Article,

Alterations in early action potential repolarization causes localized failure of sarcoplasmic reticulum Ca$^2+$ release.

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Circ. Res., 96 (5): 543--550 (March 2005)
DOI: 10.1161/01.RES.0000158966.58380.37

Abstract

Depressed contractility of failing myocytes involves a decreased rate of rise of the Ca$^2+$ transient. Synchronization of Ca$^2+$ release from the junctional sarcoplasmic reticulum (SR) is responsible for the rapid rise of the normal Ca$^2+$ transient. This study examined the idea that spatially and temporally dyssynchronous SR Ca$^2+$ release slows the rise of the cytosolic Ca$^2+$ transient in failing feline myocytes. Left ventricular hypertrophy (LVH) with and without heart failure (HF) was induced in felines by constricting the ascending aorta. Ca$^2+$ transients were measured in ventricular myocytes using confocal line scan imaging. Ca$^2+$ transients were induced by field stimulation, square wave voltage steps, or action potential (AP) voltage clamp. SR Ca$^2+$ release was significantly less well spatially and temporally synchronized in field-stimulated HF versus control or LVH myocytes. Surprisingly, depolarization of HF cells to potentials where Ca$^2+$ currents (ICa) were maximal resynchronized SR Ca$^2+$ release. Correspondingly, decreases in the amplitude of ICa desynchronized SR Ca$^2+$ release in control, LVH, and HF myocytes to the same extent. HF myocytes had significant loss of phase 1 AP repolarization and smaller ICa density, which should both reduce Ca$^2+$ influx. When normal myocytes were voltage clamped with HF AP profiles SR Ca$^2+$ release was desynchronized. SR Ca$^2+$ release becomes dyssynchronized in failing feline ventricular myocytes because of reductions in Ca$^2+$ influx induced in part by alterations in early repolarization of the AP. Therefore, therapies that restore normal early repolarization should improve the contractility of the failing heart.

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