Metabolic regulation of Kv channels and cardiac repolarization by Kvβ2 subunits

Voltage-gated potassium (Kv) channels control myocardial repolarization. Pore-forming Kvα proteins associate with intracellular Kvβ subunits, which bind pyridine nucleotides with high affinity and differentially regulate channel trafficking, plasmalemmal localization and gating properties. Nevertheless, it is unclear how Kvβ subunits regulate myocardial K⁺ currents and repolarization. Here, we tested the hypothesis that Kvβ2 subunits regulate the expression of myocardial Kv channels and confer redox sensitivity to Kv current and cardiac repolarization. Co-immunoprecipitation and in situ proximity ligation showed that in cardiac myocytes, Kvβ2 interacts with Kv1.4, Kv1.5, Kv4.2, and Kv4.3. Cardiac myocytes from mice lacking Kcnab2 (Kvβ2^-/-) had smaller cross sectional areas, reduced sarcolemmal abundance of Kvα binding partners, reduced I_to, I_K,slow1, and I_K,slow2 densities, and prolonged action potential duration compared with myocytes from wild type mice. These differences in Kvβ2^-/- mice were associated with greater P wave duration and QT interval in electrocardiograms, and lower ejection fraction, fractional shortening, and left ventricular mass in echocardiographic and morphological assessments. Direct intracellular dialysis with a high NAD(P)H:NAD(P)⁺ accelerated Kv inactivation in wild type, but not Kvβ2^-/- myocytes. Furthermore, elevated extracellular levels of lactate increased [NADH]_i and prolonged action potential duration in wild type cardiac myocytes and perfused wild type, but not Kvβ2^-/-, hearts. Taken together, these results suggest that Kvβ2 regulates myocardial electrical activity by supporting the functional expression of proteins that generate I_to and I_K,slow, and imparting redox and metabolic sensitivity to Kv channels, thereby coupling cardiac repolarization to myocyte metabolism.