns and SCRE may be bi-directionally coupled, promoting novel mechanisms of arrhythmia perpetuation.
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Affiliation(s)
- Michael A. Colman
- School of Biomedical Sciences, University of Leeds, Leeds, United Kingdom
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11
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Connolly A, Kelly A, Campos FO, Myles R, Smith G, Bishop MJ. Ventricular Endocardial Tissue Geometry Affects Stimulus Threshold and Effective Refractory Period. Biophys J 2018; 115:2486-2498. [PMID: 30503533 PMCID: PMC6301915 DOI: 10.1016/j.bpj.2018.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 10/15/2018] [Accepted: 11/05/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Understanding the biophysical processes by which electrical stimuli applied to cardiac tissue may result in local activation is important in both the experimental and clinical electrophysiology laboratory environments, as well as for gaining a more in-depth knowledge of the mechanisms of focal-trigger-induced arrhythmias. Previous computational models have predicted that local myocardial tissue architecture alone may significantly modulate tissue excitability, affecting both the local stimulus current required to excite the tissue and the local effective refractory period (ERP). In this work, we present experimental validation of this structural modulation of local tissue excitability on the endocardial tissue surface, use computational models to provide mechanistic understanding of this phenomena in relation to localized changes in electrotonic loading, and demonstrate its implications for the capture of afterdepolarizations. METHODS AND RESULTS Experiments on rabbit ventricular wedge preparations showed that endocardial ridges (surfaces of negative mean curvature) had a stimulus capture threshold that was 0.21 ± 0.03 V less than endocardial grooves (surfaces of positive mean curvature) for pairwise comparison (24% reduction, corresponding to 56.2 ± 6.4% of the energy). When stimulated at the minimal stimulus strength for capture, ridge locations showed a shorter ERP than grooves (n = 6, mean pairwise difference 7.4 ± 4.2 ms). When each site was stimulated with identical-strength stimuli, the difference in ERP was further increased (mean pairwise difference 15.8 ± 5.3 ms). Computational bidomain models of highly idealized cylindrical endocardial structures qualitatively agreed with these findings, showing that such changes in excitability are driven by structural modulation in electrotonic loading, quantifying this relationship as a function of surface curvature. Simulations further showed that capture of delayed afterdepolarizations was more likely in trabecular ridges than grooves, driven by this difference in loading. CONCLUSIONS We have demonstrated experimentally and explained mechanistically in computer simulations that the ability to capture tissue on the endocardial surface depends upon the local tissue architecture. These findings have important implications for deepening our understanding of excitability differences related to anatomical structure during stimulus application that may have important applications in the translation of novel experimental optogenetics pacing strategies. The uncovered preferential vulnerability to capture of afterdepolarizations of endocardial ridges, compared to grooves, provides important insight for understanding the mechanisms of focal-trigger-induced arrhythmias.
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Affiliation(s)
- Adam Connolly
- Department of Bioengineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Allen Kelly
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Fernando O Campos
- Department of Bioengineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Rachel Myles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Godfrey Smith
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Martin J Bishop
- Department of Bioengineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.
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12
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Henry AD, MacQuaide N, Burton FL, Rankin AC, Rowan EG, Drummond RM. Spontaneous Ca 2+ transients in rat pulmonary vein cardiomyocytes are increased in frequency and become more synchronous following electrical stimulation. Cell Calcium 2018; 76:36-47. [PMID: 30253263 DOI: 10.1016/j.ceca.2018.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 08/09/2018] [Accepted: 09/02/2018] [Indexed: 12/13/2022]
Abstract
The pulmonary veins have an external sleeve of cardiomyocytes that are a widely recognised source of ectopic electrical activity that can lead to atrial fibrillation. Although the mechanisms behind this activity are currently unknown, changes in intracellular calcium (Ca2+) signalling are purported to play a role. Therefore, the intracellular Ca2+ concentration was monitored in the pulmonary vein using fluo-4 and epifluorescence microscopy. Electrical field stimulation evoked a synchronous rise in Ca2+ in neighbouring cardiomyocytes; asynchronous spontaneous Ca2+ transients between electrical stimuli were also present. Immediately following termination of electrical field stimulation at 3 Hz or greater, the frequency of the spontaneous Ca2+ transients was increased from 0.45 ± 0.06 Hz under basal conditions to between 0.59 ± 0.05 and 0.65 ± 0.06 Hz (P < 0.001). Increasing the extracellular Ca2+ concentration enhanced this effect, with the frequency of spontaneous Ca2+ transients increasing from 0.45 ± 0.05 Hz to between 0.75 ± 0.06 and 0.94 ± 0.09 Hz after electrical stimulation at 3 to 9 Hz (P < 0.001), and this was accompanied by a significant increase in the velocity of Ca2+ transients that manifested as waves. Moreover, in the presence of high extracellular Ca2+, the spontaneous Ca2+ transients occurred more synchronously in the initial few seconds following electrical stimulation. The ryanodine receptors, which are the source of spontaneous Ca2+ transients in pulmonary vein cardiomyocytes, were found to be arranged in a striated pattern in the cell interior, as well as along the periphery of cell. Furthermore, labelling the sarcolemma with di-4-ANEPPS showed that over 90% of pulmonary vein cardiomyocytes possessed T-tubules. These findings demonstrate that the frequency of spontaneous Ca2+ transients in the rat pulmonary vein are increased following higher rates of electrical stimulation and increasing the extracellular Ca2+ concentration.
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Affiliation(s)
- Alasdair D Henry
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - N MacQuaide
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - F L Burton
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - A C Rankin
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - E G Rowan
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - R M Drummond
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.
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13
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Slabaugh JL, Brunello L, Elnakish MT, Milani-Nejad N, Gyorke S, Janssen PML. Synchronization of Intracellular Ca 2+ Release in Multicellular Cardiac Preparations. Front Physiol 2018; 9:968. [PMID: 30079034 PMCID: PMC6062622 DOI: 10.3389/fphys.2018.00968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/02/2018] [Indexed: 11/25/2022] Open
Abstract
In myocardial tissue, Ca2+ release from the sarcoplasmic reticulum (SR) that occurs via the ryanodine receptor (RyR2) channel complex. Ca2+ release through RyR2 can be either stimulated by an action potential (AP) or spontaneous. The latter is often associated with triggered afterdepolarizations, which in turn may lead to sustained arrhythmias. It is believed that some synchronization mechanism exists for afterdepolarizations and APs in neighboring myocytes, possibly a similarly timed recovery of RyR2 from refractoriness, which enables RyR2s to reach the threshold for spontaneous Ca2+ release simultaneously. To investigate this synchronization mechanism in absence of genetic factors that predispose arrhythmia, we examined the generation of triggered activity in multicellular cardiac preparations. In myocardial trabeculae from the rat, we demonstrated that in the presence of both isoproterenol and caffeine, neighboring myocytes within the cardiac trabeculae were able to synchronize their diastolic spontaneous SR Ca2+ release. Using confocal Ca2+ imaging, we could visualize Ca2+ waves in the multicellular preparation, while these waves were not always present in every myocyte within the trabeculae, we observed that, over time, the Ca2+ waves can synchronize in multiple myocytes. This synchronized activity was sufficiently strong that it could trigger a synchronized, propagated contraction in the whole trabecula encompassing even previously quiescent myocytes. The detection of Ca2+ dynamics in individual myocytes in their in situ setting at the multicellular level exposed a synchronization mechanism that could induce local triggered activity in the heart in the absence of global Ca2+ dysregulation.
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Affiliation(s)
- Jessica L Slabaugh
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH, United States.,Davis Heart Lung Research Institute, The Ohio State University, Columbus, OH, United States
| | - Lucia Brunello
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH, United States.,Davis Heart Lung Research Institute, The Ohio State University, Columbus, OH, United States
| | - Mohammad T Elnakish
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH, United States.,Davis Heart Lung Research Institute, The Ohio State University, Columbus, OH, United States.,Department of Pharmacology and Toxicology, Faculty of Pharmacy, Helwan University, Cairo, Egypt
| | - Nima Milani-Nejad
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH, United States.,Davis Heart Lung Research Institute, The Ohio State University, Columbus, OH, United States
| | - Sandor Gyorke
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH, United States.,Davis Heart Lung Research Institute, The Ohio State University, Columbus, OH, United States
| | - Paul M L Janssen
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH, United States.,Davis Heart Lung Research Institute, The Ohio State University, Columbus, OH, United States
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14
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Jones JS, Small DM, Nishimura N. In Vivo Calcium Imaging of Cardiomyocytes in the Beating Mouse Heart With Multiphoton Microscopy. Front Physiol 2018; 9:969. [PMID: 30108510 PMCID: PMC6079295 DOI: 10.3389/fphys.2018.00969] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 07/02/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Understanding the microscopic dynamics of the beating heart has been challenging due to the technical nature of imaging with micrometer resolution while the heart moves. The development of multiphoton microscopy has made in vivo, cell-resolved measurements of calcium dynamics and vascular function possible in motionless organs such as the brain. In heart, however, studies of in vivo interactions between cells and the native microenvironment are behind other organ systems. Our goal was to develop methods for intravital imaging of cardiac structural and calcium dynamics with microscopic resolution. Methods: Ventilated mice expressing GCaMP6f, a genetically encoded calcium indicator, received a thoracotomy to provide optical access to the heart. Vasculature was labeled with an injection of dextran-labeled dye. The heart was partially stabilized by a titanium probe with a glass window. Images were acquired at 30 frames per second with spontaneous heartbeat and continuously running, ventilated breathing. The data were reconstructed into three-dimensional volumes showing tissue structure, vasculature, and GCaMP6f signal in cardiomyocytes as a function of both the cardiac and respiratory cycle. Results: We demonstrated the capability to simultaneously measure calcium transients, vessel size, and tissue displacement in three dimensions with micrometer resolution. Reconstruction at various combinations of cardiac and respiratory phase enabled measurement of regional and single-cell cardiomyocyte calcium transients (GCaMP6f fluorescence). GCaMP6f fluorescence transients in individual, aberrantly firing cardiomyocytes were also quantified. Comparisons of calcium dynamics (rise-time and tau) at varying positions within the ventricle wall showed no significant depth dependence. Conclusion: This method enables studies of coupling between contraction and excitation during physiological blood perfusion and breathing at high spatiotemporal resolution. These capabilities could lead to a new understanding of normal and disease function of cardiac cells.
