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Copyright © 2007 The Biophysical Society. All rights reserved.
Biophysical Journal, Volume 92, Issue 5, 1522-1543, 1 March 2007

doi:10.1529/biophysj.106.088807

Biophysical Theory and Modeling

Kinetic Properties of the Cardiac L-Type Ca2+ Channel and Its Role in Myocyte Electrophysiology: A Theoretical Investigation

Gregory M. Faber*Jonathan SilvaLeonid Livshitz and Yoram RudyGo To Corresponding Author 

* Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
Cardiac Bioelectricity and Arrhythmia Center and Department of Biomedical Engineering, Washington University, St. Louis, Missouri

Address reprint requests to Yoram Rudy, Director, Cardiac Bioelectricity and Arrhythmia Center, 290 Whitaker Hall, Campus Box 1097, One Brookings Dr., St. Louis, MO 63130-4899. Tel.: 314-935-8160; Fax: 314-935-8168.

Abstract

The L-type Ca2+ channel (CaV1.2) plays an important role in action potential (AP) generation, morphology, and duration (APD) and is the primary source of triggering Ca2+ for the initiation of Ca2+-induced Ca2+-release in cardiac myocytes. In this article we present: 1), a detailed kinetic model of CaV1.2, which is incorporated into a model of the ventricular mycoyte where it interacts with a kinetic model of the ryanodine receptor in a restricted subcellular space; 2), evaluation of the contribution of voltage-dependent inactivation (VDI) and Ca2+-dependent inactivation (CDI) to total inactivation of CaV1.2; and 3), description of dynamic CaV1.2 and ryanodine receptor channel-state occupancy during the AP. Results are: 1), the CaV1.2 model reproduces experimental single-channel and macroscopic-current data; 2), the model reproduces rate dependence of APD, [Na+]i, and the Ca2+-transient (CaT), and restitution of APD and CaT during premature stimuli; 3), CDI of CaV1.2 is sensitive to Ca2+ that enters the subspace through the channel and from SR release. The relative contributions of these Ca2+ sources to total CDI during the AP vary with time after depolarization, switching from early SR dominance to late CaV1.2 dominance. 4), The relative contribution of CDI to total inactivation of CaV1.2 is greater at negative potentials, when VDI is weak; and 5), loss of VDI due to the CaV1.2 mutation G406R (linked to the Timothy syndrome) results in APD prolongation and increased CaT.

Introduction

Most cellular action potential (AP) models compute the membrane potential starting from macroscopic transmembrane ionic currents through large ensembles of ion channels. The ionic currents are computed using the Hodgkin-Huxley (H-H) scheme 1, which represents voltage and time-dependent conductance changes in terms of “gating variables” (e.g., activation, inactivation) that are independent of each other. Current understanding of ion-channel gating clearly indicates strong coupling between kinetic gating transitions that cannot be reproduced within the H-H paradigm 2. Also, the H-H formalism does not represent kinetic states of the ion channel (such as open, closed, inactivated) and is therefore not suitable for simulating molecular interactions, ion-channel mutations that alter specific kinetic transitions, or effects of drugs that bind to the channel in a specific conformational state. To overcome these limitations we have developed and introduced into a model of the whole-cell, single-channel based Markov models of cardiac INa3,4, IKr5,6, and IKs6, channels that are major determinants of the ventricular AP. Markov models represent discrete ion-channel states and their interactions; this property allowed us to examine kinetic state transitions of these channels during the AP 2, simulate the cellular arrhythmogenic manifestations of ion-channel mutations 2,3,4,5, and study the role of molecular subunit interactions in channel function 2,6. Recently, we used Markov models to study the cellular electrophysiological effects of state-specific drug binding (to open or inactivated state) in wild-type and mutant cardiac Na+ channels 7. Given the important role of Cav1.2, the L-type Ca2+ channel, in AP generation, rate-dependence 8,9, and conduction 10,11, and its participation in cellular calcium cycling and excitation-contraction (EC) coupling 12, it is important to develop a detailed kinetic model of this channel. Such model could be used to study various aspects of channel gating in the complex interactive cell environment, to predict the effects on the whole-cell AP of state-specific drug binding to the channel, and to simulate the cellular electrophysiological consequences of Cav1.2 mutations, such as a recently described missense mutation G406R that causes Timothy syndrome and is characterized by QT interval prolongation on the electrocardiogram and arrhythmia development, as well as an array of other organ dysfunction 13,14.

