Stabilization of cardiac ryanodine receptor prevents intracellular calcium leak and arrhythmias

SE Lehnart, C Terrenoire, S Reiken… - Proceedings of the …, 2006 - National Acad Sciences
SE Lehnart, C Terrenoire, S Reiken, XHT Wehrens, LS Song, EJ Tillman, S Mancarella
Proceedings of the National Academy of Sciences, 2006National Acad Sciences
Catecholaminergic polymorphic ventricular tachycardia is a form of exercise-induced
sudden cardiac death that has been linked to mutations in the cardiac Ca2+ release
channel/ryanodine receptor (RyR2) located on the sarcoplasmic reticulum (SR). We have
shown that catecholaminergic polymorphic ventricular tachycardia-linked RyR2 mutations
significantly decrease the binding affinity for calstabin-2 (FKBP12. 6), a subunit that
stabilizes the closed state of the channel. We have proposed that RyR2-mediated diastolic …
Catecholaminergic polymorphic ventricular tachycardia is a form of exercise-induced sudden cardiac death that has been linked to mutations in the cardiac Ca2+ release channel/ryanodine receptor (RyR2) located on the sarcoplasmic reticulum (SR). We have shown that catecholaminergic polymorphic ventricular tachycardia-linked RyR2 mutations significantly decrease the binding affinity for calstabin-2 (FKBP12.6), a subunit that stabilizes the closed state of the channel. We have proposed that RyR2-mediated diastolic SR Ca2+ leak triggers ventricular tachycardia (VT) and sudden cardiac death. In calstabin-2-deficient mice, we have now documented diastolic SR Ca2+ leak, monophasic action potential alternans, and bidirectional VT. Calstabin-deficient cardiomyocytes exhibited SR Ca2+ leak-induced aberrant transient inward currents in diastole consistent with delayed after-depolarizations. The 1,4-benzothiazepine JTV519, which increases the binding affinity of calstabin-2 for RyR2, inhibited the diastolic SR Ca2+ leak, monophasic action potential alternans and triggered arrhythmias. Our data suggest that calstabin-2 deficiency is as a critical mediator of triggers that initiate cardiac arrhythmias.
National Acad Sciences