Atrial fibrillation complicated by heart failure induces distinct remodeling of calcium cycling proteins

PLoS One. 2015 Mar 16;10(3):e0116395. doi: 10.1371/journal.pone.0116395. eCollection 2015.

Abstract

Atrial fibrillation (AF) and heart failure (HF) are two of the most common cardiovascular diseases. They often coexist and account for significant morbidity and mortality. Alterations in cellular Ca2+ homeostasis play a critical role in AF initiation and maintenance. This study was designed to specifically elucidate AF-associated remodeling of atrial Ca2+ cycling in the presence of mild HF. AF was induced in domestic pigs by atrial burst pacing. The animals underwent electrophysiologic and echocardiographic examinations. Ca2+ handling proteins were analyzed in right atrial tissue obtained from pigs with AF (day 7; n = 5) and compared to sinus rhythm (SR) controls (n = 5). During AF, animals exhibited reduction of left ventricular ejection fraction (from 73% to 58%) and prolonged atrial refractory periods. AF and HF were associated with suppression of protein kinase A (PKA)RII (-62%) and Ca2+-calmodulin-dependent kinase II (CaMKII) δ by 37%, without changes in CaMKIIδ autophosphorylation. We further detected downregulation of L-type calcium channel (LTCC) subunit α2 (-75%), sarcoplasmic reticulum Ca2+-ATPase (Serca) 2a (-29%), phosphorylated phospholamban (Ser16, -92%; Thr17, -70%), and phospho-ryanodine receptor 2 (RyR2) (Ser2808, -62%). Na+-Ca2+ exchanger (NCX) levels were upregulated (+473%), whereas expression of Ser2814-phosphorylated RyR2 and LTCCα1c subunits was not significantly altered. In conclusion, AF produced distinct arrhythmogenic remodeling of Ca2+ handling in the presence of tachycardia-induced mild HF that is different from AF without structural alterations. The changes may provide a starting point for personalized approaches to AF treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Atrial Fibrillation / complications*
  • Atrial Fibrillation / metabolism*
  • Atrial Fibrillation / physiopathology
  • Calcium / metabolism*
  • Female
  • Gene Expression Regulation, Enzymologic
  • Heart Atria / metabolism
  • Heart Failure / complications*
  • Male
  • Phosphorylation
  • Protein Kinases / metabolism
  • Proteins / metabolism*
  • Swine
  • Ventricular Dysfunction, Left

Substances

  • Proteins
  • Protein Kinases
  • Calcium

Grants and funding

This study was supported in part by research grants from the University of Heidelberg, Faculty of Medicine (Postdoc Fellowship to P.L.), from the DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung—German Centre for Cardiovascular Research) and from the BMBF (German Ministry of Education and Research) (to H.A.K. and D.T.), from the German Cardiac Society and the Hengstberger Foundation (Klaus-Georg and Sigrid Hengstberger Scholarship to D.T.), and from the Joachim Siebeneicher Foundation (to D.T.). F.W. was supported by the Cardiology Career Program of the Department of Cardiology, University of Heidelberg. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.