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Affiliation(s)
- Jason S Jones
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States
| | - David M Small
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States
| | - Nozomi Nishimura
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States
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15
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Ford KL, Moorhouse EL, Bortolozzi M, Richards MA, Swietach P, Vaughan-Jones RD. Regional acidosis locally inhibits but remotely stimulates Ca2+ waves in ventricular myocytes. Cardiovasc Res 2018; 113:984-995. [PMID: 28339694 PMCID: PMC5852542 DOI: 10.1093/cvr/cvx033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 02/17/2017] [Indexed: 11/30/2022] Open
Abstract
Aims Spontaneous Ca2+ waves in cardiomyocytes are potentially arrhythmogenic. A
powerful controller of Ca2+ waves is the cytoplasmic H+
concentration ([H+]i), which fluctuates spatially and temporally
in conditions such as myocardial ischaemia/reperfusion. H+-control of
Ca2+ waves is poorly understood. We have therefore investigated how
[H+]i co-ordinates their initiation and frequency. Methods and results Spontaneous Ca2+ waves were imaged (fluo-3) in rat isolated ventricular
myocytes, subjected to modest Ca2+-overload. Whole-cell intracellular
acidosis (induced by acetate-superfusion) stimulated wave frequency. Pharmacologically
blocking sarcolemmal Na+/H+ exchange (NHE1) prevented this
stimulation, unveiling inhibition by H+. Acidosis also increased
Ca2+ wave velocity. Restricting acidosis to one end of a myocyte, using a
microfluidic device, inhibited Ca2+ waves in the acidic zone (consistent with
ryanodine receptor inhibition), but stimulated wave emergence elsewhere in the cell.
This remote stimulation was absent when NHE1 was selectively inhibited in the acidic
zone. Remote stimulation depended on a locally evoked, NHE1-driven rise of
[Na+]i that spread rapidly downstream. Conclusion Acidosis influences Ca2+ waves via inhibitory Hi+ and stimulatory Nai+ signals (the latter facilitating intracellular
Ca2+-loading through modulation of sarcolemmal
Na+/Ca2+ exchange activity). During spatial
[H+]i-heterogeneity, Hi+-inhibition dominates in acidic regions, while rapid
Nai+ diffusion stimulates waves in downstream, non-acidic
regions. Local acidosis thus simultaneously inhibits and stimulates arrhythmogenic
Ca2+-signalling in the same myocyte. If the principle of remote
H+-stimulation of Ca2+ waves also applies in multicellular
myocardium, it raises the possibility of electrical disturbances being driven remotely
by adjacent ischaemic areas, which are known to be intensely acidic.
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Affiliation(s)
- Kerrie L Ford
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, Oxford, OX1 3PT, UK
| | - Emma L Moorhouse
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, Oxford, OX1 3PT, UK
| | - Mario Bortolozzi
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, Oxford, OX1 3PT, UK.,Department of Physics and Astronomy "G. Galilei", University of Padua, 35121 Padua, Italy
| | - Mark A Richards
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, Oxford, OX1 3PT, UK
| | - Pawel Swietach
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, Oxford, OX1 3PT, UK
| | - Richard D Vaughan-Jones
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, Oxford, OX1 3PT, UK
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16
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Walker MA, Gurev V, Rice JJ, Greenstein JL, Winslow RL. Estimating the probabilities of rare arrhythmic events in multiscale computational models of cardiac cells and tissue. PLoS Comput Biol 2017; 13:e1005783. [PMID: 29145393 PMCID: PMC5689829 DOI: 10.1371/journal.pcbi.1005783] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 09/18/2017] [Indexed: 11/24/2022] Open
Abstract
Ectopic heartbeats can trigger reentrant arrhythmias, leading to ventricular fibrillation and sudden cardiac death. Such events have been attributed to perturbed Ca2+ handling in cardiac myocytes leading to spontaneous Ca2+ release and delayed afterdepolarizations (DADs). However, the ways in which perturbation of specific molecular mechanisms alters the probability of ectopic beats is not understood. We present a multiscale model of cardiac tissue incorporating a biophysically detailed three-dimensional model of the ventricular myocyte. This model reproduces realistic Ca2+ waves and DADs driven by stochastic Ca2+ release channel (RyR) gating and is used to study mechanisms of DAD variability. In agreement with previous experimental and modeling studies, key factors influencing the distribution of DAD amplitude and timing include cytosolic and sarcoplasmic reticulum Ca2+ concentrations, inwardly rectifying potassium current (IK1) density, and gap junction conductance. The cardiac tissue model is used to investigate how random RyR gating gives rise to probabilistic triggered activity in a one-dimensional myocyte tissue model. A novel spatial-average filtering method for estimating the probability of extreme (i.e. rare, high-amplitude) stochastic events from a limited set of spontaneous Ca2+ release profiles is presented. These events occur when randomly organized clusters of cells exhibit synchronized, high amplitude Ca2+ release flux. It is shown how reduced IK1 density and gap junction coupling, as observed in heart failure, increase the probability of extreme DADs by multiple orders of magnitude. This method enables prediction of arrhythmia likelihood and its modulation by alterations of other cellular mechanisms.
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Affiliation(s)
- Mark A. Walker
- Department of Biomedical Engineering and Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States of America
| | - Viatcheslav Gurev
- TJ Watson Research Center, IBM, Yorktown Heights, NY, United States of America
| | - John J. Rice
- TJ Watson Research Center, IBM, Yorktown Heights, NY, United States of America
| | - Joseph L. Greenstein
- Department of Biomedical Engineering and Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States of America
| | - Raimond L. Winslow
- Department of Biomedical Engineering and Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States of America
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17
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Lang D, Sato D, Jiang Y, Ginsburg KS, Ripplinger CM, Bers DM. Calcium-Dependent Arrhythmogenic Foci Created by Weakly Coupled Myocytes in the Failing Heart. Circ Res 2017; 121:1379-1391. [PMID: 28970285 DOI: 10.1161/circresaha.117.312050] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 09/26/2017] [Accepted: 09/29/2017] [Indexed: 12/23/2022]
Abstract
RATIONALE Intercellular uncoupling and Ca2+ (Ca) mishandling can initiate triggered ventricular arrhythmias. Spontaneous Ca release activates inward current which depolarizes membrane potential (Vm) and can trigger action potentials in isolated myocytes. However, cell-cell coupling in intact hearts limits local depolarization and may protect hearts from this arrhythmogenic mechanism. Traditional optical mapping lacks the spatial resolution to assess coupling of individual myocytes. OBJECTIVE We investigate local intercellular coupling in Ca-induced depolarization in intact hearts, using confocal microscopy to measure local Vm and intracellular [Ca] simultaneously. METHODS AND RESULTS We used isolated Langendorff-perfused hearts from control (CTL) and heart failure (HF) mice (HF induced by transaortic constriction). In CTL hearts, 1.4% of myocytes were poorly synchronized with neighboring cells and exhibited asynchronous (AS) Ca transients. These AS myocytes were much more frequent in HF (10.8% of myocytes, P<0.05 versus CTL). Local Ca waves depolarized Vm in HF but not CTL hearts, suggesting weaker gap junction coupling in HF-AS versus CTL-AS myocytes. Cell-cell coupling was assessed by calcein fluorescence recovery after photobleach during intracellular [Ca] recording. All regions in CTL hearts exhibited faster calcein diffusion than in HF, with HF-AS myocyte being slowest. In HF-AS, enhancing gap junction conductance (with rotigaptide) increased coupling and suppressed Vm depolarization during Ca waves. Conversely, in CTL hearts, gap junction inhibition (carbenoxolone) decreased coupling and allowed Ca wave-induced depolarizations. Synchronization of Ca wave initiation and triggered action potentials were observed in HF hearts and computational models. CONCLUSIONS Well-coupled CTL myocytes are effectively voltage-clamped during Ca waves, protecting the heart from triggered arrhythmias. Spontaneous Ca waves are much more common in HF myocytes and these AS myocytes are also poorly coupled, enabling local Ca-induced inward current of sufficient source strength to overcome a weakened current sink to depolarize Vm and trigger action potentials.
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Affiliation(s)
- Di Lang
- From the Department of Pharmacology, University of California, Davis
| | - Daisuke Sato
- From the Department of Pharmacology, University of California, Davis
| | - Yanyan Jiang
- From the Department of Pharmacology, University of California, Davis
| | | | | | - Donald M Bers
- From the Department of Pharmacology, University of California, Davis.
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18
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Wilson D, Ermentrout B, Němec J, Salama G. A model of cardiac ryanodine receptor gating predicts experimental Ca 2+-dynamics and Ca 2+-triggered arrhythmia in the long QT syndrome. CHAOS (WOODBURY, N.Y.) 2017; 27:093940. [PMID: 28964110 DOI: 10.1063/1.5000711] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Abnormal Ca2+ handling is well-established as the trigger of cardiac arrhythmia in catecholaminergic polymorphic ventricular tachycardia and digoxin toxicity, but its role remains controversial in Torsade de Pointes (TdP), the arrhythmia associated with the long QT syndrome (LQTS). Recent experimental results show that early afterdepolarizations (EADs) that initiate TdP are caused by spontaneous (non-voltage-triggered) Ca2+ release from Ca2+-overloaded sarcoplasmic reticulum (SR) rather than the activation of the L-type Ca2+-channel window current. In bradycardia and long QT type 2 (LQT2), a second, non-voltage triggered cytosolic Ca2+ elevation increases gradually in amplitude, occurs before overt voltage instability, and then precedes the rise of EADs. Here, we used a modified Shannon-Puglisi-Bers model of rabbit ventricular myocytes to reproduce experimental Ca2+ dynamics in bradycardia and LQT2. Abnormal systolic Ca2+-oscillations and EADs caused by SR Ca2+-release are reproduced in a modified 0-dimensional model, where 3 gates in series control the ryanodine receptor (RyR2) conductance. Two gates control RyR2 activation and inactivation and sense cytosolic Ca2+ while a third gate senses luminal junctional SR Ca2+. The model predicts EADs in bradycardia and low extracellular [K+] and cessation of SR Ca2+-release terminate salvos of EADs. Ca2+-waves, systolic cell-synchronous Ca2+-release, and multifocal diastolic Ca2+ release seen in subcellular Ca2+-mapping experiments are observed in the 2-dimensional version of the model. These results support the role of SR Ca2+-overload, abnormal SR Ca2+-release, and the subsequent activation of the electrogenic Na+/Ca2+-exchanger as the mechanism of TdP. The model offers new insights into the genesis of cardiac arrhythmia and new therapeutic strategies.
