Ca2+Influx–Induced Sarcoplasmic Reticulum Ca2+Overload Causes Mitochondrial-Dependent Apoptosis in Ventricular Myocytes

Abstract
Increases in Ca2+influx through the L-type Ca2+channel (LTCC, Cav1.2) augment sarcoplasmic reticulum (SR) Ca2+loading and the amplitude of the cytosolic Ca2+transient to enhance cardiac myocyte contractility. Our hypothesis is that persistent increases in Ca2+influx through the LTCC cause apoptosis if the excessive influx results in SR Ca2+overload. Feline ventricular myocytes (VMs) in primary culture were infected with either an adenovirus (Ad) containing a rat Cav1.2 β2asubunit-green fluorescent protein (GFP) fusion gene (Adβ2a) to increase Ca2+influx or with AdGFP as a control. Significantly fewer β2a-VMs (21.4±5.6%) than GFP-VMs (99.6±1.7%) were viable at 96 hours. A fraction of β2a-VMs (20.8±1.8%) contracted spontaneously (SC-β2a-VMs), and viability was significantly correlated with the percentage of SC-β2a-VMs. Higher percentages of apoptotic nuclei, DNA laddering, and cytochrome C release were detected in β2a-VMs. This apoptosis was prevented with pancaspase or caspase-3 or caspase-9 inhibitors. L-type calcium current (ICa-L) density was greater in β2a-VMs (23.4±2.8 pA/pF) than in GFP-VMs (7.6±1.6 pA/pF). SC-β2a-VMs had higher diastolic intracellular Ca2+(Indo-1 ratio: 1.1±0.1 versus 0.7±0.03,P2+transients (1.89±0.27 versus 0.80±0.08) than GFP-VMs. Inhibitors of Ca2+influx, SR Ca2+uptake and release, mitochondrial Ca2+uptake, mitochondrial permeation transition pore, calpain, and Bcl-2-associated X protein protected β2a-VMs from apoptosis. These results show that persistent increases in Ca2+influx through the ICa-Lenhance contractility but lead to apoptosis through a mitochondrial death pathway if SR Ca2+overload is induced.