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(Circulation. 2009;119:2179-2187.)
© 2009 American Heart Association, Inc.
Molecular Cardiology |
From INSERM, U637 (A.M.G., A.R., L.P., E.P., R.P., S.R., J.-P.B.), Université Montpellier, France; INSERM, U772 (Y.S.-M., C.L., F.J.), Collège de France, Paris, France; Wales Heart Research Institute (S.Z., F.A.L.), Cardiff University School of Medicine, Cardiff, United Kingdom; Department of Physiology (X.Z., H.H.V.), University of Wisconsin Medical School, Madison, Wis; and Département de lInformation Médicale (R.S., M.-C.P.), Hôpital Lapeyronie, CHU Montpellier, France.
Correspondence to Jean-Pierre Benitah, Laboratoire de physiopathologie cardiovasculaire, INSERM U637, CHU Arnaud de Villeneuve, 34295 Montpellier, France. E-mail jean-pierre.benitah{at}inserm.fr
Received July 16, 2007; accepted March 3, 2009.
Background— The mineralocorticoid pathway is involved in cardiac arrhythmias associated with heart failure through mechanisms that are incompletely understood. Defective regulation of the cardiac ryanodine receptor (RyR) is an important cause of the initiation of arrhythmias. Here, we examined whether the aldosterone pathway might modulate RyR function.
Methods and Results— Using the whole-cell patch clamp method, we observed an increase in the occurrence of delayed afterdepolarizations during action potential recordings in isolated adult rat ventricular myocytes exposed for 48 hours to aldosterone 100 nmol/L, in freshly isolated myocytes from transgenic mice with human mineralocorticoid receptor expression in the heart, and in wild-type littermates treated with aldosterone. Sarcoplasmic reticulum Ca2+ load and RyR expression were not altered; however, RyR activity, visualized in situ by confocal microscopy, was increased in all cells, as evidenced by an increased occurrence and redistribution to long-lasting and broader populations of spontaneous Ca2+ sparks. These changes were associated with downregulation of FK506-binding proteins (FKBP12 and 12.6), regulatory proteins of the RyR macromolecular complex.
Conclusions— We suggest that in addition to modulation of Ca2+ influx, overstimulation of the cardiac mineralocorticoid pathway in the heart might be a major upstream factor for aberrant Ca2+ release during diastole, which contributes to cardiac arrhythmia in heart failure.
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