Cav1.2 gating is both voltage and Ca2+ dependent; the time course and magnitude of [Ca2+] near the channel is a major determinant of its inactivation kinetics. In ventricular myocytes, Cav1.2 interacts with ryanodine receptors (RyR) to trigger Ca2+ release from the sarcoplasmic reticulum (SR) through the calcium-induced-calcium-release (CICR) process. The interaction occurs in a restricted subcellular space in triad formations 15,16. Modeling the Cav1.2 channel kinetics requires representation of the dynamic Ca2+ changes in a restricted subspace for calcium. We introduce a subcellular restricted space where Cav1.2 and RyR interact to generate a Ca2+-transient. Because our interest is in the L-type Ca2+ current, its properties, and its role in the cellular AP and arrhythmia, we adopt a global cellular approach in the simulations; that is, the model subcellular space represents a subsarcolemmal space, along the length of the t-tubules, into which both L-type Ca2+ channels and RyR open. Clearly, this approach cannot be used to simulate local microscopic (molecular) processes of EC-coupling such as Ca2+ spark formation, as done by others 17,18. However, as shown in the Results section, the model recreates the relevant global properties of calcium cycling that influence the L-type Ca2+ current, ICa(L). This global approach results in major reduction of computing time, making the simulations of steady-state pacing protocols that are necessary for studying cell electrophysiology possible and practical.

Using this model, the following phenomena are studied: 1), kinetic state transitions of Cav1.2 and RyR during the AP at slow and fast rates; 2), the relative contributions of Ca2+-dependent and voltage-dependent inactivation to total inactivation of ICa(L); 3), sensitivity of Ca2+-dependent inactivation to Ca2+ entry through the channel and from SR release; 4), rate dependence of AP duration (APD adaptation) and APD restitution; 5), rate dependence of [Na+]i and of the Ca2+-transient; restitution of the Ca2+-transient during premature stimuli; 6), ICa(L) and AP modification by the Cav1.2 missense mutation G406R that has been associated with the Timothy syndrome and its arrhythmic manifestations.


Methods

A complete list of abbreviations, parameter definitions, model equations, and initial conditions can be found in Table 1 and the Appendix .

