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Updated: Sep 25, 2025

Assessment of Sarcoplasmic Reticulum Calcium Reserve and Intracellular Diastolic Calcium Removal in Isolated Ventricular Cardiomyocytes
Published on: September 18, 2017
Sarcoplasmic Reticulum Ca2+ Dysregulation in the Pathophysiology of Inherited Arrhythmia: An Update
Yuxin Du1, Laurie J Demillard2, Jun Ren3
1Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan University, Shanghai 200032 China.
Insights
Genetic mutations in sarcoplasmic reticulum (SR) proteins can cause inherited arrhythmias like CPVT and LQTS. This review explores how SR Ca2+ dysregulation triggers these life-threatening cardiac events.
Area of Science:
- Cardiology
- Molecular Biology
- Genetics
Background:
- Inherited arrhythmias are a primary cause of sudden cardiac death.
- Mutations in ion channels and sarcoplasmic reticulum (SR) proteins contribute to these conditions.
- SR Ca2+ homeostasis is crucial for cardiomyocyte function.
Purpose of the Study:
- To review normal SR Ca2+ regulation in cardiomyocytes.
- To elucidate mechanisms linking SR Ca2+ dysregulation to arrhythmias.
- To summarize the role of SR gene mutations in inherited arrhythmias.
Main Methods:
- Literature review of genetic mutations affecting SR proteins.
- Analysis of Ca2+ handling in cardiomyocytes.
- Examination of arrhythmogenic mechanisms related to SR Ca2+ dysregulation.
Main Results:
- Genetic mutations in SR proteins (RyR2, SERCA2a, etc.) are implicated in inherited arrhythmias.
- SR Ca2+ dysregulation can lead to early afterdepolarizations, delayed afterdepolarizations, and reentry.
- These disruptions in Ca2+ handling contribute to conditions like CPVT, LQTS, and ARVC/D.
Conclusions:
- SR Ca2+ dysregulation is a significant factor in inherited arrhythmias.
- Understanding these mechanisms is vital for diagnosing and treating sudden cardiac death.
- Further research into SR gene mutations can identify novel therapeutic targets.
Abstract:
Inherited arrhythmias are the leading causes for cardiac arrest and sudden cardiac death (SCD). Other than ion channel mutations, inherited arrhythmias including catecholaminergic polymorphic ventricular tachycardia (CPVT), long QT syndrome (LQTS), idiopathic ventricular fibrillation (IVF) and arrhythmogenic right ventricular cardiomyopathy (ARVC/D) may also be instigated by genetic mutations of sarcoplasmic reticulum (SR) proteins, including ryanodine receptor type-2 (RyR2), calsequestrin 2, SR Ca2+-ATPase type-2a (SERCA2a) and phospholamban. In cardiomyocytes, Ca2+ is an essential ion in addition to Na+ and K+ ions with vital roles in arrhythmogenesis. SR plays a critical role in the maintenance of Ca2+ homeostasis which can be disrupted by mutations in SR Ca2+ regulatory proteins or abnormal SR-intracellular organelle interaction. Early afterdepolarizations, delayed afterdepolarizations and reentry are three primary mechanisms contributing to arrhythmias elicited by SR Ca2+ dysregulation in cardiomyocytes. In this review, we will aim to summarize normal SR Ca2+ regulation in cardiomyocytes, mechanisms of how Ca2+ triggers arrhythmias and involvements of SR gene mutations in inherited arrhythmias as well as the possible arrhythmogenic effects of these mutations.
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