Computational modeling demonstrates that total calcium content and buffering levels (like calsequestrin) are critical determinants of pro-arrhythmic calcium oscillations in cardiac cells.
Abstract Calcium oscillations and waves are often behind instances of extra depolarization in cardiac cells, eventually giving rise to life-threatening arrhythmias. In this work, we study the conditions for the appearance of calcium oscillations in both a detailed subcellular model of calcium dynamics and a minimal model that takes into account just the minimal ingredients of the calcium toolkit. To avoid the effects of homeostatic changes and the interaction with the action potential we consider the somewhat artificial condition of a cell without pacing and with no calcium exchange with the extracellular medium. This permits us to isolate the main reasons responsible for the oscillations by controlling externally the total calcium content of the cell. We find that as the calcium content is increased, the system transitions between two stationary states, corresponding to one with closed ryanodine receptors (RyR) and most calcium in the cell stored in the sarcoplasmic reticulum (SR), and another, with open RyRs and a depleted SR. In between these states, calcium oscillations may appear. This transition depends very sensitively in the amount of buffering in the cell. We find, for instance, that at high values of calsequestrin (CSQ) oscillations disappear, while they are present for a broad range of parameters at low values of CSQ. Using the minimal model, we can relate the stability of the oscillating state to the nullcline structure of the system, and find that its range of existence is bounded by a homoclinic and a Hopf bifurcation. Author summary In cardiac cells, calcium plays a very important role. An increase in calcium levels is the trigger used by the cell to initiate contraction. Besides, calcium modulates several transmembrane currents, affecting the cell transmembrane potential. Thus, dysregulations in calcium handling have been associated with the appearance of arrhythmias. Often, this dysregulation results in the appearance of periodic calcium waves or global oscillations, providing a pro-arrhythmic substrate. In this paper, we study the onset of calcium oscillations in cardiac cells using both a detailed subcellular model of calcium dynamics and a minimal model that takes into account just the minimal ingredients of the calcium toolkit. Both reproduce the main experimental results and link this behavior with the presence of different steady-state solutions and bifurcations that depend on the total amount of calcium in the cell and in the level of buffering present. We expect that this work will help to clarify the conditions under which calcium oscillations appear in cardiac myocytes and, therefore, will represent a step further in the understanding of the origin of cardiac arrhythmias.
Marchena et al. (Fri,) studied this question.