Pathophysiology of Calcium Mediated Ventricular Arrhythmias and Novel Therapeutic Options with Focus on Gene Therapy

Int J Mol Sci. 2019 Oct 24;20(21):5304. doi: 10.3390/ijms20215304.

Abstract

Cardiac arrhythmias constitute a major health problem with a huge impact on mortality rates and health care costs. Despite ongoing research efforts, the understanding of the molecular mechanisms and processes responsible for arrhythmogenesis remains incomplete. Given the crucial role of Ca2+-handling in action potential generation and cardiac contraction, Ca2+ channels and Ca2+ handling proteins represent promising targets for suppression of ventricular arrhythmias. Accordingly, we report the different roles of Ca2+-handling in the development of congenital as well as acquired ventricular arrhythmia syndromes. We highlight the therapeutic potential of gene therapy as a novel and innovative approach for future arrhythmia therapy. Furthermore, we discuss various promising cellular and mitochondrial targets for therapeutic gene transfer currently under investigation.

Keywords: L-type calcium channel; calcium; gene therapy; genetic mutations; heart failure; ion channels; mitochondria; ryanodine receptor; sarcoplasmic Ca2+-ATPase; ventricular arrhythmias.

Publication types

  • Review

MeSH terms

  • Animals
  • Arrhythmias, Cardiac / pathology*
  • Arrhythmias, Cardiac / therapy
  • Calcium / metabolism*
  • Calcium Channels / genetics
  • Calcium Channels / metabolism
  • Genetic Therapy*
  • Humans
  • RNA, Small Interfering / genetics
  • RNA, Small Interfering / metabolism
  • RNA, Small Interfering / therapeutic use
  • Receptors, Adrenergic, beta / metabolism
  • Ryanodine Receptor Calcium Release Channel / genetics
  • Ryanodine Receptor Calcium Release Channel / metabolism
  • Sarcoplasmic Reticulum Calcium-Transporting ATPases / genetics
  • Sarcoplasmic Reticulum Calcium-Transporting ATPases / metabolism

Substances

  • Calcium Channels
  • RNA, Small Interfering
  • Receptors, Adrenergic, beta
  • Ryanodine Receptor Calcium Release Channel
  • Sarcoplasmic Reticulum Calcium-Transporting ATPases
  • Calcium