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Circulation. 1998;98:1383-1393

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(Circulation. 1998;98:1383-1393.)
© 1998 American Heart Association, Inc.


Clinical Investigation and Reports

Molecular Basis of Transient Outward Potassium Current Downregulation in Human Heart Failure

A Decrease in Kv4.3 mRNA Correlates With a Reduction in Current Density

S. Kääb, MD, PhD; J. Dixon, PhD; J. Duc, MD; D. Ashen, PhD; M. Näbauer, MD; D. J. Beuckelmann, MD; G. Steinbeck, MD; D. McKinnon, PhD; ; G. F. Tomaselli, MD

From the Department of Medicine (S.K., J. Duc, D.A., G.F.T.), Division of Molecular and Cellular Cardiology, Johns Hopkins University, Baltimore, Maryland; Department of Neurobiology and Behavior (J. Dixon, D.M.), State University of New York at Stony Brook; Department of Medicine I (S.K., M.N., G.S.), Ludwig Maximilians University of Munich (Germany); and Department of Medicine III (D.J.B.), University of Cologne (Germany).

Correspondence to Gordon Tomaselli, MD, 720 N Rutland Ave, Ross 844, Johns Hopkins University, Baltimore, MD 21205. E-mail gtomasel{at}welchlink.welch.jhu.edu

Background—Despite advances in medical therapy, congestive heart failure remains a major cause of death in the developed world. A disproportionate number of the deaths of patients with heart failure are sudden and presumed to be arrhythmic. Heart failure in humans and in animal models is associated with prolongation of the action potential duration (APD), the result of downregulation of K+ currents—prominently, the Ca2+-independent transient outward current (Ito). The mechanism for the reduction of Ito in heart failure is unknown. The K+ channel {alpha}-subunit Kv4.3, a homolog of the Drosophila Shal family, is most likely to encode all or part of the native cardiac Ito in humans.

Methods and Results—We used ribonuclease protection assays and whole-cell electrophysiological recording to study changes in the level of Kv4.3 mRNA and Ito in human tissues and isolated ventricular myocytes, respectively. We found that the level of Kv4.3 mRNA decreased by 30% in failing hearts compared with nonfailing controls. Furthermore, this reduction correlated with the reduction in peak Ito density measured in ventricular myocytes isolated from adjacent regions of the heart. There was no significant change in the steady-state level of any other mRNA studied (HERG, Kv1.4, Kir2.1, Kvß1.3, and the {alpha}1C subunit of the Ca2+ channel). mRNAs encoding Kv1.2, Kv1.5, and Kv2.1 were found in low abundance in human ventricle.

Conclusions—These data provide further support for the hypothesis that Kv4.3 encodes all or part of the native cardiac Ito in humans and that part of the downregulation of this current in heart failure may be transcriptionally regulated.


Key Words: currents • sodium • potassium • heart failure • repolarization




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[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
S. S. Po, R. C. Wu, G. J. Juang, W. Kong, and G. F. Tomaselli
Mechanism of alpha -adrenergic regulation of expressed hKv4.3 currents
Am J Physiol Heart Circ Physiol, December 1, 2001; 281(6): H2518 - H2527.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
N. Decher, O. Uyguner, C. R Scherer, B. Karaman, M. Yuksel-Apak, A. E Busch, K. Steinmeyer, and B. Wollnik
hKChIP2 is a functional modifier of hKv4.3 potassium channels: Cloning and expression of a short hKChIP2 splice variant
Cardiovasc Res, November 1, 2001; 52(2): 255 - 264.
[Abstract] [Full Text] [PDF]


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CirculationHome page
Z. Wang, W. Kutschke, K. E. Richardson, M. Karimi, and J. A. Hill
Electrical Remodeling in Pressure-Overload Cardiac Hypertrophy: Role of Calcineurin
Circulation, October 2, 2001; 104(14): 1657 - 1663.
[Abstract] [Full Text] [PDF]


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Eur Heart J SupplHome page
S. Kaab and M. Nabauer
Diversity of ion channel expression in health and disease
Eur. Heart J. Suppl., September 1, 2001; 3(suppl_K): K31 - K40.
[Abstract] [PDF]


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Am. J. Physiol. Cell Physiol.Home page
C. A. Ufret-Vincenty, D. J. Baro, and L. F. Santana
Differential contribution of sialic acid to the function of repolarizing K+ currents in ventricular myocytes
Am J Physiol Cell Physiol, August 1, 2001; 281(2): C464 - C474.
[Abstract] [Full Text] [PDF]


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J. Physiol.Home page
C. Antzelevitch
Molecular basis for the transmural distribution of the transient outward current
J. Physiol., May 15, 2001; 533(1): 1 - 1.
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J. Physiol.Home page
B. Rosati, Z. Pan, S. Lypen, H.-S. Wang, I. Cohen, J. E Dixon, and D. McKinnon
Regulation of KChIP2 potassium channel {beta} subunit gene expression underlies the gradient of transient outward current in canine and human ventricle
J. Physiol., May 15, 2001; 533(1): 119 - 125.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
P. B. Adamson and E. Vanoli
Early autonomic and repolarization abnormalities contribute to lethal arrhythmias in chronic ischemic heart failure: Characteristics of a novel heart failure model in dogs with postmyocardial infarction left ventricular dysfunction
J. Am. Coll. Cardiol., May 1, 2001; 37(6): 1741 - 1748.
[Abstract] [Full Text] [PDF]


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J. Pharmacol. Exp. Ther.Home page
T. González, M. Longobardo, R. Caballero, E. Delpón, J. Tamargo, and C. Valenzuela
Effects of Bupivacaine and a Novel Local Anesthetic, IQB-9302, on Human Cardiac K+ Channels
J. Pharmacol. Exp. Ther., April 13, 2001; 296(2): 573 - 583.
[Abstract] [Full Text]


