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Arrhythmogenic transient dynamics in cardiac myocytes.

ABSTRACT: Cardiac action potential alternans and early afterdepolarizations (EADs) are linked to cardiac arrhythmias. Periodic action potentials (period 1) in healthy conditions bifurcate to other states such as period 2 or chaos when alternans or EADs occur in pathological conditions. The mechanisms of alternans and EADs have been extensively studied under steady-state conditions, but lethal arrhythmias often occur during the transition between steady states. Why arrhythmias tend to develop during the transition is unclear. We used low-dimensional mathematical models to analyze dynamical mechanisms of transient alternans and EADs. We show that depending on the route from one state to another, action potential alternans and EADs may occur during the transition between two periodic steady states. The route taken depends on the time course of external perturbations or intrinsic signaling, such as β-adrenergic stimulation, which regulate cardiac calcium and potassium currents with differential kinetics.

SUBMITTER: Xie Y

PROVIDER: S-EPMC3984988 | biostudies-literature | 2014 Mar

REPOSITORIES: biostudies-literature

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Arrhythmogenic transient dynamics in cardiac myocytes.

Xie Yuanfang Y Izu Leighton T LT Bers Donald M DM Sato Daisuke D

Biophysical journal 20140301 6

Cardiac action potential alternans and early afterdepolarizations (EADs) are linked to cardiac arrhythmias. Periodic action potentials (period 1) in healthy conditions bifurcate to other states such as period 2 or chaos when alternans or EADs occur in pathological conditions. The mechanisms of alternans and EADs have been extensively studied under steady-state conditions, but lethal arrhythmias often occur during the transition between steady states. Why arrhythmias tend to develop during the tr ...[more]

PMID: 24655514

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Project description:RationaleIntercellular uncoupling and Ca2+ (Ca) mishandling can initiate triggered ventricular arrhythmias. Spontaneous Ca release activates inward current which depolarizes membrane potential (Vm) and can trigger action potentials in isolated myocytes. However, cell-cell coupling in intact hearts limits local depolarization and may protect hearts from this arrhythmogenic mechanism. Traditional optical mapping lacks the spatial resolution to assess coupling of individual myocytes.ObjectiveWe investigate local intercellular coupling in Ca-induced depolarization in intact hearts, using confocal microscopy to measure local Vm and intracellular [Ca] simultaneously.Methods and resultsWe used isolated Langendorff-perfused hearts from control (CTL) and heart failure (HF) mice (HF induced by transaortic constriction). In CTL hearts, 1.4% of myocytes were poorly synchronized with neighboring cells and exhibited asynchronous (AS) Ca transients. These AS myocytes were much more frequent in HF (10.8% of myocytes, P<0.05 versus CTL). Local Ca waves depolarized Vm in HF but not CTL hearts, suggesting weaker gap junction coupling in HF-AS versus CTL-AS myocytes. Cell-cell coupling was assessed by calcein fluorescence recovery after photobleach during intracellular [Ca] recording. All regions in CTL hearts exhibited faster calcein diffusion than in HF, with HF-AS myocyte being slowest. In HF-AS, enhancing gap junction conductance (with rotigaptide) increased coupling and suppressed Vm depolarization during Ca waves. Conversely, in CTL hearts, gap junction inhibition (carbenoxolone) decreased coupling and allowed Ca wave-induced depolarizations. Synchronization of Ca wave initiation and triggered action potentials were observed in HF hearts and computational models.ConclusionsWell-coupled CTL myocytes are effectively voltage-clamped during Ca waves, protecting the heart from triggered arrhythmias. Spontaneous Ca waves are much more common in HF myocytes and these AS myocytes are also poorly coupled, enabling local Ca-induced inward current of sufficient source strength to overcome a weakened current sink to depolarize Vm and trigger action potentials.

Project description:The origin of the increase in cytosolic free Ca2+ concentration ([Ca2+]i) induced by extracellular ATP was investigated in single isolated cardiac myocytes loaded with indo-1. The nucleotide added at a concentration of 10 microM triggers a few Ca2+ spikes, followed by a cluster of Ca2+ oscillations, increasing [Ca2+]i to around 200 nM from a basal value of 70 nM. Neither caffeine nor ryanodine affects the magnitude of the Ca2+ transient, but both shorten it by preventing the Ca2+ oscillations. This indicates that the latter must be related to the release of Ca2+ from the sarcoplasmic reticulum. Since ATP also induces cell depolarization (as shown by experiments using the potential sensitive dye bis-oxonol), the initial Ca2+ spikes were attributed to the opening of voltage-dependent Ca2+ channels. A small Ca2+ transient still remains under experimental conditions designed to prevent Ca2+ influx from external medium (low-Ca2+ high-Mg2+ medium containing La3+) and after depletion of the sarcoplasmic-reticulum Ca2+ load with caffeine. Under these conditions, when this Ca2+ transient was buffered by 1,2-bis-(O-aminophenoxy)ethane-NNN'N'-tetra-acetic acid, ATP was unable to trigger the initial Ca2+ spikes. These results indicate that ATP mobilizes Ca2+ ions from an intracellular pool other than the sarcoplasmic reticulum and that this Ca2+ release is responsible for the depolarization. The effects of ATP on [Ca2+]i share the same characteristics as the acidification simultaneously induced by the nucleotide (as shown by experiments using the pH-sensitive probe snarf-1). These ionic variations are highly specific to ATP and its hydrolysis-resistant analogues. They both require the presence of Mg2+ and Cl- ions in the extracellular medium, and they are prevented by pretreatment of the cells with 4,4'-di-isothiocyanostilbene or probenecid. These results suggest that: (1) the ATP-induced acidification leads to displacement of Ca2+ ions from or close to the internal face of sarcolemma; (2) the Ca2+ ions activate a non-specific membrane conductance responsible for the depolarization of the cells; (3) the depolarization leads to a Ca2+ influx, owing to the opening of the voltage-dependent Ca2+ channels; (4) this increase in Ca2+ triggers the release of Ca2+ from the sarcoplasmic reticulum, which is facilitated by the increase in inositol trisphosphate following P2-purinergic stimulation.

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Arrhythmogenic transient dynamics in cardiac myocytes.

Publications

Arrhythmogenic transient dynamics in cardiac myocytes.

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