Abrogation of ventricular arrhythmias in a model of ischemia and reperfusion by targeting myocardial calcium cycling

F del Monte, D Lebeche, JL Guerrero… - Proceedings of the …, 2004 - National Acad Sciences
F del Monte, D Lebeche, JL Guerrero, T Tsuji, AA Doye, JK Gwathmey, RJ Hajjar
Proceedings of the National Academy of Sciences, 2004National Acad Sciences
Abnormal intracellular Ca2+ cycling plays an important role in cardiac dysfunction and
ventricular arrhythmias in the setting of heart failure and transient cardiac ischemia followed
by reperfusion (I/R). We hypothesized that overexpression of the sarcoplasmic reticulum
Ca2+ ATPase pump (SERCA2a) may improve both contractile dysfunction and ventricular
arrhythmias. Continuous ECG recordings were obtained in 46 conscious rats after
adenoviral gene transfer of either SERCA2a or the reporter gene β-galactosidase (βgal) or …
Abnormal intracellular Ca2+ cycling plays an important role in cardiac dysfunction and ventricular arrhythmias in the setting of heart failure and transient cardiac ischemia followed by reperfusion (I/R). We hypothesized that overexpression of the sarcoplasmic reticulum Ca2+ ATPase pump (SERCA2a) may improve both contractile dysfunction and ventricular arrhythmias. Continuous ECG recordings were obtained in 46 conscious rats after adenoviral gene transfer of either SERCA2a or the reporter gene β-galactosidase (βgal) or parvalbumin (PV), as early as 48 h before and 48 h after 30 min ligation of the left anterior descending artery by using an implantable telemetry system. Sham-operated animals were used for comparison for hemodynamic measurements, whereas within-animal baseline was used for electrocardiographic and echocardiographic parameters. All episodes of nonsustained ventricular tachycardia (VT) and ventricular fibrillation (VF) were counted, and their durations were summed by telemetry. I/R decreased regional cardiac wall thickening as well as the maximal rate of left ventricular pressure rise (+dP/dt) and ventricular pressure fall (–dP/dt). SERCA2a restored regional wall thickening and +dP/dt and –dP/dt to levels seen preoperatively. Regional-wall motion and anterior-wall thickening were improved in the SERCA2a animals, as assessed by echocardiography and piezoelectric crystals. To assess whether these effects are SERCA2a specific, we overexpressed a skeletal-muscle protein, PV, to examine whether Ca2+ buffering alone can mitigate ventricular arrhythmias. During the first hour after I/R, the rate of nonsustained VT plus VF was 16 ± 5 episodes per h (n = 6) in the Ad.βgal group, 22 ± 6 in the Ad.PV group, and 4 ± 2(n = 6, P < 0.01) in the Ad.SERCA2a group. The decrease in VT plus VF in the Ad.SERCA2a group was consistent throughout the 48 h of monitoring. These results show that improving intracellular Ca2+ handling by overexpression of SERCA2a restores contractile function and reduces ventricular arrhythmias during I/R.
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