Endurance exercise training normalizes repolarization and calcium-handling abnormalities, preventing ventricular fibrillation in a model of sudden cardiac death

J Appl Physiol (1985). 2012 Dec 1;113(11):1772-83. doi: 10.1152/japplphysiol.00175.2012. Epub 2012 Oct 4.

Abstract

The risk of sudden cardiac death is increased following myocardial infarction. Exercise training reduces arrhythmia susceptibility, but the mechanism is unknown. We used a canine model of sudden cardiac death (healed infarction, with ventricular tachyarrhythmias induced by an exercise plus ischemia test, VF+); we previously reported that endurance exercise training was antiarrhythmic in this model (Billman GE. Am J Physiol Heart Circ Physiol 297: H1171-H1193, 2009). A total of 41 VF+ animals were studied, after random assignment to 10 wk of endurance exercise training (EET; n = 21) or a matched sedentary period (n = 20). Following (>1 wk) the final attempted arrhythmia induction, isolated myocytes were used to test the hypotheses that the endurance exercise-induced antiarrhythmic effects resulted from normalization of cellular electrophysiology and/or normalization of calcium handling. EET prevented VF and shortened in vivo repolarization (P < 0.05). EET normalized action potential duration and variability compared with the sedentary group. EET resulted in a further decrement in transient outward current compared with the sedentary VF+ group (P < 0.05). Sedentary VF+ dogs had a significant reduction in repolarizing K(+) current, which was restored by exercise training (P < 0.05). Compared with controls, myocytes from the sedentary VF+ group displayed calcium alternans, increased calcium spark frequency, and increased phosphorylation of S2814 on ryanodine receptor 2. These abnormalities in intracellular calcium handling were attenuated by exercise training (P < 0.05). Exercise training prevented ischemically induced VF, in association with a combination of beneficial effects on cellular electrophysiology and calcium handling.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Action Potentials
  • Animals
  • Calcium Signaling*
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control*
  • Disease Models, Animal
  • Dogs
  • Electrocardiography
  • Exercise Therapy*
  • Heart Rate
  • Myocardial Infarction / complications
  • Myocytes, Cardiac / metabolism*
  • Patch-Clamp Techniques
  • Phosphorylation
  • Physical Endurance*
  • Potassium / metabolism
  • Potassium Channels / metabolism
  • Ryanodine Receptor Calcium Release Channel / metabolism
  • Time Factors
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / etiology
  • Ventricular Fibrillation / metabolism
  • Ventricular Fibrillation / physiopathology
  • Ventricular Fibrillation / prevention & control*

Substances

  • Potassium Channels
  • Ryanodine Receptor Calcium Release Channel
  • Potassium