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Antoons, Gudrun; Johnson, Daniel M.; Dries, Eef; Santiago, Demetrio J.; Ozdemir, Semir; Lenaerts, Ilse; Beekman, Jet D.M.; Houtman, Marien J.C.; Sipido, Karin R. and Vos, Marc A.
(2015).
DOI: https://doi.org/10.1016/j.yjmcc.2015.10.008
Abstract
Beat-to-beat variability of ventricular repolarization (BVR) has been proposed as a strong predictor of Torsades de Pointes (TdP). BVR is also observed at the myocyte level, and a number of studies have shown the importance of calcium handling in influencing this parameter. The chronic AV block (CAVB) dog is a model of TdP arrhythmia in cardiac hypertrophy, and myocytes from these animals show extensive remodeling, including of Ca2 + handling. This remodeling process also leads to increased BVR. We aimed to determine the role that (local) Ca2 + handling plays in BVR.
In isolated LV myocytes an exponential relationship was observed between BVR magnitude and action potential duration (APD) at baseline. Inhibition of Ca2 + release from sarcoplasmic reticulum (SR) with thapsigargin resulted in a reduction of [Ca2 +]i, and of both BVR and APD. Increasing ICaL in the presence of thapsigargin restored APD but BVR remained low. In contrast, increasing ICaL with preserved Ca2 + release increased both APD and BVR. Inhibition of Ca2 + release with caffeine, as with thapsigargin, reduced BVR despite maintained APD. Simultaneous inhibition of Na+/Ca2 + exchange and ICaL decreased APD and BVR to similar degrees, whilst increasing diastolic Ca2 +. Buffering of Ca2 + transients with BAPTA reduced BVR for a given APD to a greater extent than buffering with EGTA, suggesting subsarcolemmal Ca2 + transients modulated BVR to a larger extent than the cytosolic Ca2 + transient.
In conclusion, BVR in hypertrophied dog myocytes, at any APD, is strongly dependent on SR Ca2 + release, which may act through modulation of the l-type Ca2 + current in a subsarcolemmal microdomain.