Table 1 Definitions and abbreviations
APAction potential
APDAction potential duration measured at 90% repolarization
BCLBasic cycle length
CaV1.2Cardiac L-type Ca2+ channel
RyRRyanodine receptor SR Ca2+ release channel
CaTCalcium transient
CICRCalcium induced calcium release
VDIVoltage-dependent inactivation
CDICalcium-dependent inactivation
ModeVL-type Ca2+ channel states in VDI gating mode
ModeCaL-type Ca2+ channel states in CDI gating mode
INaFast Na+ current, μA/μF
mActivation gate of INa
hFast inactivation gate of INa
jSlow inactivation gate of INa
ICa(L)Ca2+ Current through L-type Ca2+ channel, μA/μF
ICa,NaNa+ Current through L-type Ca2+ channel, μA/μF
ICa,KK+ Current through L-type Ca2+ channel, μA/μF
IKrRapid delayed rectifier K+ current, μA/μF
xrActivation gate of IKr
rKrTime-independent rectification gate of IKr
IKsSlow delayed rectifier K+ current, μA/μF
xs1Fast activation gate of IKs
xs2Slow activation gate of IKs
IK1Time-independent K+ current, μA/μF
K1Inactivation gate of IK1
IKpPlateau K+ current, μA/μF
ICa,bBackground Ca2+ current, μA/μF
ICa(T)T-Type Ca2+ current, μA/μF
INa,bBackground Na+ current, μA/μF
INaCaNa+-Ca2+ exchanger in myoplasm, μA/μF
INaCa,ssNa+-Ca2+ exchanger in subspace, μA/μF
γINaCaPosition of energy barrier controlling voltage dependence of INaCa
INaKSodium-potassium pump, μA/μF
fNaKVoltage-dependent parameter of INaK
σ[Na+]o dependent factor of INaK
Ip,CaSarcolemmal Ca2+ pump, μA/μF
Maximum conductance of channel x, mS/μF
KmHalf-saturation concentration, mM/L
PSMembrane permeability to ion S, cm/s
PS,APermeability ratio of ion S to ion A
γSActivity coefficient of ion S
Maximum current carried through channel x, μA/μF
VmTransmembrane potential, mV
zsValence of ion S
CmTotal cellular membrane capacitance, 1μF
ACapCapacitive membrane area, cm2
AGeoGeometric membrane area, cm2
RCGRatio of ACap/AGeo=2
VxVolume of compartment x, μL
Δ[S]xChange in concentration of ion S in compartment x, mM
CASQ2Calsequestrin, Ca2+ buffer in JSR
TRPNTroponin, Ca2+ buffer in myoplasm
CMDNCalmodulin, Ca2+ buffer in myoplasm
BSRAnionic SR binding sites for Ca2+ in the subspace
BSLAnionic sarcolemmal binding sites for Ca2+ in the subspace
SRSarcoplasmic reticulum
JSRJunctional SR
NSRNetwork SR
ssSubspace
myoMyoplasm
ExReversal potential of current x, mV
[S]oExtracellular concentration of ion S, mM
[S]iIntracellular concentration of ion S, mM
[S]ssSubspace concentration of ion S, mM
[Ca2+]JSRCa2+ concentration in JSR, mM
[Ca2+]JSR,tTotal Ca2+ concentration in JSR ([Ca2+]JSR+[csqn]), mM
[Ca2+]NSRCa2+ concentration in NSR, mM
IrelCa2+ release from JSR to subspace, mM/ms
adapFunction describing RyR channel adaptation
gradedrelICa(L) dependent function for determining graded response of Irel
vgainofrelFunction describing voltage dependence of gain
IupCa2+ uptake from myoplasm to SR, mM/ms
IleakCa2+ leak from NSR to myoplasm, mM/ms
ItrCa2+ transfer from NSR to JSR, mM/ms
τtrTime constant of Ca2+ transfer from NSR to JSR, ms
IdiffCa2+ transfer from subspace to myoplasm, mM/ms
τdiffTime constant of Ca2+ transfer from subspace to myoplasm, ms
Ca2+ flux from ICa(L)
Ca2+ flux from Irel
FFaraday constant, 96,487 C/mol
RGas constant, 8314 J/kmol/K
TTemperature, 310°K
τ0Rate constant of monoexponential decay for the probability density function fit to the open probability data of the L-type Ca2+ channel
ICa,tTotal transmembrane Ca2+ current
ICa,t=ICa(L)+ICa,b+Ip,Ca-2*INaCa-2*INaCass
INa,tTotal transmembrane Na+ current
INa,t=INa+INa,b+3*INaK+ICa,Na+3*INaCa+3*INaCass
IK,tTotal transmembrane K+ current
IK,t=IKs+IKr+IK1+ICa,K+IKp-2*INaK
ItotTotal transmembrane current
Itot=ICa,t+INa,t+IK,t
IstimStimulus current, μA/μF

L-type Ca2+ channel Markov model

A Markov representation of the L-type Ca2+ channel (Fig. 1) was developed and incorporated into a ventricular cell model. L-type Ca2+ channels are known to inactivate due to an increase in membrane potential or an increase in intracellular Ca2+. The former, known as voltage-dependent inactivation (VDI), is accompanied by a gating current whereas the latter, known as Ca2+-dependent inactivation (CDI), is not. This discovery by Hadley and Lederer 19 suggests that the mechanisms by which these inactivation processes occur are separate, implying that channels that have inactivated due to voltage can still be inactivated by Ca2+ and vice versa. This is further supported by experiments where VDI or CDI are altered or eliminated by point mutations to the CaV1.2 gene. This is perhaps best illustrated by the CaV1.2 mutation G406R, which is the underlying cause of the Timothy syndrome, which almost completely eliminates VDI while leaving CDI unaffected 13,14. VDI of CaV1.2 is also affected by mutations to the pore-encoding portion of the channel 20 or mutations within the I-II linker 13,21. CDI, which involves Ca2+ binding to calmodulin (CaM) that is constitutively tethered to a region of the CaV1.2 C-terminus known as the IQ motif, is eliminated by mutations to either the IQ motif 22,23,24 or to CaM 25. There has been recent evidence that VDI may also be dependent on the IQ-CaM complex 26, giving rise to the possibility that VDI and CDI are not entirely independent. We model the channel with two distinct kinetic modes 27,28: a voltage-gating mode (ModeV) with a single conducting state, and a mode where the channel is inactivated via a Ca2+-dependent process (ModeCa). We selected the minimum number of channel states necessary to reflect structural properties of the channel (four voltage sensitive transitions before channel opening reflecting movement of four voltage sensors, one for each of the four homologous domains making up the α1 subunit of CaV1.2) and to describe the complex channel behavior (fast and slow voltage-dependent inactivation states, IVf and IVs, 29). The two-tier structure (upper tier, ModeV; lower tier, ModeCa) implies that the channel can be inactivated by Ca2+ at any time, independent of the channel being closed, open, or inactivated by voltage. In addition, this means that channels can be simultaneously inactivated via both voltage-dependent and Ca2+-dependent mechanisms. Despite the relatively large number of channel states, the total number of transition rates that must be computed each time step is small (rates computed for state transitions within ModeV are the same for ModeCa and transition rates between ModeV and ModeCa are the same from any state).

