Key result
Low aerobic capacity links to ~5-fold higher ventricular fibrillation incidence and increased diastolic calcium leak.
Why the study?
Does inborn low aerobic capacity increase diastolic Ca2+ leak and susceptibility to ventricular fibrillation in a selectively bred rat model?
Does inborn low aerobic capacity increase diastolic Ca2+ leak and susceptibility to ventricular fibrillation in a selectively bred rat model?
A genetic predisposition to low aerobic capacity is associated with hyperphosphorylation of RyR2 by CaMKII, resulting in diastolic Ca2+ leak and increased susceptibility to ventricular arrhythmias.
Does not support clinical translation; leaves open whether low aerobic capacity drives human arrhythmia risk via Ca2+ leak.
AIM: Rats selectively bred for inborn low capacity of running (LCR) display a series of poor health indices, whereas rats selected for high capacity of running (HCR) display a healthy profile. We hypothesized that selection of low aerobic capacity over generations leads to a phenotype with increased diastolic Ca(2+) leak that trigger arrhythmia. METHODS: We used rats selected for HCR (N = 10) or LCR (N = 10) to determine the effect of inborn aerobic capacity on Ca(2+) leak and susceptibility of ventricular arrhythmia. We studied isolated Fura-2/AM-loaded cardiomyocytes to detect Ca(2+) handling and function on an inverted epifluorescence microscope. To determine arrhythmogenicity, we did a final experiment with electrical burst pacing in Langendorff-perfused hearts. RESULTS: Ca(2+) handling was impaired by reduced Ca(2+) amplitude, prolonged time to 50% Ca(2+) decay and reduced sarcoplasmic reticulum (SR) Ca(2+) content. Impaired Ca(2+) removal was influenced by reduced SR Ca(2+) ATP-ase 2a (SERCA2a) function and increased sodium/Ca(2+) exchanger (NCX) in LCR rats. Diastolic Ca(2) leak was 87% higher in LCR rats. The leak was reduced by CaMKII inhibition. Expression levels of phosphorylated threonine 286 CaMKII levels and increased RyR2 phosphorylation at the serine 2814 site mechanistically support our findings of increased leak in LCR. LCR rats had significantly higher incidence of ventricular fibrillation. CONCLUSION: Selection of inborn low aerobic capacity over generations leads to a phenotype with increased risk of ventricular fibrillation. Increased phosphorylation of CaMKII at serine 2814 at the cardiac ryanodine receptor appears as an important mechanism of impaired Ca(2+) handling and diastolic Ca(2+) leak that results in increased susceptibility to ventricular fibrillation.
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Høydal et al. (2014) studied Arrhythmogenicity and defective Ca2+ handling (n=20). Inborn low aerobic running capacity (LCR) vs. Inborn high aerobic running capacity (HCR) was evaluated on Incidence of sustained ventricular fibrillation (p=<0.01). Rats with inborn low aerobic capacity demonstrated 83% increased diastolic SR Ca2+ leak and a significantly higher incidence of burst-pacing induced ventricular fibrillation (5/5 vs 1/5, p<0.01).
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