Ca2+/calmodulin-dependent protein kinase II regulates cardiac Na+ channels

Stefan Wagner, Nataliya Dybkova, Eva C L Rasenack, Claudius Jacobshagen, Larissa Fabritz, Paulus Kirchhof, Sebastian K G Maier, Tong Zhang, Gerd Hasenfuss, Joan Heller Brown, Donald M Bers, Lars S Maier

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380 Citations (Scopus)


In heart failure (HF), Ca(2+)/calmodulin kinase II (CaMKII) expression is increased. Altered Na(+) channel gating is linked to and may promote ventricular tachyarrhythmias (VTs) in HF. Calmodulin regulates Na(+) channel gating, in part perhaps via CaMKII. We investigated effects of adenovirus-mediated (acute) and Tg (chronic) overexpression of cytosolic CaMKIIdelta(C) on Na(+) current (I(Na)) in rabbit and mouse ventricular myocytes, respectively (in whole-cell patch clamp). Both acute and chronic CaMKIIdelta(C) overexpression shifted voltage dependence of Na(+) channel availability by -6 mV (P < 0.05), and the shift was Ca(2+) dependent. CaMKII also enhanced intermediate inactivation and slowed recovery from inactivation (prevented by CaMKII inhibitors autocamtide 2-related inhibitory peptide [AIP] or KN93). CaMKIIdelta(C) markedly increased persistent (late) inward I(Na) and intracellular Na(+) concentration (as measured by the Na(+) indicator sodium-binding benzofuran isophthalate [SBFI]), which was prevented by CaMKII inhibition in the case of acute CaMKIIdelta(C) overexpression. CaMKII coimmunoprecipitates with and phosphorylates Na(+) channels. In vivo, transgenic CaMKIIdelta(C) overexpression prolonged QRS duration and repolarization (QT intervals), decreased effective refractory periods, and increased the propensity to develop VT. We conclude that CaMKII associates with and phosphorylates cardiac Na(+) channels. This alters I(Na) gating to reduce availability at high heart rate, while enhancing late I(Na) (which could prolong action potential duration). In mice, enhanced CaMKIIdelta(C) activity predisposed to VT. Thus, CaMKII-dependent regulation of Na(+) channel function may contribute to arrhythmogenesis in HF.

Original languageEnglish
Pages (from-to)3127-38
Number of pages12
JournalJournal of Clinical Investigation
Issue number12
Publication statusPublished - Dec 2006


  • Action Potentials
  • Adenoviridae
  • Animals
  • Arrhythmias, Cardiac
  • Blotting, Western
  • Calcium-Calmodulin-Dependent Protein Kinases
  • Gene Expression Regulation, Enzymologic
  • Immunoprecipitation
  • Mice
  • Mice, Transgenic
  • Myocytes, Cardiac
  • Patch-Clamp Techniques
  • Phosphorylation
  • Protein Binding
  • Rabbits
  • Sodium Channels


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