Altered Pharmacologic Responsiveness of Reduced L-Type Calcium Currents in Myocytes Surviving in the Infarcted Heart

Altered Pharmacology of I_ca,L in Myocytes From Infarcted Heart. The pharmacologic responses of macroscopic L-type calcium channel currents to the dihydropyridine agonist, Bay K 8644, and β-adrenergic receptor stimulation by isoproterenol were studied in myocytes enzymatically dissociated from the epicardial border zone of the arrhythmic 5-day infarcted canine heart (IZs). Calcium currents were recorded at 36° to 37° C using the whole cell, patch clamp method and elicited by applying step depolarizations from a holding potential of -40 mV to various test potentials for 250-msec duration at 8-second intervals. A Cs⁺ -rich and 10 mM EGTA-containing pipette solution and a Na⁺-and K⁺-free external solutions were used to isolate calcium currents from other contaminating currents. During control, peak I_ca,L, density was found to be significantly less in IZs (4.0 ± 1.1 pA/pF) than in myocytes dispersed from the epicardium of the normal noninfarcted heart (NZs; 6.5 ± 1.8 pA/pF). Bay K 8644 (I μM) significantly increased peak I_ca,L density 3.5-fold above control levels in both NZs (to 22.5 ± 6.2 pA/pF; n = 7) and IZs (to 12.8 ± 3.0 pA/pF; n = 5), yet peak I_ca,L density in the presence of drug was significantly less in IZs than NZs. The effects of Bay K 8644 on kinetics of current decay and steady-state inactivation relations of peak I_ca,L were similar in the two cell types. In contrast, the response of peak L-type current density to isoproterenol (1 μM) was significantly diminished in IZs compared to NZs regardless of whether Ba²⁺ or Ca²⁺ ions carried the current. Thus, these results indicate an altered responsiveness to β-adrenergic stimulation in cells that survive in the infarcted heart. Furthermore, application of forskolin (1 μM and 10 μM) or intracellular cAMP (200 μM), agents known to act downstream of the β-receptor, also produced a smaller increase in peak I_Ba density in IZs versus NZs, suggesting that multiple defects exist in the β-adrenergic signaling pathway of IZs. In conclusion, these studies illustrate that reduced macroscopic calcium currents of cells in the infracted heart exhibit an altered pharmacologic profile that has important implications in the development of drugs for the diseased heart.