Display large version of this figure
Figure 1
State diagram of the L-type Ca2+ channel Markov model. The upper tier (ModeV, gray) represents a voltage-dependent inactivation gating mode (VDI) and the lower tier (ModeCa, black) represents a Ca2+-dependent inactivation gating mode (CDI). See Appendix for transition rates.

Experimental protocols to study L-type Ca2+ channels often utilize charge carriers other than Ca2+ to separate voltage-dependent inactivation from Ca2+-dependent inactivation. To reproduce these experimental protocols with the model, we eliminate Ca2+-dependent inactivation by setting the transition rates from ModeV to ModeCa to zero. Simulations where this is done are noted in the text and in the figure caption.

The L-type Ca2+ channel Markov model was validated utilizing a wide range of experimental data. Our guide was to select experimental data that were recorded in guinea pig ventricular myocytes at 37°C. In addition, we preferentially selected experimental data that were recorded in the absence of β-agonists as these have a significant effect on current magnitude, voltage-dependent properties, and Ca2+-dependent properties of the channel.

The L-type Markov model (Fig. 1) includes four closed states (C0, C1, C2, and C3), a single open state (O), two states representing channels that have undergone fast or slow voltage-dependent inactivation (IVf and IVs), five states representing channels that have undergone Ca2+-dependent inactivation (C0Ca, C1Ca, C2Ca, C3Ca, and ICa), and two states that represent inactivation via both voltage and Ca2+-dependent mechanisms (IVfCa and IVsCa). The transition rates in each loop of the model (e.g., C3-O-IVs) obey microscopic reversibility.


Cell model

The theoretical LRd model of a mammalian ventricular AP 30,31,32 (Figure 2A) provides the basis for the simulations of cellular behavior in this study. The model is based mostly on guinea pig ventricular myocyte experimental data; it includes membrane ionic channel currents, pumps, and exchangers. The model also accounts for processes that regulate intracellular concentration changes of Na+, K+, and Ca2+. Intracellular Ca2+ cycling processes represented in the model include Ca2+ uptake and release by the SR and its buffering. Buffers include calmodulin and troponin (in the myoplasm), sarcolemmal and SR Ca2+ binding sites (in the subspace), and calsequestrin (in the SR).

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Figure 2
(A) Schematic for the four compartment model (bulk myoplasm, JSR, NSR, and subspace) of the guinea pig ventricular myocyte. Symbols are defined in Table 1. (B) State diagram of the ryanodine receptor, RyR, (modified from Fill et al. 39). See Appendix for transition rates.

Subspace compartment

Electron microscopic views of myocytes reveal invaginations in the cell membrane, known as transverse or t-tubules, that increase the total surface area of the myocyte and provide a pathway by which extracellular Ca2+ can be readily available for entry upon cell depolarization. The junctional sarcoplasmic reticular membrane makes close contact with sarcolemmal membrane all along the t-tubules, the distance between the two membranes being very small (15–20nm). The confined volume between the two membranes is commonly referred to as the restricted space or the subsarcolemmal space. It is known that Ca2+ entry via L-type Ca2+ channels is the signal for the opening of RyRs and Ca2+ release from the SR. Immunogold-labeling techniques 33,34 have shown that L-type Ca2+ channels cluster in t-tubules and the areas of the plasma membrane that overlie the SR membrane, supporting their important role in the CICR process. Ca2+ entry into the restricted space via L-type Ca2+ channels (followed closely by Ca2+ release from the SR) generates Ca2+ concentrations near the inner membrane surface that are much greater than those observed in the bulk myoplasm. The magnitude of these concentrations and the rate at which the concentrations return to basal levels is dependent upon several factors including: 1), subspace volume; 2), Ca2+ diffusion rates from the subspace to the bulk myoplasmic volume; 3), the presence of buffers within the subspace; 4), the rate of Ca2+ entry into the subspace (i.e., via L-type and RyR channels); and 5), the rate of Ca2+ removal (i.e., via forward Na+/Ca2+ exchange). We model the subspace as a single compartment comprising 2% of the total volume of the myocyte into which both L-type Ca2+ channels and RyR open (see Appendix for derivation of subspace volume). Immunofluorescence of the Na+-Ca2+ exchange protein 35,36 has shown that these proteins are present with greater density within the t-tubules, hence 20% of the Na+-Ca2+ exchanger is included in the modeled subspace 37. Finally, we include sarcolemmal and SR membrane binding sites that buffer calcium 38.


