Ankyrin-B reduction enhances Ca spark-mediated SR Ca release promoting cardiac myocyte arrhythmic activity

Emmanuel Camors1, Peter J Mohler, Donald M Bers

  • 1Department of Pharmacology, University of California, Davis, CA 95616-8636, USA.

Insights

Reduced Ankyrin-B (AnkB) function in heart cells increases calcium sparks and waves, raising the risk of arrhythmias. This occurs due to altered ion transport and coordinated RyR openings, not increased total SR calcium leak.

Area of Science:

  • Cardiology
  • Molecular Biology
  • Electrophysiology

Background:

  • Ankyrin-B (AnkB) loss-of-function is linked to human ventricular arrhythmias and sudden cardiac death.
  • AnkB deficiency in cardiac myocytes affects key ion transporters like Na/Ca exchanger (NCX) and Na/K-ATPase (NKA), impacting intracellular sodium ([Na](i)) and calcium ([Ca](i)) regulation.
  • Understanding AnkB's role in cardiac calcium handling is crucial for preventing arrhythmias.

Purpose of the Study:

  • To investigate the effects of AnkB reduction on cardiac intracellular sodium ([Na](i)), calcium ([Ca](i)), and sarcoplasmic reticulum (SR) calcium release.
  • To determine the mechanisms underlying altered calcium handling and its contribution to arrhythmogenesis in AnkB-deficient myocytes.

Main Methods:

  • Comparison of cardiac myocytes from AnkB heterozygous (AnkB(+/-)) and wild-type (WT) mice.
  • Measurement of intracellular ion concentrations, calcium transients, SR calcium content, and SR calcium leak.
  • Analysis of spontaneous calcium sparks (CaSpF) and ryanodine receptor (RyR) activity in intact and permeabilized myocytes.

Main Results:

  • AnkB(+/-) myocytes exhibited reduced NCX and NKA transport function but maintained normal [Na](i) and diastolic [Ca](i).
  • Larger Ca transients, increased SR Ca content, and enhanced fractional SR Ca release were observed in AnkB(+/-) myocytes.
  • AnkB(+/-) myocytes showed a significantly higher frequency of spontaneous diastolic Ca sparks (CaSpF) due to more coordinated RyR openings, despite unaffected total SR Ca leak.

Conclusions:

  • AnkB reduction alters cardiac ion transport, leading to increased coupled RyR openings and more frequent Ca sparks and waves.
  • This altered calcium dynamics, specifically the bias towards Ca sparks, enhances the propensity for pro-arrhythmic events in AnkB(+/-) mice.
  • The findings highlight a novel mechanism by which AnkB deficiency promotes triggered arrhythmias through localized RyR regulation.

Related Concept Videos

Mechanism of Cardiac Arrhythmias01:28

Mechanism of Cardiac Arrhythmias

Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which indirectly block calcium...
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of the heart's...
G-Protein Gated Ion Channels01:21

G-Protein Gated Ion Channels

GPCRs are primarily responsible for our sense of smell, taste, and vision.  The binding of a sensory stimulus activates GPCR to stimulate effector proteins, many of which are ion channels in the sensory organs. GPCRs modulate the opening and closing of the target ion channels either directly by binding them, or by releasing second messengers that activate these channels. As ions move across the membrane, the membrane potential is altered, which induces an appropriate response.
Sensory organs,...
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers01:20

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...