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Affiliation(s)
- Dan Wilson
- Department of Mathematics, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA
| | - Bard Ermentrout
- Department of Mathematics, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA
| | - Jan Němec
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA
| | - Guy Salama
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA
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19
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Campos FO, Shiferaw Y, Vigmond EJ, Plank G. Stochastic spontaneous calcium release events and sodium channelopathies promote ventricular arrhythmias. CHAOS (WOODBURY, N.Y.) 2017; 27:093910. [PMID: 28964108 PMCID: PMC5568869 DOI: 10.1063/1.4999612] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Premature ventricular complexes (PVCs), the first initiating beats of a variety of cardiac arrhythmias, have been associated with spontaneous calcium release (SCR) events at the cell level. However, the mechanisms underlying the degeneration of such PVCs into arrhythmias are not fully understood. The objective of this study was to investigate the conditions under which SCR-mediated PVCs can lead to ventricular arrhythmias. In particular, we sought to determine whether sodium (Na+) current loss-of-function in the structurally normal ventricles provides a substrate for unidirectional conduction block and reentry initiated by SCR-mediated PVCs. To achieve this goal, a stochastic model of SCR was incorporated into an anatomically accurate compute model of the rabbit ventricles with the His-Purkinje system (HPS). Simulations with reduced Na+ current due to a negative-shift in the steady-state channel inactivation showed that SCR-mediated delayed afterdepolarizations led to PVC formation in the HPS, where the electrotonic load was lower, conduction block, and reentry in the 3D myocardium. Moreover, arrhythmia initiation was only possible when intrinsic electrophysiological heterogeneity in action potential within the ventricles was present. In conclusion, while benign in healthy individuals SCR-mediated PVCs can lead to life-threatening ventricular arrhythmias when combined with Na+ channelopathies.
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Affiliation(s)
- Fernando O Campos
- Department of Congenital Heart Diseases and Pediatric Cardiology, German Heart Institute Berlin, Berlin, Germany
| | - Yohannes Shiferaw
- Department of Physics, California State University, Northridge, California 91330, USA
| | | | - Gernot Plank
- Institute of Biophysics, Medical University of Graz, Graz, Austria
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20
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Györke S, Belevych AE, Liu B, Kubasov IV, Carnes CA, Radwański PB. The role of luminal Ca regulation in Ca signaling refractoriness and cardiac arrhythmogenesis. J Gen Physiol 2017; 149:877-888. [PMID: 28798279 PMCID: PMC5583712 DOI: 10.1085/jgp.201711808] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 06/19/2017] [Accepted: 07/12/2017] [Indexed: 01/05/2023] Open
Abstract
Györke et al. discuss the role of sarcoplasmic reticulum Ca2+ in cardiac refractoriness and pathological implications.
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Affiliation(s)
- Sándor Györke
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, OH .,Davis Heart and Lung Research Institute, Columbus, OH
| | - Andriy E Belevych
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, OH.,Davis Heart and Lung Research Institute, Columbus, OH
| | - Bin Liu
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, OH.,Davis Heart and Lung Research Institute, Columbus, OH
| | - Igor V Kubasov
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, St. Petersburg, Russia
| | - Cynthia A Carnes
- College of Pharmacy, The Ohio State University, Columbus, OH.,Davis Heart and Lung Research Institute, Columbus, OH
| | - Przemysław B Radwański
- College of Pharmacy, The Ohio State University, Columbus, OH.,Davis Heart and Lung Research Institute, Columbus, OH
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21
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Ko CY, Liu MB, Song Z, Qu Z, Weiss JN. Multiscale Determinants of Delayed Afterdepolarization Amplitude in Cardiac Tissue. Biophys J 2017; 112:1949-1961. [PMID: 28494965 DOI: 10.1016/j.bpj.2017.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 03/02/2017] [Accepted: 03/06/2017] [Indexed: 11/17/2022] Open
Abstract
Spontaneous calcium (Ca) waves in cardiac myocytes underlie delayed afterdepolarizations (DADs) that trigger cardiac arrhythmias. How these subcellular/cellular events overcome source-sink factors in cardiac tissue to generate DADs of sufficient amplitude to trigger action potentials is not fully understood. Here, we evaluate quantitatively how factors at the subcellular scale (number of Ca wave initiation sites), cellular scale (sarcoplasmic reticulum (SR) Ca load), and tissue scale (synchrony of Ca release in populations of myocytes) determine DAD features in cardiac tissue using a combined experimental and computational modeling approach. Isolated patch-clamped rabbit ventricular myocytes loaded with Fluo-4 to image intracellular Ca were rapidly paced during exposure to elevated extracellular Ca (2.7 mmol/L) and isoproterenol (0.25 μmol/L) to induce diastolic Ca waves and subthreshold DADs. As the number of paced beats increased from 1 to 5, SR Ca content (assessed with caffeine pulses) increased, the number of Ca wave initiation sites increased, integrated Ca transients and DADs became larger and shorter in duration, and the latency period to the onset of Ca waves shortened with reduced variance. In silico analysis using a computer model of ventricular tissue incorporating these experimental measurements revealed that whereas all of these factors promoted larger DADs with higher probability of generating triggered activity, the latency period variance and SR Ca load had the greatest influences. Therefore, incorporating quantitative experimental data into tissue level simulations reveals that increased intracellular Ca promotes DAD-mediated triggered activity in tissue predominantly by increasing both the synchrony (decreasing latency variance) of Ca waves in nearby myocytes and SR Ca load, whereas the number of Ca wave initiation sites per myocyte is less important.
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Affiliation(s)
- Christopher Y Ko
- Division of Cardiology, Department of Medicine, UCLA Cardiovascular Research Laboratory, University of California, Los Angeles, California
| | - Michael B Liu
- Division of Cardiology, Department of Medicine, UCLA Cardiovascular Research Laboratory, University of California, Los Angeles, California
| | - Zhen Song
- Division of Cardiology, Department of Medicine, UCLA Cardiovascular Research Laboratory, University of California, Los Angeles, California
| | - Zhilin Qu
- Division of Cardiology, Department of Medicine, UCLA Cardiovascular Research Laboratory, University of California, Los Angeles, California; Department of Biomathematics, David Geffen School of Medicine, University of California, Los Angeles, California
| | - James N Weiss
- Division of Cardiology, Department of Medicine, UCLA Cardiovascular Research Laboratory, University of California, Los Angeles, California; Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, California.
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Stochastic initiation and termination of calcium-mediated triggered activity in cardiac myocytes. Proc Natl Acad Sci U S A 2017; 114:E270-E279. [PMID: 28049836 DOI: 10.1073/pnas.1614051114] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Cardiac myocytes normally initiate action potentials in response to a current stimulus that depolarizes the membrane above an excitation threshold. Aberrant excitation can also occur due to spontaneous calcium (Ca2+) release (SCR) from intracellular stores after the end of a preceding action potential. SCR drives the Na+/Ca2+ exchange current inducing a "delayed afterdepolarization" that can in turn trigger an action potential if the excitation threshold is reached. This "triggered activity" is known to cause arrhythmias, but how it is initiated and terminated is not understood. Using computer simulations of a ventricular myocyte model, we show that initiation and termination are inherently random events. We determine the probability of those events from statistical measurements of the number of beats before initiation and before termination, respectively, which follow geometric distributions. Moreover, we elucidate the origin of randomness by a statistical analysis of SCR events, which do not follow a Poisson process observed in other eukaryotic cells. Due to synchronization of Ca2+ releases during the action potential upstroke, waiting times of SCR events after the upstroke are narrowly distributed, whereas SCR amplitudes follow a broad normal distribution with a width determined by fluctuations in the number of independent Ca2+ wave foci. This distribution enables us to compute the probabilities of initiation and termination of bursts of triggered activity that are maintained by a positive feedback between the action potential upstroke and SCR. Our results establish a theoretical framework for interpreting complex and varied manifestations of triggered activity relevant to cardiac arrhythmias.
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Arora R, Aistrup GL, Supple S, Frank C, Singh J, Tai S, Zhao A, Chicos L, Marszalec W, Guo A, Song LS, Wasserstrom JA. Regional distribution of T-tubule density in left and right atria in dogs. Heart Rhythm 2016; 14:273-281. [PMID: 27670628 DOI: 10.1016/j.hrthm.2016.09.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The peculiarities of transverse tubule (T-tubule) morphology and distribution in the atrium-and how they contribute to excitation-contraction coupling-are just beginning to be understood. OBJECTIVES The objectives of this study were to determine T-tubule density in the intact, live right and left atria in a large animal and to determine intraregional differences in T-tubule organization within each atrium. METHODS Using confocal microscopy, T-tubules were imaged in both atria in intact, Langendorf-perfused normal dog hearts loaded with di-4-ANEPPS. T-tubules were imaged in large populations of myocytes from the endocardial surface of each atrium. Computerized data analysis was performed using a new MatLab (Mathworks, Natick, MA) routine, AutoTT. RESULTS There was a large percentage of myocytes that had no T-tubules in both atria with a higher percentage in the right atrium (25.1%) than in the left atrium (12.5%) (P < .02). The density of transverse and longitudinal T-tubule elements was low in cells that did contain T-tubules, but there were no significant differences in density between the left atrial appendage, the pulmonary vein-posterior left atrium, the right atrial appendage, and the right atrial free wall. In contrast, there were significant differences in sarcomere spacing and cell width between different regions of the atria. CONCLUSION There is a sparse T-tubule network in atrial myocytes throughout both dog atria, with significant numbers of myocytes in both atria-the right atrium more so than the left atrium-having no T-tubules at all. These regional differences in T-tubule distribution, along with differences in cell width and sarcomere spacing, may have implications for the emergence of substrate for atrial fibrillation.
