BACKGROUND: beta-Adrenergic receptor blockade is one of the most effective treatments for heart failure, a leading cause of mortality worldwide. The use of beta-adrenergic receptor blockers in patients with heart failure is counterintuitive, however, because they are known to decrease contractility in normal hearts. The ryanodine receptor (RyR2) on cardiac sarcoplasmic reticulum is the key calcium release channel required for excitation-contraction coupling. In failing hearts, the stoichiometry and function of the RyR2 macromolecular complex is altered. Decreased levels of phosphatases (PP1 and PP2A) and hyperphosphorylation by protein kinase A result in dissociation of the regulatory protein FKBP12.6 and channels with increased open probability. METHODS AND RESULTS: Here, we show that systemic oral administration of a beta-adrenergic receptor blocker reverses protein kinase A hyperphosphorylation of RyR2, restores the stoichiometry of the RyR2 macromolecular complex, and normalizes single-channel function in a canine model of heart failure. CONCLUSIONS: These results may, in part, explain the improved cardiac function observed in heart failure patients treated with beta-adrenergic receptor blockers.
BACKGROUND: beta-Adrenergic receptor blockade is one of the most effective treatments for heart failure, a leading cause of mortality worldwide. The use of beta-adrenergic receptor blockers in patients with heart failure is counterintuitive, however, because they are known to decrease contractility in normal hearts. The ryanodine receptor (RyR2) on cardiac sarcoplasmic reticulum is the key calcium release channel required for excitation-contraction coupling. In failing hearts, the stoichiometry and function of the RyR2 macromolecular complex is altered. Decreased levels of phosphatases (PP1 and PP2A) and hyperphosphorylation by protein kinase A result in dissociation of the regulatory protein FKBP12.6 and channels with increased open probability. METHODS AND RESULTS: Here, we show that systemic oral administration of a beta-adrenergic receptor blocker reverses protein kinase A hyperphosphorylation of RyR2, restores the stoichiometry of the RyR2 macromolecular complex, and normalizes single-channel function in a canine model of heart failure. CONCLUSIONS: These results may, in part, explain the improved cardiac function observed in heart failurepatients treated with beta-adrenergic receptor blockers.
Authors: Jian Shan; Matthew J Betzenhauser; Alexander Kushnir; Steven Reiken; Albano C Meli; Anetta Wronska; Miroslav Dura; Bi-Xing Chen; Andrew R Marks Journal: J Clin Invest Date: 2010-11-22 Impact factor: 14.808
Authors: Alexander Kushnir; Jian Shan; Matthew J Betzenhauser; Steven Reiken; Andrew R Marks Journal: Proc Natl Acad Sci U S A Date: 2010-05-17 Impact factor: 11.205
Authors: Djalila Mekahli; Geert Bultynck; Jan B Parys; Humbert De Smedt; Ludwig Missiaen Journal: Cold Spring Harb Perspect Biol Date: 2011-06-01 Impact factor: 10.005
Authors: T A M Kaandorp; J J Bax; S E Bleeker; J Doornbos; E P Viergever; D Poldermans; E E van der Wall; A de Roos; H J Lamb Journal: J Cardiovasc Magn Reson Date: 2010-01-27 Impact factor: 5.364