Physiologic, Pathologic, and Therapeutic Paracrine Modulation of Cardiac Excitation-Contraction Coupling

Physiologic, Pathologic, and Therapeutic Paracrine Modulation of Cardiac Excitation-Contraction Coupling

Joshua Mayourian, Delaine K. Ceholski, David M. Gonzalez, Timothy J. Cashman, Susmita Sahoo, Roger J. Hajjar, Kevin D. Costa

Endothelial–cardiomyocyte interplay through paracrine factors. Endothelial cell NO increases basal contractility via nitrosylation of L-type Ca2+ channel (LTCC) and ryanodine receptor (RyR2). NO attenuates β-adrenergic effects on cardiomyocyte excitation–contraction coupling via cGMP-dependent degradation of cAMP and protein kinase G (PKG)-mediated decrease of LTCC activity. PKG also phosphorylates troponin I, leading to myofilament calcium desensitization and thus increased lusitropy. Endothelin-1, which mainly acts through the endothelin A (ETA) receptor in ventricular cardiomyocytes, may increase calcium entry via protein kinase C (PKC)-mediated (1) increase of LTCC activity, (2) indirect activation of sodium–calcium exchanger (NCX) reverse mode by increasing Na+–H+ exchanger activity, and (3) direct activation of NCX reverse (shown) and forward (not shown) mode. Endothelin-1 alters myofilament Ca2+ sensitivity via protein kinase C/D (PKC/D) phosphorylation of troponin I and myosin-binding protein C. Finally, endothelin-1 may increase calcium-induced calcium release via inositol trisphosphate (IP3) activation of inositol trisphosphate receptor (IP3R), which sensitizes RyR2 on the sarcoplasmic reticulum (SR). Green and red arrows denote activation and inhibition, respectively. PLB indicates phospholamban; and SERCA, sarcoendoplasmic reticulum Ca2+-ATPase. [Powerpoint File]

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