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Affiliation(s)
- Rishi Arora
- Division of Cardiology, Department of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois,.
| | - Gary L Aistrup
- Division of Cardiology, Department of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Stephen Supple
- Division of Cardiology, Department of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Caleb Frank
- Division of Cardiology, Department of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jasleen Singh
- Division of Cardiology, Department of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Shannon Tai
- Division of Cardiology, Department of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anne Zhao
- Division of Cardiology, Department of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Laura Chicos
- Division of Cardiology, Department of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - William Marszalec
- Division of Cardiology, Department of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ang Guo
- Division of Cardiology, University of Iowa School of Medicine, Iowa City, Iowa
| | - Long-Sheng Song
- Division of Cardiology, University of Iowa School of Medicine, Iowa City, Iowa
| | - J Andrew Wasserstrom
- Division of Cardiology, Department of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Pueyo E, Orini M, Rodríguez JF, Taggart P. Interactive effect of beta-adrenergic stimulation and mechanical stretch on low-frequency oscillations of ventricular action potential duration in humans. J Mol Cell Cardiol 2016; 97:93-105. [DOI: 10.1016/j.yjmcc.2016.05.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/21/2016] [Accepted: 05/03/2016] [Indexed: 01/27/2023]
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Song Z, Ko CY, Nivala M, Weiss JN, Qu Z. Calcium-voltage coupling in the genesis of early and delayed afterdepolarizations in cardiac myocytes. Biophys J 2016; 108:1908-21. [PMID: 25902431 DOI: 10.1016/j.bpj.2015.03.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 03/04/2015] [Accepted: 03/10/2015] [Indexed: 02/01/2023] Open
Abstract
Early afterdepolarizations (EADs) and delayed afterdepolarizations (DADs) are voltage oscillations known to cause cardiac arrhythmias. EADs are mainly driven by voltage oscillations in the repolarizing phase of the action potential (AP), while DADs are driven by spontaneous calcium (Ca) release during diastole. Because voltage and Ca are bidirectionally coupled, they modulate each other's behaviors, and new AP and Ca cycling dynamics can emerge from this coupling. In this study, we performed computer simulations using an AP model with detailed spatiotemporal Ca cycling incorporating stochastic openings of Ca channels and ryanodine receptors to investigate the effects of Ca-voltage coupling on EAD and DAD dynamics. Simulations were complemented by experiments in mouse ventricular myocytes. We show that: 1) alteration of the Ca transient due to increased ryanodine receptor leakiness and/or sarco/endoplasmic reticulum Ca ATPase activity can either promote or suppress EADs due to the complex effects of Ca on ionic current properties; 2) spontaneous Ca waves also exhibit complex effects on EADs, but cannot induce EADs of significant amplitude without the participation of ICa,L; 3) lengthening AP duration and the occurrence of EADs promote DADs by increasing intracellular Ca loading, and two mechanisms of DADs are identified, i.e., Ca-wave-dependent and Ca-wave-independent; and 4) Ca-voltage coupling promotes complex EAD patterns such as EAD alternans that are not observed for solely voltage-driven EADs. In conclusion, Ca-voltage coupling combined with the nonlinear dynamical behaviors of voltage and Ca cycling play a key role in generating complex EAD and DAD dynamics observed experimentally in cardiac myocytes, whose mechanisms are complex but analyzable.
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Affiliation(s)
- Zhen Song
- Cardiovascular Research Laboratory, University of California, Los Angeles, California; Department of Medicine (Cardiology), University of California, Los Angeles, California
| | - Christopher Y Ko
- Cardiovascular Research Laboratory, University of California, Los Angeles, California; Department of Medicine (Cardiology), University of California, Los Angeles, California
| | - Michael Nivala
- Cardiovascular Research Laboratory, University of California, Los Angeles, California; Department of Medicine (Cardiology), University of California, Los Angeles, California
| | - James N Weiss
- Cardiovascular Research Laboratory, University of California, Los Angeles, California; Department of Medicine (Cardiology), University of California, Los Angeles, California; Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Zhilin Qu
- Cardiovascular Research Laboratory, University of California, Los Angeles, California; Department of Medicine (Cardiology), University of California, Los Angeles, California.
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Němec J, Kim JJ, Salama G. The link between abnormal calcium handling and electrical instability in acquired long QT syndrome--Does calcium precipitate arrhythmic storms? PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2015; 120:210-21. [PMID: 26631594 DOI: 10.1016/j.pbiomolbio.2015.11.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/17/2015] [Accepted: 11/19/2015] [Indexed: 12/19/2022]
Abstract
Release of Ca(2+) ions from sarcoplasmic reticulum (SR) into myocyte cytoplasm and their binding to troponin C is the final signal form myocardial contraction. Synchronous contraction of ventricular myocytes is necessary for efficient cardiac pumping function. This requires both shuttling of Ca(2+) between SR and cytoplasm in individual myocytes, and organ-level synchronization of this process by means of electrical coupling among ventricular myocytes. Abnormal Ca(2+) release from SR causes arrhythmias in the setting of CPVT (catecholaminergic polymorphic ventricular tachycardia) and digoxin toxicity. Recent optical mapping data indicate that abnormal Ca(2+) handling causes arrhythmias in models of both repolarization impairment and profound bradycardia. The mechanisms involve dynamic spatial heterogeneity of myocardial Ca(2+) handling preceding arrhythmia onset, cell-synchronous systolic secondary Ca(2+) elevation (SSCE), as well as more complex abnormalities of intracellular Ca(2+) handling detected by subcellular optical mapping in Langendorff-perfused hearts. The regional heterogeneities in Ca(2+) handling cause action potential (AP) heterogeneities through sodium-calcium exchange (NCX) activation and eventually overwhelm electrical coupling of the tissue. Divergent Ca(2+) dynamics among different myocardial regions leads to temporal instability of AP duration and - on the patient level - in T wave lability. Although T-wave alternans has been linked to cardiac arrhythmias, non-alternans lability is observed in pre-clinical models of the long QT syndrome (LQTS) and CPVT, and in LQTS patients. Analysis of T wave lability may provide a real-time window on the abnormal Ca(2+) dynamics causing specific arrhythmias such as Torsade de Pointes (TdP).
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Affiliation(s)
- Jan Němec
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Jong J Kim
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Guy Salama
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA 15261, USA.
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Hatano A, Okada JI, Washio T, Hisada T, Sugiura S. An integrated finite element simulation of cardiomyocyte function based on triphasic theory. Front Physiol 2015; 6:287. [PMID: 26539124 PMCID: PMC4611143 DOI: 10.3389/fphys.2015.00287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 09/28/2015] [Indexed: 11/13/2022] Open
Abstract
In numerical simulations of cardiac excitation-contraction coupling, the intracellular potential distribution and mobility of cytosol and ions have been mostly ignored. Although the intracellular potential gradient is small, during depolarization it can be a significant driving force for ion movement, and is comparable to diffusion in terms of net flux. Furthermore, fluid in the t-tubules is thought to advect ions to facilitate their exchange with the extracellular space. We extend our previous finite element model that was based on triphasic theory to examine the significance of these factors in cardiac physiology. Triphasic theory allows us to study the behavior of solids (proteins), fluids (cytosol) and ions governed by mechanics and electrochemistry in detailed subcellular structures, including myofibrils, mitochondria, the sarcoplasmic reticulum, membranes, and t-tubules. Our simulation results predicted an electrical potential gradient inside the t-tubules at the onset of depolarization, which corresponded to the Na(+) channel distribution therein. Ejection and suction of fluid between the t-tubules and the extracellular compartment during isometric contraction were observed. We also examined the influence of t-tubule morphology and mitochondrial location on the electrophysiology and mechanics of the cardiomyocyte. Our results confirm that the t-tubule structure is important for synchrony of Ca(2+) release, and suggest that mitochondria in the sub-sarcolemmal region might serve to cancel Ca(2+) inflow through surface sarcolemma, thereby maintaining the intracellular Ca(2+) environment in equilibrium.