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Circ. Res.Home page
M. Nabauer
Tuning Repolarization in the Heart : A Multitude of Potassium Channels and Regulatory Pathways
Circ. Res., March 16, 2001; 88(5): 453 - 455.
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Circ. Res.Home page
T.-T. Zhang, K. Takimoto, A. F. R. Stewart, C. Zhu, and E. S. Levitan
Independent Regulation of Cardiac Kv4.3 Potassium Channel Expression by Angiotensin II and Phenylephrine
Circ. Res., March 16, 2001; 88(5): 476 - 482.
[Abstract] [Full Text] [PDF]


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Pharmacol. Rev.Home page
C.-C. Shieh, M. Coghlan, J. P. Sullivan, and M. Gopalakrishnan
Potassium Channels: Molecular Defects, Diseases, and Therapeutic Opportunities
Pharmacol. Rev., December 1, 2000; 52(4): 557 - 594.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
J. L. Greenstein, R. Wu, S. Po, G. F. Tomaselli, and R. L. Winslow
Role of the Calcium-Independent Transient Outward Current Ito1 in Shaping Action Potential Morphology and Duration
Circ. Res., November 24, 2000; 87(11): 1026 - 1033.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
P. G.A. Volders, M. A. Vos, B. Szabo, K. R. Sipido, S.H.M. de Groot, A. P.M. Gorgels, H. J.J. Wellens, and R. Lazzara
Progress in the understanding of cardiac early afterdepolarizations and torsades de pointes: time to revise current concepts
Cardiovasc Res, June 1, 2000; 46(3): 376 - 392.
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Am. J. Physiol. Cell Physiol.Home page
Y. A. Kuryshev, T. I. Gudz, A. M. Brown, and B. A. Wible
KChAP as a chaperone for specific K+ channels
Am J Physiol Cell Physiol, May 1, 2000; 278(5): C931 - C941.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
L. C. Baker, B. London, B.-R. Choi, G. Koren, and G. Salama
Enhanced Dispersion of Repolarization and Refractoriness in Transgenic Mouse Hearts Promotes Reentrant Ventricular Tachycardia
Circ. Res., March 3, 2000; 86(4): 396 - 407.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
E. Cerbai, A. Crucitti, L. Sartiani, P. De Paoli, R. Pino, M. L. Rodriguez, G. Gensini, and A. Mugelli
Long-term treatment of spontaneously hypertensive rats with losartan and electrophysiological remodeling of cardiac myocytes
Cardiovasc Res, January 14, 2000; 45(2): 388 - 396.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
T. Kiyosue and M. Arita
Altered expression of cardiac K+ channel genes during sub-acute and healing phases of myocardial infarction
Cardiovasc Res, October 1, 1999; 44(1): 13 - 16.
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CirculationHome page
Y. A. Kuryshev, G. M. Brittenham, H. Fujioka, P. Kannan, C.-C. Shieh, S. A. Cohen, and A. M. Brown
Decreased Sodium and Increased Transient Outward Potassium Currents in Iron-Loaded Cardiac Myocytes : Implications for the Arrhythmogenesis of Human Siderotic Heart Disease
Circulation, August 10, 1999; 100(6): 675 - 683.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
P. Schaffer, B. Pelzmann, E. Bernhart, P. Lang, H. Machler, B. Rigler, and B. Koidl
Repolarizing currents in ventricular myocytes from young patients with tetralogy of Fallot
Cardiovasc Res, August 1, 1999; 43(2): 332 - 343.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
G. F. Tomaselli and E. Marban
Electrophysiological remodeling in hypertrophy and heart failure
Cardiovasc Res, May 1, 1999; 42(2): 270 - 283.
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Cardiovasc ResHome page
D. M. Roden and S. Kupershmidt
From genes to channels: normal mechanisms
Cardiovasc Res, May 1, 1999; 42(2): 318 - 326.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
F. Aimond, J. L Alvarez, J.-M. Rauzier, P. Lorente, and G. Vassort
Ionic basis of ventricular arrhythmias in remodeled rat heart during long-term myocardial infarction
Cardiovasc Res, May 1, 1999; 42(2): 402 - 415.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
U. C. Hoppe, D. C. Johns, E. Marban, and B. O'Rourke
Manipulation of Cellular Excitability by Cell Fusion : Effects of Rapid Introduction of Transient Outward K+ Current on the Guinea Pig Action Potential
Circ. Res., April 30, 1999; 84(8): 964 - 972.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
M. Song, G. Helguera, M. Eghbali, N. Zhu, M. M. Zarei, R. Olcese, L. Toro, and E. Stefani
Remodeling of Kv4.3 Potassium Channel Gene Expression under the Control of Sex Hormones
J. Biol. Chem., August 17, 2001; 276(34): 31883 - 31890.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
C. A. Ufret-Vincenty, D. J. Baro, W. J. Lederer, H. A. Rockman, L. E. Quinones, and L. F. Santana
Role of Sodium Channel Deglycosylation in the Genesis of Cardiac Arrhythmias in Heart Failure
J. Biol. Chem., July 20, 2001; 276(30): 28197 - 28203.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
G. J. Rozanski and Z. Xu
Glutathione and K+ channel remodeling in postinfarction rat heart
Am J Physiol Heart Circ Physiol, June 1, 2002; 282(6): H2346 - H2355.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
Z. Kassiri, C. Zobel, T.-T. T. Nguyen, J. D. Molkentin, and P. H. Backx
Reduction of Ito Causes Hypertrophy in Neonatal Rat Ventricular Myocytes
Circ. Res., March 22, 2002; 90(5): 578 - 585.
[Abstract] [Full Text] [PDF]