Sood Subeena, Chelu Mihail G, van Oort Ralph J, Skapura Darlene, Santonastasi Marco, Dobrev Dobromir, Wehrens Xander H T
Department of Molecular Physiology and Biophysics, Houston, Texas 77030, USA.
Heart Rhythm. 2008 Jul;5(7):1047-54. doi: 10.1016/j.hrthm.2008.03.030. Epub 2008 Mar 27.
Although defective Ca(2+) homeostasis may contribute to arrhythmogenesis in atrial fibrillation (AF), the underlying molecular mechanisms remain poorly understood. Studies in patients with AF revealed that impaired diastolic closure of sarcoplasmic reticulum (SR) Ca(2+)-release channels (ryanodine receptors, RyR2) is associated with reduced levels of the RyR2-inhibitory subunit FKBP12.6.
The objective of the present study was to test the hypothesis that Ca(2+) leak from the SR through RyR2 increases the propensity for AF in FKBP12.6-deficient (-/-) mice.
Surface electrocardiogram and intracardiac electrograms were recorded simultaneously in FKBP12.6-/- mice and wild-type (WT) littermates. Right atrial programmed stimulation was performed before and after injection of RyR2 antagonist tetracaine (0.5 mg/kg). Intracellular Ca(2+) transients were recorded in atrial myocytes from FKBP12.6-/- and WT mice.
FKBP12.6-/- mice had structurally normal atria and unaltered expression of key Ca(2+)-handling proteins. AF episodes were inducible in 81% of FKBP12.6-/-, but in only 7% of WT mice (P <.05), and were prevented by tetracaine in all FKBP12.6-/- mice. SR Ca(2+) leak in FKBP12.6-/- myocytes was 53% larger than in WT myocytes, and FKBP12.6-/- myocytes showed increased incidence of spontaneous SR Ca(2+) release events, which could be blocked by tetracaine.
The increased vulnerability to AF in FKBP12.6-/- mice substantiates the notion that defective SR Ca(2+) release caused by abnormal RyR2 and FKBP12.6 interactions may contribute to the initiation or maintenance of atrial fibrillation.
尽管钙离子稳态缺陷可能导致心房颤动(AF)的心律失常发生,但其潜在分子机制仍知之甚少。对AF患者的研究表明,肌浆网(SR)钙离子释放通道(雷诺丁受体,RyR2)舒张期关闭受损与RyR2抑制亚基FKBP12.6水平降低有关。
本研究的目的是验证以下假设:通过RyR2从SR漏出的钙离子增加了FKBP12.6缺陷(-/-)小鼠发生AF的倾向。
同时记录FKBP12.6-/-小鼠和野生型(WT)同窝小鼠的体表心电图和心内电图。在注射RyR2拮抗剂丁卡因(0.5mg/kg)前后进行右心房程控刺激。记录FKBP12.6-/-和WT小鼠心房肌细胞内的钙离子瞬变。
FKBP12.6-/-小鼠的心房结构正常,关键钙离子处理蛋白的表达未改变。81%的FKBP12.6-/-小鼠可诱发AF发作,而WT小鼠仅为7%(P<.05),所有FKBP12.6-/-小鼠的AF发作均被丁卡因预防。FKBP12.6-/-肌细胞中的SR钙离子漏出比WT肌细胞大53%,FKBP12.6-/-肌细胞中自发性SR钙离子释放事件发生率增加,可被丁卡因阻断。
FKBP12.6-/-小鼠对AF的易感性增加证实了以下观点:由异常的RyR2和FKBP12.6相互作用引起的SR钙离子释放缺陷可能有助于房颤的起始或维持。