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Am J Physiol Heart Circ Physiol 280: H354-H360, 2001;
0363-6135/01 $5.00
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Vol. 280, Issue 1, H354-H360, January 2001

Accelerated inactivation in a mutant Na+ channel associated with idiopathic ventricular fibrillation

Xiaoping Wan1, Shenghan Chen2, Azita Sadeghpour2, Qing Wang2, and Glenn E. Kirsch1

1 Department of Physiology and Biophysics, Rammelkamp Center for Education and Research, Case Western Reserve University, MetroHealth Campus, Cleveland 44109; and 2 Departments of Molecular Cardiology and of Cardiology, Center for Molecular Genetics, The Cleveland Clinic Foundation, Cleveland, Ohio 44195

Idiopathic ventricular fibrillation (IVF) can cause sudden death in both adults and children. One form of IVF (Brugada syndrome), characterized by S-T segment elevation (STE) in the electrocardiogram, has been linked to mutations of SCN5A, the gene encoding the voltage-gated cardiac Na+ channel. A missense mutation of SCN5A that substitutes glutamine for leucine at codon 567 (L567Q, in the cytoplasmic linker between domains I and II) is identified with sudden infant death and Brugada syndrome in one family. However, neither the functional effect of the L567Q mutation nor the molecular mechanism underlying the pathogenicity of the mutation is known. Patch-clamp analysis of L567Q channels expressed in human embryonic kidney cells revealed a marked acceleration and a negative shift in the voltage dependence of inactivation. Unlike other Brugada mutations, this phenotype was expressed independently of temperature or auxiliary beta 1-subunits. These results support a proposed linkage between Brugada syndrome and some instances of sudden infant death and the hypothesis that reduced Na+ conductance is the primary cause of IVF with STE.

SCN5A; Brugada syndrome; arrhythmia; sudden infant death syndrome


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