Increasing ryanodine receptor open probability alone does not produce arrhythmogenic calcium waves: Threshold sarcoplasmic reticulum calcium content is required

Diastolic waves of Ca release have been shown to activate delayed afterdepolarizations as well as some cardiac arrhythmias. The aim of this study was to investigate whether increasing ryanodine receptor open probability alone or in the presence of β-adrenergic stimulation produces diastolic Ca release from the sarcoplasmic reticulum (SR). When voltage-clamped rat ventricular myocytes were exposed to caffeine (0.5 to 1.0 mmol), diastolic Ca release was seen to accompany the first few stimuli but was never observed in the steady state. We attribute the initial phase of diastolic Ca release to a decrease in the threshold SR Ca content required to activate Ca waves and its subsequent disappearance to a decrease of SR content below this threshold. Application of isoproterenol (1 μmol/L) increased the amplitude of the systolic Ca transient and also the SR Ca content but did not usually produce diastolic Ca release. Subsequent addition of caffeine, however, resulted in diastolic Ca release. We estimated the time course of recovery of SR Ca content following recovery from emptying with a high (10 mmol/L) concentration of caffeine. Diastolic Ca release recommenced only when SR content had increased back to its final level. We conclude that increasing ryanodine receptor open probability alone does not produce arrhythmogenic diastolic Ca release because of the accompanying decrease of SR Ca content. β-Adrenergic stimulation increases SR content and thereby allows the increased ryanodine receptor open probability to produce diastolic Ca release. The implications of these results for arrhythmias associated with abnormal ryanodine receptors are discussed. © 2007 American Heart Association, Inc.