Beta-blocker treatment of patients with atrial fibrillation attenuates spontaneous calcium release-induced electrical activity

Aims: Atrial fibrillation (AF) has been associated with excessive spontaneous calcium release, linked to cyclic AMP (cAMP)-dependent phosphorylation of calcium regulatory proteins. Because β-blockers are expected to attenuate cAMP-dependent signaling, we aimed to examine whether the treatment of pat...

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Bibliographic Details
Authors: Jiménez-Sábado, Verónica|||0000-0001-7720-988X, Casabella Ramón, Sergi|||0000-0001-7597-350X, Llach, Anna|||0000-0002-7486-1079, Gich, Ignasi|||0000-0003-3975-6588, Casellas Casanovas, Sandra|||0009-0000-5558-3125, Ciruela, Francisco|||0000-0003-0832-3739, Chen, S.R. Wayne, Guerra Ramos, José María|||0000-0001-5397-9177, Ginel, Antonino|||0000-0002-8820-7545, Benítez, Raúl|||0000-0002-8782-9406, Cinca, Juan|||0000-0003-4819-4265, Tarifa, Carmen|||0000-0001-8954-6058, Madsen, Leif Hove|||0000-0001-5493-3998
Format: article
Publication Date:2023
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:302803
Online Access:https://ddd.uab.cat/record/302803
https://dx.doi.org/urn:doi:10.1016/j.biopha.2022.114169
Access Level:Open access
Keyword:Arrhythmia
Calcium currents
Calcium sparks
Human atrial myocyte
Sarcoplasmic reticulum
β-blocker treatment
Description
Summary:Aims: Atrial fibrillation (AF) has been associated with excessive spontaneous calcium release, linked to cyclic AMP (cAMP)-dependent phosphorylation of calcium regulatory proteins. Because β-blockers are expected to attenuate cAMP-dependent signaling, we aimed to examine whether the treatment of patients with β-blockers affected the incidence of spontaneous calcium release events or transient inward currents (I). Methods: The impact of treatment with commonly used β-blockers was analyzed in human atrial myocytes from 371 patients using patch-clamp technique, confocal calcium imaging or immunofluorescent labeling. Data were analyzed using multivariate regression analysis taking into account potentially confounding effects of relevant clinical factors Results: The L-type calcium current (I) density was diminished significantly in patients with chronic but not paroxysmal AF and the treatment of patients with β-blockers did not affect I density in any group. By contrast, the I frequency was elevated in patients with either paroxysmal or chronic AF that did not receive treatment, and β-blocker treatment reduced the frequency to levels observed in patients without AF. Confocal calcium imaging showed that β-blocker treatment also reduced the calcium spark frequency in patients with AF to levels observed in those without AF. Furthermore, phosphorylation of the ryanodine receptor (RyR2) at Ser-2808 and phospholamban at Ser-16 was significantly lower in patients with AF that received β-blockers. Conclusion: Together, our findings demonstrate that β-blocker treatment may be of therapeutic utility to prevent spontaneous calcium release-induced atrial electrical activity; especially in patients with a history of paroxysmal AF displaying preserved I density.