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Affiliation(s)
- Asuka Hatano
- Department of Mechanical Engineering, School of Engineering, The University of Tokyo Tokyo, Japan
| | - Jun-Ichi Okada
- Department of Human and Engineered Environmental Studies, Graduate School of Frontier Sciences, The University of Tokyo Chiba, Japan
| | - Takumi Washio
- Department of Human and Engineered Environmental Studies, Graduate School of Frontier Sciences, The University of Tokyo Chiba, Japan
| | - Toshiaki Hisada
- Department of Human and Engineered Environmental Studies, Graduate School of Frontier Sciences, The University of Tokyo Chiba, Japan
| | - Seiryo Sugiura
- Department of Human and Engineered Environmental Studies, Graduate School of Frontier Sciences, The University of Tokyo Chiba, Japan
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28
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Liu MB, de Lange E, Garfinkel A, Weiss JN, Qu Z. Delayed afterdepolarizations generate both triggers and a vulnerable substrate promoting reentry in cardiac tissue. Heart Rhythm 2015; 12:2115-24. [PMID: 26072025 PMCID: PMC4583816 DOI: 10.1016/j.hrthm.2015.06.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Delayed afterdepolarizations (DADs) have been well characterized as arrhythmia triggers, but their role in generating a tissue substrate vulnerable to reentry is not well understood. OBJECTIVE The purpose of this study was to test the hypothesis that random DADs can self-organize to generate both an arrhythmia trigger and a vulnerable substrate simultaneously in cardiac tissue as a result of gap junction coupling. METHODS Computer simulations in 1-dimensional cable and 2-dimensional tissue models were performed. The cellular DAD amplitude was varied by changing the strength of sarcoplasmic reticulum calcium release. Random DAD latency and amplitude in different cells were simulated using gaussian distributions. RESULTS Depending on the strength of spontaneous sarcoplasmic reticulum calcium release and other conditions, random DADs in cardiac tissue resulted in the following behaviors: (1) triggered activity (TA); (2) a vulnerable tissue substrate causing unidirectional conduction block and reentry by inactivating sodium channels; (3) both triggers and a vulnerable substrate simultaneously by generating TA in regions next to regions with subthreshold DADs susceptible to unidirectional conduction block and reentry. The probability of the latter 2 behaviors was enhanced by reduced sodium channel availability, reduced gap junction coupling, increased tissue heterogeneity, and less synchronous DAD latency. CONCLUSION DADs can self-organize in tissue to generate arrhythmia triggers, a vulnerable tissue substrate, and both simultaneously. Reduced sodium channel availability and gap junction coupling potentiate this mechanism of arrhythmias, which are relevant to a variety of heart disease conditions.
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Affiliation(s)
- Michael B Liu
- UCLA Cardiovascular Research Laboratory; Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California
| | - Enno de Lange
- UCLA Cardiovascular Research Laboratory; Department of Knowledge Engineering, Maastricht University, Maastricht, The Netherlands
| | - Alan Garfinkel
- UCLA Cardiovascular Research Laboratory; Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Integrative Biology and Physiology, University of California, Los Angeles, California
| | - James N Weiss
- UCLA Cardiovascular Research Laboratory; Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Integrative Biology and Physiology, University of California, Los Angeles, California; Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Zhilin Qu
- UCLA Cardiovascular Research Laboratory; Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California.
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29
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Kim JJ, Němec J, Li Q, Salama G. Synchronous systolic subcellular Ca2+-elevations underlie ventricular arrhythmia in drug-induced long QT type 2. Circ Arrhythm Electrophysiol 2015; 8:703-12. [PMID: 25722252 PMCID: PMC4472565 DOI: 10.1161/circep.114.002214] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 02/11/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Repolarization delay is a common clinical problem, which can promote ventricular arrhythmias. In myocytes, abnormal sarcoplasmic reticulum Ca(2+)-release is proposed as the mechanism that causes early afterdepolarizations, the cellular equivalent of ectopic-activity in drug-induced long-QT syndrome. A crucial missing link is how such a stochastic process can overcome the source-sink mismatch to depolarize sufficient ventricular tissue to initiate arrhythmias. METHODS AND RESULTS Optical maps of action potentials and Ca(2+)-transients from Langendorff rabbit hearts were measured at low (150×150 μm(2)/pixel) and high (1.5×1.5 μm(2)/pixel) resolution before and during arrhythmias. Drug-induced long QT type 2, elicited with dofetilide inhibition of IKr (the rapid component of rectifying K+ current), produced spontaneous Ca(2+)-elevations during diastole and systole, before the onset of arrhythmias. Diastolic Ca(2+-)waves appeared randomly, propagated within individual myocytes, were out-of-phase with adjacent myocytes, and often died-out. Systolic secondary Ca(2+-)elevations were synchronous within individual myocytes, appeared 188±30 ms after the action potential-upstroke, occurred during high cytosolic Ca(2+) (40%-60% of peak-Ca(2+)-transients), appeared first in small islands (0.5×0.5 mm(2)) that enlarged and spread throughout the epicardium. Synchronous systolic Ca(2+-)elevations preceded voltage-depolarizations (9.2±5 ms; n=5) and produced pronounced Spatial Heterogeneities of Ca(2+)-transient-durations and action potential-durations. Early afterdepolarizations originating from sites with the steepest gradients of membrane-potential propagated and initiated arrhythmias. Interestingly, more complex subcellular Ca(2+)-dynamics (multiple chaotic Ca(2+)-waves) occurred during arrhythmias. K201, a ryanodine receptor stabilizer, eliminated Ca(2+)-elevations and arrhythmias. CONCLUSIONS The results indicate that systolic and diastolic Ca(2+)-elevations emanate from sarcoplasmic reticulum Ca(2+)-release and systolic Ca(2+)-elevations are synchronous because of high cytosolic and luminal-sarcoplasmic reticulum Ca(2+), which overcomes source-sink mismatch to trigger arrhythmias in intact hearts.
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Affiliation(s)
- Jong J Kim
- From the Department of Bioengineering (J.J.K., G.S.), and Department of Medicine, Heart and Vascular Institute (J.J.K., J.N., Q.L., G.S.), University of Pittsburgh, PA; and Tsinghua University School of Medicine, China (Q.L)
| | - Jan Němec
- From the Department of Bioengineering (J.J.K., G.S.), and Department of Medicine, Heart and Vascular Institute (J.J.K., J.N., Q.L., G.S.), University of Pittsburgh, PA; and Tsinghua University School of Medicine, China (Q.L)
| | - Qiao Li
- From the Department of Bioengineering (J.J.K., G.S.), and Department of Medicine, Heart and Vascular Institute (J.J.K., J.N., Q.L., G.S.), University of Pittsburgh, PA; and Tsinghua University School of Medicine, China (Q.L)
| | - Guy Salama
- From the Department of Bioengineering (J.J.K., G.S.), and Department of Medicine, Heart and Vascular Institute (J.J.K., J.N., Q.L., G.S.), University of Pittsburgh, PA; and Tsinghua University School of Medicine, China (Q.L).
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30
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Campos FO, Shiferaw Y, Prassl AJ, Boyle PM, Vigmond EJ, Plank G. Stochastic spontaneous calcium release events trigger premature ventricular complexes by overcoming electrotonic load. Cardiovasc Res 2015; 107:175-83. [PMID: 25969391 DOI: 10.1093/cvr/cvv149] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 05/07/2015] [Indexed: 12/21/2022] Open
Abstract
AIMS Premature ventricular complexes (PVCs) due to spontaneous calcium (Ca) release (SCR) events at the cell level can precipitate ventricular arrhythmias. However, the mechanistic link between SCRs and PVC formation remains incompletely understood. The aim of this study was to investigate the conditions under which delayed afterdepolarizations resulting from stochastic subcellular SCR events can overcome electrotonic source-sink mismatch, leading to PVC initiation. METHODS AND RESULTS A stochastic subcellular-scale mathematical model of SCR was incorporated in a realistic model of the rabbit ventricles and Purkinje system (PS). Elevated levels of diastolic sarcoplasmic reticulum Ca(2+) (CaSR) were imposed until triggered activity was observed, allowing us to compile statistics on probability, timing, and location of PVCs. At CaSR≥ 1500 µmol/L PVCs originated in the PS. When SCR was incapacitated in the PS, PVCs also emerged in the ventricles, but at a higher CaSR (≥1550 µmol/L) and with longer waiting times. For each model configuration tested, the probability of PVC occurrence increased from 0 to 100% within a well-defined critical CaSR range; this transition was much more abrupt in organ-scale models (∼50 µmol/L CaSR range) than in the tissue strand (∼100 µmol/L) or single-cell (∼450 µmol/L) models. Among PVCs originating in the PS, ∼68% were located near Purkinje-ventricular junctions (<1 mm). CONCLUSION SCR events overcome source-sink mismatch to trigger PVCs at a critical CaSR threshold. Above this threshold, PVCs emerge due to increased probability and reduced variability in timing of SCR events, leading to significant diastolic depolarization. Sites of lower electronic load, such as the PS, are preferential locations for triggering.
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Affiliation(s)
| | - Yohannes Shiferaw
- Department of Physics, California State University, Northridge, CA, USA
| | - Anton J Prassl
- Institute of Biophysics, Medical University of Graz, Graz, Austria
| | - Patrick M Boyle
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Edward J Vigmond
- LIRYC Institute, University of Bordeaux, Bordeaux, France Department of Electrical and Computer Engineering, University of Calgary, Calgary, Canada
| | - Gernot Plank
- Institute of Biophysics, Medical University of Graz, Graz, Austria
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31
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Affiliation(s)
- Bruce B. Lerman
- From the Division of Cardiology, Department of Medicine, Cornell University, Medical Center, New York, NY
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32
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Greene D, Shiferaw Y. Approximate analytical solutions for excitation and propagation in cardiac tissue. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2015; 91:042719. [PMID: 25974539 DOI: 10.1103/physreve.91.042719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Indexed: 06/04/2023]
Abstract
It is well known that a variety of cardiac arrhythmias are initiated by a focal excitation in heart tissue. At the single cell level these currents are typically induced by intracellular processes such as spontaneous calcium release (SCR). However, it is not understood how the size and morphology of these focal excitations are related to the electrophysiological properties of cardiac cells. In this paper a detailed physiologically based ionic model is analyzed by projecting the excitation dynamics to a reduced one-dimensional parameter space. Based on this analysis we show that the inward current required for an excitation to occur is largely dictated by the voltage dependence of the inward rectifier potassium current (I(K1)), and is insensitive to the detailed properties of the sodium current. We derive an analytical expression relating the size of a stimulus and the critical current required to induce a propagating action potential (AP), and argue that this relationship determines the necessary number of cells that must undergo SCR in order to induce ectopic activity in cardiac tissue. Finally, we show that, once a focal excitation begins to propagate, its propagation characteristics, such as the conduction velocity and the critical radius for propagation, are largely determined by the sodium and gap junction currents with a substantially lesser effect due to repolarizing potassium currents. These results reveal the relationship between ion channel properties and important tissue scale processes such as excitation and propagation.