Ryanodine receptor Markov model

A Markov model of the RyR, modified from that originally presented by Fill et al. 39 is utilized in the simulations (Figure 2B). The RyR Markov model is based upon experiments by Zahradniková et al. 40 where individual RyR channels were fused into a planar lipid bilayer. This preparation allows for direct control of Ca2+ concentrations to determine rates of channel activation and inactivation (an approach that shows that RyR channels both activate and inactivate due to a rise in subspace calcium ([Ca2+]ss). In addition, the four transitions necessary to reach the open state reflect the homotetrameric structure of RyR 41. All of the channel transition rates are increased to adjust for the temperature differences between the experiments (23°C) and model (37°C). An addition to the original Fill 39 model is the inclusion of four additional inactivation states (I1–I4) connected to the closed states (C1–C4). This change allowed RyR channels to deactivate without having to pass through the open state, preventing reopening of the channel during repolarization and during rest. In our simulations, when channels could only recover from inactivation through the open state, Ca2+ leaked from the SR for the duration of the AP preventing SR refilling and normal decay of the calcium transient. This behavior could not be observed in the lipid bilayer experiments where RyRs were not stimulated by APs.

It has been suggested that calsequestrin (CASQ2) may also be an important modulator of RyR activity 42,43. CASQ2 is a high-capacity, low-affinity buffer of Ca2+ located in the SR. Kawasaki and Kasai 44 demonstrated that introduction of CASQ2 to the SR increased the RyR open probability and Hidalgo and Donoso 45 showed that interventions that led to conformational change of CASQ2 resulted in opening of RyRs. Studies by Györke et al. 46 showed that low SR Ca2+ led to CASQ2 inhibition of RyR opening and that upon elevation of SR Ca2+ this inhibition decreased. Communication between CASQ2 and RyR may be mediated by the auxiliary proteins triadin and junctin 47,48. Because RyR channels in the experiments of Zahradniková et al. 40 were studied in isolation, their dependence on CASQ2 was not apparent and hence not incorporated into their Markov model of RyR. We incorporate this dependence into the RyR Markov model presented here.


Simulation protocols

During pacing, a stimulus of −80μA/μF is applied for a duration of 0.5ms. The model is paced with a conservative current stimulus carried by K+49. A discrete time step of 0.0002ms is used during computation of the AP (or during voltage clamp simulations) and 0.002ms during the diastolic interval. APD is measured as the interval between the time of maximum upstroke velocity (dV/dtmax) and 90% repolarization (APD).



Results

L-type Ca2+ channel: model validation and gating properties

Figure 3A compares the simulated ICa(L) current-voltage relationship to the experimentally measured current-voltage relationship 50. L-type Ca2+ channels typically begin to activate between −40 and −30mV and peak current is reached between 0 and +10mV. Figure 3C shows simulated voltage-dependent inactivation (VDI) properties of ICa(L) compared to the experimentally measured data reproduced in Figure 3B51. To eliminate CDI, Findlay substituted extracellular Ca2+ with Mg2+. We eliminate CDI by not permitting transitions from ModeV to ModeCa (setting transition rates to zero). In both model and experiment, channel inactivation increases with increased prepulse voltage and with increased prepulse duration. Because the experiments were conducted at 23°C, the values for the prepulse duration were adjusted to 37°C utilizing a Q10=2 in the simulation. Findlay observed two time constants of inactivation for the L-type Ca2+ channel. The model accounts for this observation by including two voltage-dependent inactivation states, one for which transitions into the state are fast (IVf) and one for which transitions are slow (IVs).

