Proarrhythmic consequences of a KCNQ1 AKAP-binding domain mutation: computational models of whole cells and heterogeneous tissue

Circ Res. 2004 Dec 10;95(12):1216-24. doi: 10.1161/01.RES.0000150055.06226.4e. Epub 2004 Nov 4.

Abstract

The KCNQ1-G589D gene mutation, associated with a long-QT syndrome, has been shown to disrupt yotiao-mediated targeting of protein kinase A and protein phosphatase-1 to the I(Ks) channel. To investigate how this defect may lead to ventricular arrhythmia during sympathetic stimulation, we use integrative computational models of beta-adrenergic signaling, myocyte excitation-contraction coupling, and action potential propagation in a rabbit ventricular wedge. Paradoxically, we find that the KCNQ1-G589D mutation alone does not prolong the QT interval. But when coupled with beta-adrenergic stimulation in a whole-cell model, the KCNQ1-G589D mutation induced QT prolongation and transient afterdepolarizations, known cellular mechanisms for arrhythmogenesis. These cellular mechanisms amplified tissue heterogeneities in a three-dimensional rabbit ventricular wedge model, elevating transmural dispersion of repolarization and creating other T-wave abnormalities on simulated electrocardiograms. Increasing heart rate protected both single myocyte and the coupled myocardium models from arrhythmic consequences. These findings suggest that the KCNQ1-G589D mutation disrupts a critical link between beta-adrenergic signaling and myocyte electrophysiology, creating both triggers of cardiac arrhythmia and a myocardial substrate vulnerable to such electrical disturbances.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Action Potentials / drug effects
  • Adaptor Proteins, Signal Transducing / metabolism*
  • Adrenergic beta-1 Receptor Agonists
  • Amino Acid Substitution*
  • Animals
  • Binding Sites
  • Computational Biology
  • Computer Simulation*
  • Cytoskeletal Proteins / metabolism*
  • Electrocardiography
  • Heart Ventricles / cytology
  • Ion Transport / drug effects
  • Isoproterenol / pharmacology
  • KCNQ Potassium Channels
  • KCNQ1 Potassium Channel
  • Long QT Syndrome / etiology*
  • Long QT Syndrome / genetics
  • Long QT Syndrome / physiopathology
  • Models, Cardiovascular*
  • Models, Molecular*
  • Mutation, Missense*
  • Myocardial Contraction
  • Myocytes, Cardiac / metabolism*
  • Point Mutation*
  • Potassium / metabolism
  • Potassium Channels, Voltage-Gated / chemistry
  • Potassium Channels, Voltage-Gated / genetics*
  • Potassium Channels, Voltage-Gated / metabolism
  • Protein Binding
  • Protein Conformation
  • Protein Interaction Mapping
  • Rabbits
  • Receptors, Adrenergic, beta-1 / physiology*
  • Structure-Activity Relationship

Substances

  • Adaptor Proteins, Signal Transducing
  • Adrenergic beta-1 Receptor Agonists
  • Cytoskeletal Proteins
  • KCNQ Potassium Channels
  • KCNQ1 Potassium Channel
  • Potassium Channels, Voltage-Gated
  • Receptors, Adrenergic, beta-1
  • Isoproterenol
  • Potassium