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Affiliation(s)
- D'Artagnan Greene
- Department of Physics and Astronomy, California State University, Northridge, California 91330, USA
| | - Yohannes Shiferaw
- Department of Physics and Astronomy, California State University, Northridge, California 91330, USA
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Perspective: a dynamics-based classification of ventricular arrhythmias. J Mol Cell Cardiol 2015; 82:136-52. [PMID: 25769672 DOI: 10.1016/j.yjmcc.2015.02.017] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 02/05/2015] [Accepted: 02/20/2015] [Indexed: 02/04/2023]
Abstract
Despite key advances in the clinical management of life-threatening ventricular arrhythmias, culminating with the development of implantable cardioverter-defibrillators and catheter ablation techniques, pharmacologic/biologic therapeutics have lagged behind. The fundamental issue is that biological targets are molecular factors. Diseases, however, represent emergent properties at the scale of the organism that result from dynamic interactions between multiple constantly changing molecular factors. For a pharmacologic/biologic therapy to be effective, it must target the dynamic processes that underlie the disease. Here we propose a classification of ventricular arrhythmias that is based on our current understanding of the dynamics occurring at the subcellular, cellular, tissue and organism scales, which cause arrhythmias by simultaneously generating arrhythmia triggers and exacerbating tissue vulnerability. The goal is to create a framework that systematically links these key dynamic factors together with fixed factors (structural and electrophysiological heterogeneity) synergistically promoting electrical dispersion and increased arrhythmia risk to molecular factors that can serve as biological targets. We classify ventricular arrhythmias into three primary dynamic categories related generally to unstable Ca cycling, reduced repolarization, and excess repolarization, respectively. The clinical syndromes, arrhythmia mechanisms, dynamic factors and what is known about their molecular counterparts are discussed. Based on this framework, we propose a computational-experimental strategy for exploring the links between molecular factors, fixed factors and dynamic factors that underlie life-threatening ventricular arrhythmias. The ultimate objective is to facilitate drug development by creating an in silico platform to evaluate and predict comprehensively how molecular interventions affect not only a single targeted arrhythmia, but all primary arrhythmia dynamics categories as well as normal cardiac excitation-contraction coupling.
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Greer-Short A, Poelzing S. Distinguishing between overdrive excited and suppressed ventricular beats in guinea pig ventricular myocardium. Front Physiol 2015; 6:14. [PMID: 25741282 PMCID: PMC4332283 DOI: 10.3389/fphys.2015.00014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/09/2015] [Indexed: 11/13/2022] Open
Abstract
Rapid ventricular pacing rates induces two types of beats following pacing cessation: recovery cycle length (RCL) prolongation (overdrive suppression) and RCL shortening (overdrive excitation). The goals of this study were to compare common experimental protocols for studying triggered activity in whole-heart preparations and differentiate between recovery beats using a new methodology. Post-pacing recovery beat cycle length (RCL) and QRS were normalized to pre-paced R-R and QRS intervals and analyzed using a K-means clustering algorithm. Control hearts only produced suppressed beats: RCL ratio increased with rapid pacing (25 ± 4.0%, n = 10) without changing QRS duration. Rapid pacing during hypercalcemia + hypothermia (5.5 mM and 34°C) produced significantly earlier excited beats (53 ± 14%, n = 5) with wider QRS durations (58 ± 6.3%, n = 5) than suppressed beats. Digoxin + hypothermia (0.75 μM) produced the most excited beats with significantly earlier RCL (44 ± 3.2%, n = 6) and wider QRS (60 ± 3.1%, n = 6) ratios relative to suppressed beats. Increasing pacing further shortened RCL (30 ± 7.8%, n = 6). In a prospective study, TTX (100 nM) increased RCL ratio (15 ± 6.0%, n = 10) without changing the QRS duration of excited beats. The algorithm was compared to a cross-correlation analysis with 93% sensitivity and 94% specificity. This ECG based algorithm distinguishes between triggered and automatic activity.
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Affiliation(s)
- Amara Greer-Short
- Department of Biomedical Engineering and Mechanics, Center for Heart and Regenerative Medicine, Virginia Polytechnic Institute and State University, Virginia Tech Carilion Research Institute Roanoke, VA, USA ; School of Biomedical Engineering and Sciences, Virginia Polytechnic Institute and State University Blacksburg, VA, USA
| | - Steven Poelzing
- Department of Biomedical Engineering and Mechanics, Center for Heart and Regenerative Medicine, Virginia Polytechnic Institute and State University, Virginia Tech Carilion Research Institute Roanoke, VA, USA ; School of Biomedical Engineering and Sciences, Virginia Polytechnic Institute and State University Blacksburg, VA, USA
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Sato D, Bartos DC, Ginsburg KS, Bers DM. Depolarization of cardiac membrane potential synchronizes calcium sparks and waves in tissue. Biophys J 2015; 107:1313-7. [PMID: 25229139 DOI: 10.1016/j.bpj.2014.07.053] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 03/05/2014] [Accepted: 07/15/2014] [Indexed: 10/24/2022] Open
Abstract
The diastolic membrane potential (Vm) can be hyperpolarized or depolarized by various factors such as hyperkalemia or hypokalemia in the long term, or by delayed afterdepolarizations in the short term. In this study, we investigate how Vm affects Ca sparks and waves. We use a physiologically detailed mathematical model to investigate individual factors that affect Ca spark generation and wave propagation. We focus on the voltage range of -90 ∼ -70 mV, which is just below the Vm for sodium channel activation. We find that Vm depolarization promotes Ca wave propagation and hyperpolarization prevents it. This finding is directly validated in voltage clamp experiments with Ca waves using isolated rat ventricular myocytes. Ca transport by the sodium-calcium exchanger (NCX) is determined by Vm as well as Na and Ca concentrations. Depolarized Vm reduces NCX-mediated efflux, elevating [Ca]i, and thus promoting Ca wave propagation. Moreover, depolarized Vm promotes spontaneous Ca releases that can cause initiation of multiple Ca waves. This indicates that during delayed afterdepolarizations, Ca release units (CRUs) interact with not just the immediately adjacent CRUs via Ca diffusion, but also further CRUs via fast (∼0.1 ms) changes in Vm mediated by the voltage and Ca-sensitive NCX. This may contribute significantly to synchronization of Ca waves among multiple cells in tissue.
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Affiliation(s)
- Daisuke Sato
- Department of Pharmacology, University of California, Davis, Davis, California.
| | - Daniel C Bartos
- Department of Pharmacology, University of California, Davis, Davis, California
| | - Kenneth S Ginsburg
- Department of Pharmacology, University of California, Davis, Davis, California
| | - Donald M Bers
- Department of Pharmacology, University of California, Davis, Davis, California.
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36
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Hammer KP, Hohendanner F, Blatter LA, Pieske BM, Heinzel FR. Variations in local calcium signaling in adjacent cardiac myocytes of the intact mouse heart detected with two-dimensional confocal microscopy. Front Physiol 2015; 5:517. [PMID: 25628569 PMCID: PMC4290493 DOI: 10.3389/fphys.2014.00517] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 12/18/2014] [Indexed: 11/13/2022] Open
Abstract
Dyssynchronous local Ca release within individual cardiac myocytes has been linked to cellular contractile dysfunction. Differences in Ca kinetics in adjacent cells may also provide a substrate for inefficient contraction and arrhythmias. In a new approach we quantify variation in local Ca transients between adjacent myocytes in the whole heart. Langendorff-perfused mouse hearts were loaded with Fluo-8 AM to detect Ca and Di-4-ANEPPS to visualize cell membranes. A spinning disc confocal microscope with a fast camera allowed us to record Ca signals within an area of 465 μm by 315 μm with an acquisition speed of 55 fps. Images from multiple transients recorded at steady state were registered to their time point in the cardiac cycle to restore averaged local Ca transients with a higher temporal resolution. Local Ca transients within and between adjacent myocytes were compared with regard to amplitude, time to peak and decay at steady state stimulation (250 ms cycle length). Image registration from multiple sequential Ca transients allowed reconstruction of high temporal resolution (2.4 ± 1.3 ms) local CaT in 2D image sets (N = 4 hearts, n = 8 regions). During steady state stimulation, spatial Ca gradients were homogeneous within cells in both directions and independent of distance between measured points. Variation in CaT amplitudes was similar across the short and the long side of neighboring cells. Variations in TAU and TTP were similar in both directions. Isoproterenol enhanced the CaT but not the overall pattern of spatial heterogeneities. Here we detected and analyzed local Ca signals in intact mouse hearts with high temporal and spatial resolution, taking into account 2D arrangement of the cells. We observed significant differences in the variation of CaT amplitude along the long and short axis of cardiac myocytes. Variations of Ca signals between neighboring cells may contribute to the substrate of cardiac remodeling.
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Affiliation(s)
- Karin P Hammer
- Department of Cardiology, Medical University of Graz Graz, Austria ; Department of Internal Medicine II, University Hospital Regensburg Regensburg, Germany
| | - Felix Hohendanner
- Molecular Biophysics and Physiology, Rush Medical College, Rush University Chicago, IL, USA
| | - Lothar A Blatter
- Molecular Biophysics and Physiology, Rush Medical College, Rush University Chicago, IL, USA
| | - Burkert M Pieske
- Department of Cardiology, Medical University of Graz Graz, Austria ; Department of Cardiology, Charité-Universitaetsmedizin Berlin Berlin, Germany
| | - Frank R Heinzel
- Department of Cardiology, Medical University of Graz Graz, Austria ; Department of Cardiology, Charité-Universitaetsmedizin Berlin Berlin, Germany
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37
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Lu XL, Rubart M. Micron-scale voltage and [Ca(2+)]i imaging in the intact heart. Front Physiol 2014; 5:451. [PMID: 25520663 PMCID: PMC4251286 DOI: 10.3389/fphys.2014.00451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 11/03/2014] [Indexed: 12/03/2022] Open
Abstract
Studies in isolated cardiomyocytes have provided tremendous information at the cellular and molecular level concerning regulation of transmembrane voltage (Vm) and intracellular calcium ([Ca2+]i). The ability to use the information gleaned to gain insight into the function of ion channels and Ca2+ handling proteins in a more complex system, e.g., the intact heart, has remained a challenge. We have developed laser scanning fluorescence microscopy-based approaches to monitor, at the sub-cellular to multi-cellular level in the immobilized, Langendorff-perfused mouse heart, dynamic changes in [Ca2+]i and Vm. This article will review the use of single- or dual-photon laser scanning microscopy [Ca2+]i imaging in conjunction with transgenic reporter technology to (a) interrogate the extent to which transplanted, donor-derived myocytes or cardiac stem cell-derived de novo myocytes are capable of forming a functional syncytium with the pre-existing myocardium, using entrainment of [Ca2+]i transients by the electrical activity of the recipient heart as a surrogate for electrical coupling, and (b) characterize the Ca2+ handling phenotypes of cellular implants. Further, we will review the ability of laser scanning fluorescence microscopy in conjunction with a fast-response voltage-sensitive to resolve, on a subcellular level in Langendorff-perfused mouse hearts, Vm dynamics that typically occur during the course of a cardiac action potential. Specifically, the utility of this technique to measure microscopic-scale voltage gradients in the normal and diseased heart is discussed.
