Open AccessPotential new mechanisms of pro-arrhythmia in arrhythmogenic cardiomyopathy: focus on calcium sensitive pathways
Author(s) -
Chantal J.M. van Opbergen,
Mario Delmar,
Toon A.B. van Veen
Publication year - 2017
Publication title -
netherlands heart journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.578
H-Index - 37
eISSN - 1876-6250
pISSN - 1568-5888
DOI - 10.1007/s12471-017-0946-7
Subject(s) - phospholamban , medicine , heart failure , endoplasmic reticulum , cardiomyopathy , calcium signaling , serca , calcium , calmodulin , calcium in biology , microbiology and biotechnology , cardiology , endocrinology , bioinformatics , biology , atpase , biochemistry , enzyme
Arrhythmogenic cardiomyopathy, or its most well-known subform arrhythmogenic right ventricular cardiomyopathy (ARVC), is a cardiac disease mainly characterised by a gradual replacement of the myocardial mass by fibrous and fatty tissue, leading to dilatation of the ventricular wall, arrhythmias and progression towards heart failure. ARVC is commonly regarded as a disease of the intercalated disk in which mutations in desmosomal proteins are an important causative factor. Interestingly, the Dutch founder mutation PLN R14Del has been identified to play an additional, and major, role in ARVC patients within the Netherlands. This is remarkable since the phospholamban (PLN) protein plays a leading role in regulation of the sarcoplasmic reticulum calcium load rather than in the establishment of intercellular integrity. In this review we outline the intracellular cardiac calcium dynamics and relate pathophysiological signalling, induced by disturbed calcium handling, with activation of calmodulin dependent kinase II (CaMKII) and calcineurin A (CnA). We postulate a thus far unrecognised role for Ca 2+ sensitive signalling proteins in maladaptive remodelling of the macromolecular protein complex that forms the intercalated disk, during pro-arrhythmic remodelling of the heart.