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Johnson, DM; Heijman, J; Pollard, CE; Valentin, JP; Crijns, HJGM; Abi-Gerges, N; Volders, PGA.
IKs restricts excessive beat-to-beat variability of repolarization during beta-adrenergic receptor stimulation
J MOL CELL CARDIOL. 2010; 48(1): 122-130.
Doi: 10.1016/j.yjmcc.2009.08.033
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
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Heijman Jordi
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- Abstract:
- In vivo studies have suggested that increased beat-to-beat variability of ventricular repolarization duration (BVR) is a better predictor of drug-induced torsades de pointes than repolarization prolongation alone. Cellular BVR and its dynamics before proarrhythmic events are poorly understood. We investigated differential responses of BVR in single myocytes during I-Ks blockade versus I-Kr blockade and late-I-Na augmentation, under the influence of beta-adrenergic receptor stimulation. Transmembrane action potentials were recorded from isolated canine left-ventricular midmyocytes at various pacing rates. I-Ks was blocked by HMR1556, I-Kr by dofetilide. Late I-Na was augmented by sea anemone toxin-II. Isoproterenol was added for beta-adrenergic receptor stimulation. BAPTA-AM buffered intracellular Ca2+. SEA0400 partially inhibited the Na+-Ca2+ exchanger. BVR was quantified as variability of action-potential duration at 90% repolarization: Sigma(vertical bar APD90; i+1 minus APD90; i vertical bar)/[nbeats x root 2] for 30 consecutive action potentials. Baseline BVR was significantly increased by I-Kr blockade and late-I-Na augmentation, especially at slow pacing rates. beta-adrenergic stimulation restabilized these BVR changes. In contrast, I-Ks blockade caused very little change in repolarization when compared to baseline conditions, but predisposed the myocyte to increased BVR during beta-adrenergic stimulation, especially at fast rates. BAPTA-AM and SEA0400 reduced this excessive BVR and eliminated early afterdepolarizations. In conclusion, beta-adrenergic receptor stimulation exaggerates BVR during I-Ks blockade, indicating a BVR-stabilizing role of beta-adrenergic-sensitive I-Ks. Loss of I-Ks plus overriding of Ca2+-dependent membrane currents, including inward Na+-Ca2+ exchange current, conspire to proarrhythmic BVR under these conditions. (C) 2009 Elsevier Inc. All rights reserved.
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Action potential
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Arrhythmia
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Beta-adrenergic receptor stimulation
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Calcium
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Contraction
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Ion channels
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Potassium
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Sodium-calcium exchanger
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Repolarization
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Ventricles