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Am J Physiol Heart Circ Physiol 297: H1235-H1242, 2009. First published July 31, 2009; doi:10.1152/ajpheart.01320.2008
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Spontaneous calcium release in tissue from the failing canine heart

Gregory S. Hoeker, Rodolphe P. Katra, Lance D. Wilson, Bradley N. Plummer, and Kenneth R. Laurita

The Heart and Vascular Research Center, MetroHealth Campus, and the Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio

Submitted December 22, 2008 ; accepted in final form July 29, 2009

Abnormalities in calcium handling have been implicated as a significant source of electrical instability in heart failure (HF). While these abnormalities have been investigated extensively in isolated myocytes, how they manifest at the tissue level and trigger arrhythmias is not clear. We hypothesize that in HF, triggered activity (TA) is due to spontaneous calcium release from the sarcoplasmic reticulum that occurs in an aggregate of myocardial cells (an SRC) and that peak SCR amplitude is what determines whether TA will occur. Calcium and voltage optical mapping was performed in ventricular wedge preparations from canines with and without tachycardia-induced HF. In HF, steady-state calcium transients have reduced amplitude [135 vs. 170 ratiometric units (RU), P < 0.05] and increased duration (252 vs. 229 s, P < 0.05) compared with those of normal. Under control conditions and during β-adrenergic stimulation, TA was more frequent in HF (53% and 93%, respectively) compared with normal (0% and 55%, respectively, P < 0.025). The mechanism of arrhythmias was SCRs, leading to delayed afterdepolarization-mediated triggered beats. Interestingly, the rate of SCR rise was greater for events that triggered a beat (0.41 RU/ms) compared with those that did not (0.18 RU/ms, P < 0.001). In contrast, there was no difference in SCR amplitude between the two groups. In conclusion, TA in HF tissue is associated with abnormal calcium regulation and mediated by the spontaneous release of calcium from the sarcoplasmic reticulum in aggregates of myocardial cells (i.e., an SCR), but importantly, it is the rate of SCR rise rather than amplitude that was associated with TA.

heart failure; arrhythmia; delayed afterdepolarization; triggered activity



Address for reprint requests and other correspondence: K. R. Laurita, MetroHealth Campus, Case Western Reserve Univ., 2500 MetroHealth Dr., Rammelkamp, 6th fl., Cleveland, OH 44109-1998 (e-mail: klaurita{at}metrohealth.org).




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P. A. Boyden
The failing ventricle: what initiates the complex ventricular arrhythmias?
Am J Physiol Heart Circ Physiol, October 1, 2009; 297(4): H1198 - H1199.
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