The role of the calcium and the voltage clocks in sinoatrial node dysfunction.
The role of the calcium and the voltage clocks in sinoatrial node dysfunction.
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钙和电压时钟在窦节点功能障碍中的作用。
DOI：
10.3349/ymj.2011.52.2.211
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发表时间：
2011-03
影响因子：
2.4
通讯作者：
Lin SF
中科院分区：
文献类型：
--
作者：
Joung B;Chen PS;Lin SF
Recent evidence indicates that the voltage clock (cyclic activation and deactivation of membrane ion channels) and Ca2+ clocks (rhythmic spontaneous sarcoplasmic reticulum Ca2+ release) jointly regulate sinoatrial node (SAN) automaticity. However, the relative importance of the voltage clock and Ca2+ clock for pacemaking was not revealed in sick sinus syndrome. Previously, we mapped the intracellular calcium (Cai) and membrane potentials of the normal intact SAN simultaneously using optical mapping in Langendorff-perfused canine right atrium. We demonstrated that the sinus rate increased and the leading pacemaker shifted to the superior SAN with robust late diastolic Cai elevation (LDCAE) during β-adrenergic stimulation. We also showed that the LDCAE was caused by spontaneous diastolic sarcoplasmic reticulum (SR) Ca2+ release and was closely related to heart rate changes. In contrast, in pacing induced canine atrial fibrillation and SAN dysfunction models, Ca2+ clock of SAN was unresponsiveness to β-adrenergic stimulation and caffeine. Ryanodine receptor 2 (RyR2) in SAN was down-regulated. Using the prolonged low dose isoproterenol together with funny current block, we produced a tachybradycardia model. In this model, chronically elevated sympathetic tone results in abnormal pacemaking hierarchy in the right atrium, including suppression of the superior SAN and enhanced pacemaking from ectopic sites. Finally, if the LDCAE was too small to trigger an action potential, then it induced only delayed afterdepolarization (DAD)-like diastolic depolarization (DD). The failure of DAD-like DD to consistently trigger a sinus beat is a novel mechanism of atrial arrhythmogenesis. We conclude that dysfunction of both the Ca2+ clock and the voltage clock are important in sick sinus syndrome.
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影响因子：
37.8
作者：
Joung B;Tang L;Maruyama M;Han S;Chen Z;Stucky M;Jones LR;Fishbein MC;Weiss JN;Chen PS;Lin SF
通讯作者：
Lin SF
影响因子：
5.5
作者：
Ju, YK;Allen, DG
通讯作者：
Allen, DG
影响因子：
5.5
作者：
Hüser, J;Blatter, LA;Lipsius, SL
通讯作者：
Lipsius, SL
影响因子：
158.5
作者：
Milanesi, R;Baruscotti, M;DiFrancesco, D
通讯作者：
DiFrancesco, D
影响因子：
20.1
作者：
Efimov IR;Fedorov VV;Joung B;Lin SF
通讯作者：
Lin SF