Clinical phenotype and functional characterization of CASQ2 mutations associated with catecholaminergic polymorphic

Marina Raffaele di Barletta1, Serge Viatchenko-Karpinski, Alessandra Nori

  • 1Molecular Cardiology, IRCCS Fondazione Maugeri, University of Pavia, Via Ferrata 8 27100, Pavia, Italy.

Circulation
|August 16, 2006
PubMed
Abstract

Insights

Two new mutations in the cardiac calsequestrin gene (CASQ2) were identified in children with catecholaminergic polymorphic ventricular tachycardia (CPVT). These mutations disrupt intracellular calcium regulation, leading to dangerous heart rhythms.

Area of Science:

  • Cardiovascular Genetics
  • Molecular Cardiology
  • Arrhythmogenesis

Background:

  • Four mutations in the human cardiac calsequestrin gene (CASQ2) are linked to catecholaminergic polymorphic ventricular tachycardia (CPVT).
  • Understanding the mechanisms of CPVT caused by CASQ2 mutations is limited due to insufficient in vitro characterization of identified mutants.

Purpose of the Study:

  • To identify and characterize novel CASQ2 mutations associated with CPVT.
  • To investigate the functional consequences of these mutations on cardiac myocyte calcium handling and arrhythmogenesis.

Main Methods:

  • Genetic sequencing to identify CASQ2 mutations in CPVT patients.
  • In vitro characterization of CASQ2 mutant protein function, including calcium binding.
  • Expression of mutant CASQ2 in rat myocytes to assess sarcoplasmic reticulum calcium storage and calcium transients.
  • Electrophysiological studies to evaluate the impact of mutations on arrhythmogenic events.

Main Results:

  • A homozygous 16-bp deletion (CASQ2(G112+5X)) and a compound heterozygous mutation (CASQ2(L167H)) were identified in CPVT patients.
  • CASQ2(G112+5X) exhibited impaired calcium binding, while both mutants reduced sarcoplasmic reticulum calcium capacity in myocytes.
  • Myocytes expressing mutants showed reduced I(Ca)-induced Ca2+ transients and spontaneous Ca2+ sparks; isoproterenol induced delayed afterdepolarizations in CASQ2(G112+5X) expressing myocytes.

Conclusions:

  • The identified CASQ2(L167H) and CASQ2(G112+5X) mutations impair cardiac myocyte function by altering calcium regulation.
  • These distinct abnormalities in intracellular calcium handling contribute to the development of tachyarrhythmias in CPVT patients.
  • The study elucidates the molecular mechanisms underlying CPVT associated with novel CASQ2 mutations.

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