β-adrenergic stimulation augments transmural dispersion of repolarization via modulation of delayed rectifier currents IKs and IKr in the human ventricle

Sci Rep. 2017 Nov 21;7(1):15922. doi: 10.1038/s41598-017-16218-3.

Abstract

Long QT syndrome (LQTS) is an inherited or drug induced condition associated with delayed repolarization and sudden cardiac death. The cardiac potassium channel, IKr, and the adrenergic-sensitive cardiac potassium current, IKs, are two primary contributors to cardiac repolarization. This study aimed to elucidate the role of β-adrenergic (β-AR) stimulation in mediating the contributions of IKr and IKs to repolarizing the human left ventricle (n = 18). Optical mapping was used to measure action potential durations (APDs) in the presence of the IKs blocker JNJ-303 and the IKr blocker E-4031. We found that JNJ-303 alone did not increase APD. However, under isoprenaline (ISO), both the application of JNJ-303 and additional E-4031 significantly increased APD. With JNJ-303, ISO decreased APD significantly more in the epicardium as compared to the endocardium, with subsequent application E-4031 increasing mid- and endocardial APD80 more significantly than in the epicardium. We found that β-AR stimulation significantly augmented the effect of IKs blocker JNJ-303, in contrast to the reduced effect of IKr blocker E-4031. We also observed synergistic augmentation of transmural repolarization gradient by the combination of ISO and E-4031. Our results suggest β-AR-mediated increase of transmural dispersion of repolarization, which could pose arrhythmogenic risk in LQTS patients.

MeSH terms

  • Action Potentials / drug effects
  • Adult
  • Aged
  • Female
  • Heart Conduction System / drug effects
  • Heart Ventricles / drug effects
  • Heart Ventricles / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Potassium Channel Blockers / pharmacology
  • Potassium Channels / metabolism*
  • Receptors, Adrenergic, beta / metabolism*
  • Young Adult

Substances

  • Potassium Channel Blockers
  • Potassium Channels
  • Receptors, Adrenergic, beta