Lebek, Simon and Pichler, Konstantin and Reuthner, Kathrin and Trum, Maximillian and Tafelmeier, Maria and Mustroph, Julian and Camboni, Daniele and Rupprecht, Leopold and Schmid, Christof and Maier, Lars S. and Arzt, Michael and Wagner, Stefan (2020) Enhanced CaMKII-Dependent Late I-Na Induces Atrial Proarrhythmic Activity in Patients With Sleep-Disordered Breathing. CIRCULATION RESEARCH, 126 (5). pp. 603-615. ISSN 0009-7330, 1524-4571
Full text not available from this repository. (Request a copy)Abstract
Rationale: Sleep-disordered breathing (SDB) is frequently associated with atrial arrhythmias. Increased CaMKII (Ca/calmodulin-dependent protein kinase II) activity has been previously implicated in atrial arrhythmogenesis. Objective:We hypothesized that CaMKII-dependent dysregulation of Na current (I-Na) may contribute to atrial proarrhythmic activity in patients with SDB. Methods and Results: We prospectively enrolled 113 patients undergoing elective coronary artery bypass grafting for cross-sectional study and collected right atrial appendage biopsies. The presence of SDB (defined as apnea-hypopnea index >= 15/h) was assessed with a portable SDB monitor the night before surgery. Compared with 56 patients without SDB, patients with SDB (57) showed a significantly increased level of activated CaMKII. Patch clamp was used to measure I-Na. There was a significantly enhanced late I-Na, but reduced peak I-Na due to enhanced steady-state inactivation in atrial myocytes of patients with SDB consistent with significantly increased CaMKII-dependent cardiac Na channel phosphorylation (Na(V)1.5, at serine 571, Western blotting). These gating changes could be fully reversed by acute CaMKII inhibition (AIP [autocamtide-2 related inhibitory peptide]). As a consequence, we observed significantly more cellular afterdepolarizations and more severe premature atrial contractions in atrial trabeculae of patients with SDB, which could be blocked by either AIP or KN93 (N-[2-[[[(E)-3-(4-chlorophenyl)prop-2-enyl]-methylamino]methyl]phenyl]-N-(2-hydroxyethyl)-4-methoxybenzenesulfonamide). In multivariable linear regression models incorporating age, sex, body mass index, existing atrial fibrillation, existing heart failure, diabetes mellitus, and creatinine levels, apnea-hypopnea index was independently associated with increased CaMKII activity, enhanced late I-Na and correlated with premature atrial contraction severity. Conclusions: In atrial myocardium of patients with SDB, increased CaMKII-dependent phosphorylation of Na(V)1.5 results in dysregulation of I-Na with proarrhythmic activity that was independent from preexisting comorbidities. Inhibition of CaMKII may be useful for prevention or treatment of arrhythmias in SDB.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PROTEIN-KINASE-II; CARDIAC REPOLARIZATION; CA2+ LEAK; FIBRILLATION; SODIUM; PHOSPHORYLATION; PREVALENCE; ACTIVATION; APNEA; CONTRACTILITY; action potential; atrial appendage; atrial fibrillation; CaMKII; heart failure; Na channel; sleep apnea |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 30 Mar 2021 08:21 |
| Last Modified: | 30 Mar 2021 08:21 |
| URI: | https://pred.uni-regensburg.de/id/eprint/45058 |
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