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Affiliation(s)
- Xiao-Long Lu
- Riley Heart Research Center, Department of Pediatrics, Wells Center for Pediatric Research, Indiana University School of Medicine Indianapolis, IN, USA
| | - Michael Rubart
- Riley Heart Research Center, Department of Pediatrics, Wells Center for Pediatric Research, Indiana University School of Medicine Indianapolis, IN, USA
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38
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Lou Q, Belevych AE, Radwański PB, Liu B, Kalyanasundaram A, Knollmann BC, Fedorov VV, Györke S. Alternating membrane potential/calcium interplay underlies repetitive focal activity in a genetic model of calcium-dependent atrial arrhythmias. J Physiol 2014; 593:1443-58. [PMID: 25384790 DOI: 10.1113/jphysiol.2014.280784] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 10/23/2014] [Indexed: 01/09/2023] Open
Abstract
KEY POINTS Atrial fibrillation is often initiated and perpetuated by abnormal electrical pulses repetitively originating from regions outside the heart's natural pacemaker. In this study we examined the causal role of abnormal calcium releases from the sarcoplasmic reticulum in producing repetitive electrical discharges in atrial cells and tissues. Calsequestrin2 is a protein that stabilizes the closed state of calcium release channels, i.e. the ryanodine receptors. In the atria from mice predisposed to abnormal calcium releases secondary to the absence of calsequestrin2, we observed abnormal repetitive electrical discharges that may lead to atrial fibrillation. Here, we report a novel pathological rhythm generator. Specifically, abnormal calcium release leads to electrical activation, which in turn results in another abnormal calcium release. This process repeats itself and thus sustains the repetitive electrical discharges. These results suggest that improving the stability of ryanodine receptors might be useful to treat atrial fibrillation. ABSTRACT Aberrant diastolic calcium (Ca) release due to leaky ryanodine receptors (RyR2s) has been recently associated with atrial fibrillation (AF) and catecholaminergic polymorphic ventricular tachycardia (CPVT). However, it remains unclear how diastolic Ca release contributes to the rising of rapid repetitive focal activity, which is considered as a common AF triggering mechanism. To address this question, we conducted simultaneous voltage/Ca optical mapping in atrial tissue and one-/two-dimensional confocal imaging in atrial tissue and myocytes from wild-type (WT, n = 15) and CPVT mice lacking calsequestrin 2 (Casq2(-/-), n = 45), which promotes diastolic Ca release. During β-adrenergic stimulation (100 nM isoproterenol), only Casq2(-/-) atrial myocytes showed pacing-induced self-sustained repetitive activity (31 ± 21 s vs. none in WT). Importantly, in atrial tissue, this repetitive activity could translate to Ca-dependent focal arrhythmia. Ectopic action potential (AP) firing during repetitive activity occurred only when diastolic Ca release achieved a sufficient level of synchronization. The AP, in turn, synchronized subsequent diastolic Ca release by temporally aligning multiple sources of Ca waves both within individual myocytes and throughout the atrial tissue. This alternating interplay between AP and diastolic Ca release perpetuates the self-sustaining repetitive activity. In fact, pharmacological disruption of synchronized diastolic Ca release (by ryanodine) prevented aberrant APs; and vice versa, the inhibition of AP (by TTX or 0 Na, 0 Ca solution) de-synchronized diastolic Ca release. Taken together, these results suggest that a cyclical interaction between synchronized diastolic Ca release and AP forms a pathological rhythm generator that is involved in Ca-dependent atrial arrhythmias in CPVT.
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Affiliation(s)
- Qing Lou
- Department of Physiology & Cell Biology, College of Medicine, The Ohio State University, Columbus, OH, USA; Davis Heart & Lung Research Institute, The Ohio State University, Columbus, OH, USA
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39
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Qu Z, Weiss JN. Mechanisms of ventricular arrhythmias: from molecular fluctuations to electrical turbulence. Annu Rev Physiol 2014; 77:29-55. [PMID: 25340965 DOI: 10.1146/annurev-physiol-021014-071622] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Ventricular arrhythmias have complex causes and mechanisms. Despite extensive investigation involving many clinical, experimental, and computational studies, effective biological therapeutics are still very limited. In this article, we review our current understanding of the mechanisms of ventricular arrhythmias by summarizing the state of knowledge spanning from the molecular scale to electrical wave behavior at the tissue and organ scales and how the complex nonlinear interactions integrate into the dynamics of arrhythmias in the heart. We discuss the challenges that we face in synthesizing these dynamics to develop safe and effective novel therapeutic approaches.
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Affiliation(s)
- Zhilin Qu
- Departments of 1Medicine (Cardiology) and
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40
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Abstract
In a normal human life span, the heart beats about 2 to 3 billion times. Under diseased conditions, a heart may lose its normal rhythm and degenerate suddenly into much faster and irregular rhythms, called arrhythmias, which may lead to sudden death. The transition from a normal rhythm to an arrhythmia is a transition from regular electrical wave conduction to irregular or turbulent wave conduction in the heart, and thus this medical problem is also a problem of physics and mathematics. In the last century, clinical, experimental, and theoretical studies have shown that dynamical theories play fundamental roles in understanding the mechanisms of the genesis of the normal heart rhythm as well as lethal arrhythmias. In this article, we summarize in detail the nonlinear and stochastic dynamics occurring in the heart and their links to normal cardiac functions and arrhythmias, providing a holistic view through integrating dynamics from the molecular (microscopic) scale, to the organelle (mesoscopic) scale, to the cellular, tissue, and organ (macroscopic) scales. We discuss what existing problems and challenges are waiting to be solved and how multi-scale mathematical modeling and nonlinear dynamics may be helpful for solving these problems.
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Affiliation(s)
- Zhilin Qu
- Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California 90095, USA
- Correspondence to: Zhilin Qu, PhD, Department of Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA, A2-237 CHS, 650 Charles E. Young Drive South, Los Angeles, CA 90095, Tel: 310-794-6050, Fax: 310-206-9133,
| | - Gang Hu
- Department of Physics, Beijing Normal University, Beijing 100875, China
| | - Alan Garfinkel
- Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California 90095, USA
- Department of Integrative Biology and Physiology, University of California, Los Angeles, California 90095, USA
| | - James N. Weiss
- Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California 90095, USA
- Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, California 90095, USA
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41
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Abstract
Synchronized SR calcium (Ca) release is critical to normal cardiac myocyte excitation-contraction coupling, and ideally this release shuts off completely between heartbeats. However, other SR Ca release events are referred to collectively as SR Ca leak (which includes Ca sparks and waves as well as smaller events not detectable as Ca sparks). Much, but not all, of the SR Ca leak occurs via ryanodine receptors and can be exacerbated in pathological states such as heart failure. The extent of SR Ca leak is important because it can (a) reduce SR Ca available for release, causing systolic dysfunction; (b) elevate diastolic [Ca]i, contributing to diastolic dysfunction; (c) cause triggered arrhythmias; and (d) be energetically costly because of extra ATP used to repump Ca. This review addresses quantitative aspects and manifestations of SR Ca leak and its measurement, and how leak is modulated by Ca, associated proteins, and posttranslational modifications in health and disease.
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Affiliation(s)
- Donald M Bers
- Department of Pharmacology, University of California, Davis, California 95616;
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42
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Nivala M, Ko CY, Nivala M, Weiss JN, Qu Z. The emergence of subcellular pacemaker sites for calcium waves and oscillations. J Physiol 2013; 591:5305-20. [PMID: 24042497 DOI: 10.1113/jphysiol.2013.259960] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Calcium (Ca(2+)) waves generating oscillatory Ca(2+) signals are widely observed in biological cells. Experimental studies have shown that under certain conditions, initiation of Ca(2+) waves is random in space and time, while under other conditions, waves occur repetitively from preferred locations (pacemaker sites) from which they entrain the whole cell. In this study, we use computer simulations to investigate the self-organization of Ca(2+) sparks into pacemaker sites generating Ca(2+) oscillations. In both ventricular myocyte experiments and computer simulations of a heterogeneous Ca(2+) release unit (CRU) network model, we show that Ca(2+) waves occur randomly in space and time when the Ca(2+) level is low, but as the Ca(2+) level increases, waves occur repetitively from the same sites. Our analysis indicates that this transition to entrainment can be attributed to the fact that random Ca(2+) sparks self-organize into Ca(2+) oscillations differently at low and high Ca(2+) levels. At low Ca(2+), the whole cell Ca(2+) oscillation frequency of the coupled CRU system is much slower than that of an isolated single CRU. Compared to a single CRU, the distribution of interspike intervals (ISIs) of the coupled CRU network exhibits a greater variation, and its ISI distribution is asymmetric with respect to the peak, exhibiting a fat tail. At high Ca(2+), however, the coupled CRU network has a faster frequency and lesser ISI variation compared to an individual CRU. The ISI distribution of the coupled network no longer exhibits a fat tail and is well-approximated by a Gaussian distribution. This same Ca(2+) oscillation behaviour can also be achieved by varying the number of ryanodine receptors per CRU or the distance between CRUs. Using these results, we develop a theory for the entrainment of random oscillators which provides a unified explanation for the experimental observations underlying the emergence of pacemaker sites and Ca(2+) oscillations.
