title: Molecular basis of downregulation of G-protein-coupled inward rectifying K(+) current (I(K,ACh) in chronic human atrial fibrillation: decrease in GIRK4 mRNA correlates with reduced I(K,ACh) and muscarinic receptor-mediated shortening of action potentials.
abstract: BACKGROUND
  Clinical and experimental evidence suggest that the parasympathetic nervous system is involved in the pathogenesis of atrial fibrillation (AF). However, it is unclear whether changes in G-protein-coupled inward rectifying K(+) current (I(K,ACh)) contribute to chronic AF.
  
  
  RESULTS
  In the present study, we used electrophysiological recordings and competitive reverse-transcription polymerase chain reaction to study changes in I(K,ACh) and the level of the I(K,ACh) GIRK4 subunit in isolated human atrial myocytes and the atrial tissue of 39 patients with sinus rhythm and 24 patients with chronic AF. The density of I(K,ACh) was approximately 50% smaller in myocytes from patients with AF compared with those in sinus rhythm, and this was accompanied by decreased levels of GIRK4 mRNA. The current density of the inward rectifying K(+) current (I(K1)) was 2-fold larger during AF than in sinus rhythm, in correspondence with an increase in Kir2.1 mRNA. The larger I(K1) in AF is consistent with more negative membrane potentials in right atrial trabeculae from AF patients. Moreover, action potential duration was reduced in AF, and the action potential shortening produced by muscarinic receptor stimulation was attenuated, indicating that the changes of I(K1) and I(K,ACh) were functionally relevant.
  
  
  CONCLUSIONS
  Chronic human AF induces transcriptionally mediated upregulation of I(K1) but downregulation of I(K,ACh) and attenuates the muscarinic receptor-mediated shortening of atrial action potentials. This suggests that atrial myocytes adapt to a chronically high rate by downregulating I(K,ACh) to counteract the shortening of the atrial effective refractory period due to electrical remodeling.
authors.affiliation: Department of Pharmacology, University of Technology, Dresden, Germany. dobrev@rcs.urz.tu-dresden.de
authors.forename: D
authors.initials: D
authors.lastname: Dobrev
authors.forename: E
authors.initials: E
authors.lastname: Graf
authors.forename: E
authors.initials: E
authors.lastname: Wettwer
authors.forename: H M
authors.initials: HM
authors.lastname: Himmel
authors.forename: O
authors.initials: O
authors.lastname: Hála
authors.forename: C
authors.initials: C
authors.lastname: Doerfel
authors.forename: T
authors.initials: T
authors.lastname: Christ
authors.forename: S
authors.initials: S
authors.lastname: Schüler
authors.forename: U
authors.initials: U
authors.lastname: Ravens
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000200:Action Potentials / Q000187:drug effects; D000368:Aged; D001281:Atrial Fibrillation / Q000235:genetics* / Q000378:metabolism / Q000503:physiopathology*; D002217:Carbachol / Q000494:pharmacology; D002478:Cells, Cultured; D002908:Chronic Disease; D015536:Down-Regulation; D004553:Electric Conductivity; D005260:Female; D051676:G Protein-Coupled Inwardly-Rectifying Potassium Channels; D006325:Heart Atria / Q000166:cytology; D020962:Heterotrimeric GTP-Binding Proteins / Q000378:metabolism; D006801:Humans; D008297:Male; D018721:Muscarinic Agonists / Q000494:pharmacology; D009206:Myocardium / Q000166:cytology; D015221:Potassium Channels / Q000096:biosynthesis* / Q000235:genetics; D024661:Potassium Channels, Inwardly Rectifying / Q000502:physiology*; D012333:RNA, Messenger / Q000096:biosynthesis; D011976:Receptors, Muscarinic / Q000502:physiology*
chemical_list: D051676:G Protein-Coupled Inwardly-Rectifying Potassium Channels; D018721:Muscarinic Agonists; D015221:Potassium Channels; D024661:Potassium Channels, Inwardly Rectifying; D012333:RNA, Messenger; D011976:Receptors, Muscarinic; D002217:Carbachol; D020962:Heterotrimeric GTP-Binding Proteins; D000109:Acetylcholine