Cellular signaling underlying atrial tachycardia remodeling of L-type calcium current

XY Qi, YH Yeh, L Xiao, B Burstein, A Maguy… - Circulation …, 2008 - Am Heart Assoc
XY Qi, YH Yeh, L Xiao, B Burstein, A Maguy, D Chartier, LR Villeneuve, BJJM Brundel…
Circulation research, 2008Am Heart Assoc
Atrial tachycardia (AT) downregulates L-type Ca2+ current (I CaL) and causes atrial
fibrillation–promoting electric remodeling. This study assessed potential underlying signal
transduction. Cultured adult canine atrial cardiomyocytes were paced at 0, 1, or 3 Hz (P0,
P1, P3) for up to 24 hours. Cellular tachypacing (P3) mimicked effects of in vivo AT:
decreased I CaL and transient outward current (I to), unchanged I CaT, I Kr, and I Ks, and
reduced action potential duration (APD). I CaL was unchanged in P3 at 2 and 8 hours but …
Atrial tachycardia (AT) downregulates L-type Ca2+ current (ICaL) and causes atrial fibrillation–promoting electric remodeling. This study assessed potential underlying signal transduction. Cultured adult canine atrial cardiomyocytes were paced at 0, 1, or 3 Hz (P0, P1, P3) for up to 24 hours. Cellular tachypacing (P3) mimicked effects of in vivo AT: decreased ICaL and transient outward current (Ito), unchanged ICaT, IKr, and IKs, and reduced action potential duration (APD). ICaL was unchanged in P3 at 2 and 8 hours but decreased by 55±6% at 24 hours. Tachypacing caused Ca2+i accumulation in P3 cells at 2 to 8 hours, but, by 24 hours, Ca2+i returned to baseline. Cav1.2 mRNA expression was not altered at 2 hours but decreased significantly at 8 and 24 hours (32±4% and 48±4%, respectively) and protein expression was decreased (47±8%) at 24 hours only. Suppressing Ca2+i increases during tachypacing with the ICaL blocker nimodipine or the Ca2+ chelator BAPTA-AM prevented ICaL downregulation. Calcineurin activity increased in P3 at 2 and 8 hours, respectively, returning to baseline at 24 hours. Nuclear factor of activated T cells (NFAT) nuclear translocation was enhanced in P3 cells. Ca2+-dependent signaling was probed with inhibitors of Ca2+/calmodulin (W-7), calcineurin (FK-506), and NFAT (INCA6): each prevented ICaL downregulation. Significant APD reductions (≈30%) at 24 hours in P3 cells were prevented by nimodipine, BAPTA-AM, W-7, or FK-506. Thus, rapid atrial cardiomyocyte activation causes Ca2+ loading, which activates the Ca2+-dependent calmodulin–calcineurin–NFAT system to cause transcriptional downregulation of ICaL, restoring Ca2+i to normal at the cost of APD reduction. These studies elucidate for the first time the molecular feedback mechanisms underlying arrhythmogenic AT remodeling.
Am Heart Assoc