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Affiliation(s)
- Michael Nivala
- Z. Qu: Department of Medicine, David Geffen School of Medicine at UCLA, A2-237 CHS, 650 Charles E. Young Drive South, Los Angeles, CA 90095.
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43
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Decreased RyR2 refractoriness determines myocardial synchronization of aberrant Ca2+ release in a genetic model of arrhythmia. Proc Natl Acad Sci U S A 2013; 110:10312-7. [PMID: 23733959 DOI: 10.1073/pnas.1300052110] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Dysregulated intracellular Ca(2+) signaling is implicated in a variety of cardiac arrhythmias, including catecholaminergic polymorphic ventricular tachycardia. Spontaneous diastolic Ca(2+) release (DCR) can induce arrhythmogenic plasma membrane depolarizations, although the mechanism responsible for DCR synchronization among adjacent myocytes required for ectopic activity remains unclear. We investigated the synchronization mechanism(s) of DCR underlying untimely action potentials and diastolic contractions (DCs) in a catecholaminergic polymorphic ventricular tachycardia mouse model with a mutation in cardiac calsequestrin. We used a combination of different approaches including single ryanodine receptor channel recording, optical imaging (Ca(2+) and membrane potential), and contractile force measurements in ventricular myocytes and intact cardiac muscles. We demonstrate that DCR occurs in a temporally and spatially uniform manner in both myocytes and intact myocardial tissue isolated from cardiac calsequestrin mutation mice. Such synchronized DCR events give rise to triggered electrical activity that results in synchronous DCs in the myocardium. Importantly, we establish that synchronization of DCR is a result of a combination of abbreviated ryanodine receptor channel refractoriness and the preceding synchronous stimulated Ca(2+) release/reuptake dynamics. Our study reveals how aberrant DCR events can become synchronized in the intact myocardium, leading to triggered activity and the resultant DCs in the settings of a cardiac rhythm disorder.
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44
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Asfaw M, Alvarez-Lacalle E, Shiferaw Y. The timing statistics of spontaneous calcium release in cardiac myocytes. PLoS One 2013; 8:e62967. [PMID: 23690970 PMCID: PMC3656860 DOI: 10.1371/journal.pone.0062967] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 03/27/2013] [Indexed: 11/19/2022] Open
Abstract
A variety of cardiac arrhythmias are initiated by a focal excitation that disrupts the regular beating of the heart. In some cases it is known that these excitations are due to calcium (Ca) release from the sarcoplasmic reticulum (SR) via propagating subcellular Ca waves. However, it is not understood what are the physiological factors that determine the timing of these excitations at both the subcellular and tissue level. In this paper we apply analytic and numerical approaches to determine the timing statistics of spontaneous Ca release (SCR) in a simplified model of a cardiac myocyte. In particular, we compute the mean first passage time (MFPT) to SCR, in the case where SCR is initiated by spontaneous Ca sparks, and demonstrate that this quantity exhibits either an algebraic or exponential dependence on system parameters. Based on this analysis we identify the necessary requirements so that SCR occurs on a time scale comparable to the cardiac cycle. Finally, we study how SCR is synchronized across many cells in cardiac tissue, and identify a quantitative measure that determines the relative timing of SCR in an ensemble of cells. Using this approach we identify the physiological conditions so that cell-to-cell variations in the timing of SCR is small compared to the typical duration of an SCR event. We argue further that under these conditions inward currents due to SCR can summate and generate arrhythmogenic triggered excitations in cardiac tissue.
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Affiliation(s)
- Mesfin Asfaw
- Department of Physics and Astronomy, California State University Northridge, Northridge, California, United States of America
| | - Enric Alvarez-Lacalle
- Department de Física Aplicada, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Yohannes Shiferaw
- Department of Physics and Astronomy, California State University Northridge, Northridge, California, United States of America
- * E-mail:
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45
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Abstract
Ca(2+) waves were probably first observed in the early 1940s. Since then Ca(2+) waves have captured the attention of an eclectic mixture of mathematicians, neuroscientists, muscle physiologists, developmental biologists, and clinical cardiologists. This review discusses the current state of mathematical models of Ca(2+) waves, the normal physiological functions Ca(2+) waves might serve in cardiac cells, as well as how the spatial arrangement of Ca(2+) release channels shape Ca(2+) waves, and we introduce the idea of Ca(2+) phase waves that might provide a useful framework for understanding triggered arrhythmias.
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Affiliation(s)
- Leighton T Izu
- Department of Pharmacology, University of California, Davis, USA.
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46
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Williams R. Circulation Research
“In This Issue” Anthology. Circ Res 2012. [DOI: 10.1161/res.0b013e31826f7938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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47
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Store-dependent deactivation: cooling the chain-reaction of myocardial calcium signaling. J Mol Cell Cardiol 2012; 58:77-83. [PMID: 23108187 DOI: 10.1016/j.yjmcc.2012.10.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 10/11/2012] [Accepted: 10/21/2012] [Indexed: 01/08/2023]
Abstract
In heart cells, Ca(2+) released from the internal storage unit, the sarcoplasmic reticulum (SR) through ryanodine receptor (RyR2) channels is the predominant determinant of cardiac contractility. Evidence obtained in recent years suggests that SR Ca(2+) release is tightly regulated not only by cytosolic Ca(2+) but also by intra-store Ca(2+) concentration. Specifically, Ca(2+)-induced Ca(2+) release (CICR) that relies on auto-catalytic action of Ca(2+) at the cytosolic side of RyR2s is precisely balanced and counteracted by RyR2 deactivation dependent on a reciprocal decrease of Ca(2+) at the luminal side of RyR2s. Dysregulation of this inherently unstable Ca(2+) signaling is considered to be an underlying cause of triggered arrhythmias, and is associated with genetic and acquired forms of sudden cardiac death. In this article, we present an overview of recent advances in our understanding of the regulatory role luminal Ca(2+) plays in Ca(2+) handling, with a particular emphasis on the role of Ca(2+)release refractoriness in aberrant Ca(2+) release.
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48
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Circulation Research
Thematic Synopsis. Circ Res 2012. [DOI: 10.1161/circresaha.112.280024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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49
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Tveito A, Lines GT, Edwards AG, Maleckar MM, Michailova A, Hake J, McCulloch A. Slow Calcium-Depolarization-Calcium waves may initiate fast local depolarization waves in ventricular tissue. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2012; 110:295-304. [PMID: 22841534 DOI: 10.1016/j.pbiomolbio.2012.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Accepted: 07/16/2012] [Indexed: 10/28/2022]
Abstract
Intercellular calcium waves in cardiac myocytes are a well-recognized, if incompletely understood, phenomenon. In a variety of preparations, investigators have reported multi-cellular calcium waves or triggered propagated contractions, but the mechanisms of propagation and pathological importance of these events remain unclear. Here, we review existing experimental data and present a computational approach to investigate the mechanisms of multi-cellular calcium wave propagation. Over the past 50 years, the standard modeling paradigm for excitable cardiac tissue has seen increasingly detailed models of the dynamics of individual cells coupled in tissue solely by intercellular and interstitial current flow. Although very successful, this modeling regime has been unable to capture two important phenomena: 1) the slow intercellular calcium waves observed experimentally, and 2) how intercellular calcium events resulting in delayed after depolarizations at the cellular level could overcome a source-sink mismatch to initiate depolarization waves in tissue. In this paper, we introduce a mathematical model with subcellular spatial resolution, in which we allow both inter- and intracellular current flow and calcium diffusion. In simulations of coupled cells employing this model, we observe: a) slow inter-cellular calcium waves propagating at about 0.1 mm/s, b) faster Calcium-Depolarization-Calcium (CDC) waves, traveling at about 1 mm/s, and c) CDC-waves that can set off fast depolarization-waves (50 cm/s) in tissue with varying gap-junction conductivity.
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Affiliation(s)
- Aslak Tveito
- Center for Biomedical Computing, Simula Research Laboratory, Norway
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50
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Nivala M, Ko CY, Nivala M, Weiss JN, Qu Z. Criticality in intracellular calcium signaling in cardiac myocytes. Biophys J 2012; 102:2433-42. [PMID: 22713558 DOI: 10.1016/j.bpj.2012.05.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 04/30/2012] [Accepted: 05/01/2012] [Indexed: 11/18/2022] Open
Abstract
Calcium (Ca) is a ubiquitous second messenger that regulates many biological functions. The elementary events of local Ca signaling are Ca sparks, which occur randomly in time and space, and integrate to produce global signaling events such as intra- and intercellular Ca waves and whole-cell Ca oscillations. Despite extensive experimental characterization in many systems, the transition from local random to global synchronous events is still poorly understood. Here we show that criticality, a ubiquitous dynamical phenomenon in nature, is responsible for the transition from local to global Ca signaling. We demonstrate this first in a computational model of Ca signaling in a cardiac myocyte and then experimentally in mouse ventricular myocytes, complemented by a theoretical agent-based model to delineate the underlying dynamics. We show that the interaction between the Ca release units via Ca-induced Ca release causes self-organization of Ca spark clusters. When the coupling between Ca release units is weak, the cluster-size distribution is exponential. As the interactions become strong, the cluster-size distribution changes to a power-law distribution, which is characteristic of criticality in thermodynamic and complex nonlinear systems, and facilitates the formation and propagation of Ca waves and whole-cell Ca oscillations. Our findings illustrate how criticality is harnessed by a biological cell to regulate Ca signaling via self-organization of random subcellular events into cellular-scale oscillations, and provide a general theoretical framework for the transition from local Ca signaling to global Ca signaling in biological cells.
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Affiliation(s)
- Michael Nivala
- Cardiology Division, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA
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