Abstract-Cardiac] i transients Ⅲ ryanodine receptor Ⅲ excitation-contraction coupling Ⅲ CPVT C atecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited arrhythmogenic disease characterized by stress-induced, adrenergically mediated bidirectional or polymorphic ventricular tachycardia occurring in structurally normal hearts. 1 During exercise or acute emotions, CPVT patients develop life-threatening ventricular arrhythmias, leading to syncope or sudden death. The first cardiac ryanodine receptor (RyR2) mutation identified in a CPVT family was R4497C. 2 Today, more than 70 RyR2 mutations have been reported (http://www.fsm.it/cardmoc), and they comprise the most common genetic subtype of CPVT, 3-7 although mutations in the calsequestrin gene can also cause CPVT. 8,9 Diverging results and conclusions have been generated from expression studies of RyR2 R4496C in heterologous systems. Jiang et al showed that RyR2 R4496C (the mouse equivalent of the human RyR2 R4497C mutation), when expressed in human embryonic kidney (HEK) cells, exhibits increased basal activity and increased sensitivity to luminal Ca 2ϩ . 10 However, other authors found no difference in the basal activity of RyR2 R4497C but, instead, showed increased activity and gating frequency after protein kinase A phosphorylation 11 or sarcoplasmic reticulum (SR) Ca 2ϩ overload. 12 The expression studies were carried out in a variety of models, which may explain the inhomogeneous findings. Furthermore, heterologous systems lack cardiac intracellular environment with all the RyR2 accessory proteins 13 and most Ca 2ϩ -handling proteins, so analysis in native cardiac myocytes is now critical to elucidate the mechanisms by which the mutation leads to cardiac arrhythmia.Recently, a knock-in mouse model carrier of the RyR2 R4496C mutation was developed. 14 Their phenotype presents extraordinary similarity with the clinical manifestations of patients carrying the RyR2 R4497C mutation, including the development of bidirectional ventricular tachycardia. When exposed to adrenaline and caffeine, the RyR2 R4496C cardiomyocytes develop delayed afterdepolarizations (DADs), 15 suggesting that triggered arrhythmias are elicited by adrenergic activation. 16 Here we demonstrate that untreated RyR2 R4496C myocytes have increased spontaneous Ca 2ϩ release in diastole during electric pacing, because of the enhanced Ca 2ϩ sensitivity of mutant RyR2; this abnormality is further augmented by exposure to isoproterenol and increasing pacing rates. Materials and Methods Ventricular cardiomyocytes from male and female RyR2R4496Cϩ/Ϫ mice (RyR2 R4496C ) and their wild-type (WT) RyR2 R4496CϪ/Ϫ littermates were isolated using a standard enzymatic digestion. 17 [Ca 2ϩ ] i transients and Ca 2ϩ sparks were viewed in isolated myocytes by confocal microscopy and analyzed using homemade routines. All experiments were carried out according to the ethical principles laid down by the French (Ministry of Agriculture) and European Union

Activation of] required for the latter process (ED 50 ‫؍‬ ϳ200 M) appears to be reached only within the dyadic space. Rapid injection of 5 M sorcin onto the cytosolic face of RyRs reconstituted in lipid bilayers resulted in complete inhibition of channel activity in < 20 ms. Thus, sorcin is a potent inhibitor of both spontaneous and I Ca -triggered RyR activity and is kinetically capable of playing a role in terminating the positive feedback loop of CICR.

Background-The mineralocorticoid pathway is involved in cardiac arrhythmias associated with heart failure through mechanisms that are incompletely understood. Defective regulation of the cardiac ryanodine receptor (RyR) is an important cause of the initiation of arrhythmias. Here, we examined whether the aldosterone pathway might modulate RyR function. Methods and Results-Using the whole-cell patch clamp method, we observed an increase in the occurrence of delayed afterdepolarizations during action potential recordings in isolated adult rat ventricular myocytes exposed for 48 hours to aldosterone 100 nmol/L, in freshly isolated myocytes from transgenic mice with human mineralocorticoid receptor expression in the heart, and in wild-type littermates treated with aldosterone. Sarcoplasmic reticulum Ca 2ϩ load and RyR expression were not altered; however, RyR activity, visualized in situ by confocal microscopy, was increased in all cells, as evidenced by an increased occurrence and redistribution to long-lasting and broader populations of spontaneous Ca