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Sarcoplasmic Reticulum Calcium Content Fluctuation Is the Key to Cardiac Alternans

TLDR
Investigation of beat-to-beat alternation in the amplitude of the systolic Ca2+ transient (Ca2+ alternans) found that it was found that, in rat ventricular myocytes, stimulating with small (20 mV) depolarizing pulses produced alternans of the amplitudes of the Ca2- transient, which results from the steep dependence on SR Ca2+.
Abstract
The aim of this work was to investigate whether beat-to-beat alternation in the amplitude of the systolic Ca 2+ transient (Ca 2+ alternans) is due to changes of sarcoplasmic reticulum (SR) Ca 2+ content, and if so, whether the alternans arises due to a change in the gain of the feedback controlling SR Ca 2+ content. We found that, in rat ventricular myocytes, stimulating with small (20 mV) depolarizing pulses produced alternans of the amplitude of the Ca 2+ transient. Confocal measurements showed that the larger transients resulted from propagation of Ca 2+ waves. SR Ca 2+ content (measured from caffeine-evoked membrane currents) alternated in phase with the alternans of Ca 2+ transient amplitude. After a large transient, if SR Ca 2+ content was elevated by brief exposure of the cell to a Na + -free solution, then the alternans was interrupted and the next transient was also large. This shows that changes of SR Ca 2+ content are sufficient to produce alternans. The dependence of Ca 2+ transient amplitude on SR content was steeper under alternating than under control conditions. During alternation, the Ca 2+ efflux from the cell was also a steeper function of SR Ca 2+ content than under control. We attribute these steeper relationships to the fact that the larger responses in alternans depend on wave propagation and that wave propagation is a steep function of SR Ca 2+ content. In conclusion, alternans of systolic Ca 2+ appears to depend on alternation of SR Ca 2+ content. This, in turn results from the steep dependence on SR Ca 2+ content of Ca 2+ release and therefore Ca 2+ efflux from the cell as a consequence of wave propagation.

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Citations
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Calcium and Excitation-Contraction Coupling in the Heart.

TL;DR: The factors that regulate and fine-tune the initiation and termination of release of Ca, including the role of Ca buffers, mitochondria, Ca leak, and regulation of diastolic [Ca2+]i are reviewed.
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From Pulsus to Pulseless: The Saga of Cardiac Alternans

TL;DR: These insights have illuminated the mechanistic basis underlying the clinical association of cardiac alternans (eg, T wave alternans) with arrhythmia risk, which may lead to novel therapeutic approaches to avert sudden cardiac death.
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Orphaned ryanodine receptors in the failing heart

TL;DR: It is concluded that the increased spatial dispersion of the TTs and orphaned RyRs lead to the loss of local control and Ca(2+) instability in heart failure.
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A Rabbit Ventricular Action Potential Model Replicating Cardiac Dynamics at Rapid Heart Rates

TL;DR: This study modified the L-type calcium (Ca) current and Ca(i) cycling formulations based on new experimental patch-clamp data obtained in isolated rabbit ventricular myocytes, and developed a minimal seven-state Markovian model of I(Ca,L) that reproduced Ca- and voltage-dependent kinetics.
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Calcium and Arrhythmogenesis

TL;DR: A systematic review of the mechanisms of Ca2+ transport (forward excitation-contraction coupling) in the ventricular cell as well as what is known for other cardiac cell types will provide a more complete understanding of the molecular basis for the targeted control of cellular calcium in the treatment and prevention of arrhythmias.
References
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Journal ArticleDOI

Muscarinic activation of ionic currents measured by a new whole-cell recording method

TL;DR: Nystatin, applied extracellularly, is shown to cause a rapid and reversible increase of membrane conductance to cations, and dose-response curves for the effect of ACh on Ca-activated K currents are obtained.
Journal ArticleDOI

Excitation-Contraction Coupling and Cardiac Contractile Force.

TL;DR: The major cellular structures involved in E-C coupling include myofilaments, Na/Ca exchange and the sarcolemmal Ca-pump as mentioned in this paper, as well as the sources and sinks of activator calcium.
Journal ArticleDOI

Mechanism linking T-wave alternans to the genesis of cardiac fibrillation

TL;DR: Repolarization alternans at the level of the single cell accounts for T- wave alternans on the surface ECG and establishes a mechanism linking T-wave alternans of the ECG to the pathogenesis of sudden cardiac death.
Journal ArticleDOI

Defective excitation-contraction coupling in experimental cardiac hypertrophy and heart failure.

TL;DR: The same defect in EC coupling that develops during hypertrophy may contribute to heart failure when compensatory mechanisms fail because it appears to reside in a change in the relation between SR calcium-release channels and sarcolemmal calcium channels.
Journal ArticleDOI

Fractional SR Ca release is regulated by trigger Ca and SR Ca content in cardiac myocytes.

TL;DR: This study assessed how the fractional SR Ca release as described by Bassani et al. is affected by alteration of trigger Ca and of SR Ca content and found it to be very close to the limiting SR Ca capacity.
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