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Figure 3
L-type Ca2+ channel current-voltage relationship and voltage-dependent inactivation. (A) Simulated ICa(L) current-voltage relationship (normalized) compared to experimental data recorded in guinea pig ventricular myocytes (from Rose et al. 50, with permission) (●). (B and C) Voltage-dependent inactivation (VDI) of ICa(L) obtained from a double-pulse protocol (inset). The simulations are conducted in the absence of Ca2+-dependent inactivation (transitions from ModeV to ModeCa are prevented). Panels (B) show experimental time course (left) and voltage dependence (right) of VDI recorded in guinea pig ventricular myocytes at 23°C (Findlay 51, with permission) utilizing Mg2+ as the charge carrier. The voltage dependence curves (right panel), from upper to lower, correspond to prepulse durations of 10, 20, 50, 100, 200, 500, and 1000ms. Panels (C) show the corresponding simulated time course and voltage dependence of VDI. The voltage dependence curves, from upper to lower, correspond to prepulse durations of 4, 8, 20, 40, 80, 200, and 400ms (the simulations are conducted for body temperature, 37°C).

The L-type Ca2+ channel Markov model recreates single channel properties as shown in Fig. 4. The simulated open time histogram for a voltage step to +10mV (Figure 4A) can be fit by a monoexponential probability density function with a τo=0.8ms, in agreement with the experiments of Cavalié et al. 52. The latency to first opening is shown in Figure 4B, with the simulation showing strong correlation to experimental data by Cavalié et al. 52 who observed >90% channel openings within 6ms of depolarization. The simulations were conducted without Ca2+-dependent inactivation.

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Figure 4
Single channel properties of the L-type Ca2+ channel. The experimental data (from Cavalié et al. 52, with permission) are from single channel recordings in guinea pig ventricular myocytes at 32°C, and were measured utilizing Ba2+ as the charge carrier. To model Ba2+ as the charge carrier, all simulations were conducted without transitions to ModeCa. (A) Simulated (left) and experimental (right) 52 open time histograms measured for a voltage step to +10mV from a holding potential of −65mV (B, inset). The open probability data were fit by a monoexponential probability density function with a time constant of τ0=0.8 for both measured and simulated data. (B) Simulated latency to first opening. Channels are simulated with the same square pulse protocol as panel A.

Following SR Ca2+ release, Ca2+ concentrations within the subspace can reach a value 50 times higher than myoplasmic concentrations. Therefore, the L-type Ca2+ channel Markov model must be responsive to large changes in Ca2+. Figure 5A shows the sensitivity of ICa(L) to [Ca2+]ss, both simulated and experimentally measured 53. It should be noted that the experimental data are a measure of single channel activity, while the simulated data are a measure of peak ICa(L). There is a strong correlation between the simulated and experimental data, both exhibiting a KD=3μM. In addition, for both experiment and model, even for very high concentrations of subspace Ca2+, the channel does not inactivate completely (to zero). In the simulation (and experiment), the tested [Ca2+]ss was applied and the model was allowed to reach steady state at that concentration before application of the square pulse. Hence, this study provides the steady-state dependence of ICa(L) on [Ca2+]ss and gives no indication of the time course of Ca2+-dependent inactivation. This time course was determined by optimizing the morphology of ICa(L) during the AP clamp protocol shown in Fig. 8, where SR release was kept intact. The time course of ICa(L) recovery from Ca2+-dependent inactivation is shown in Figure 5B. The experimental data (solid circles) 54 were measured in guinea pig ventricular myocytes at 35°C with SR Ca2+ release intact. The experimentally measured time constant of recovery is τ=92ms, and the model time constant of recovery is τ=101ms. When we eliminate CDI in the model, the time constant of recovery shows only a slight decrease (τ=88ms). This is in agreement with experimental results that show no significant difference in the rate of ICa(L) recovery when utilizing either Ca2+ or Ba2+ as the charge carrier (Ian Findlay, PhD, Université de Tours, France personal communication, 2004).

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Figure 5
(A) Dependence of peak ICa(L) on intracellular subspace Ca2+. Values are normalized to control conditions of [Ca2+]ss= 0.02μM. For each value of [Ca2+]ss, the channel is allowed to reach steady state before application of a square voltage pulse to 0mV. The experimental data (from Höfer et al. 53, with permission) (●) provide normalized channel activity recorded utilizing a cell attached patch in guinea pig ventricular myocytes at 37°C. (B) ICa(L) recovery from inactivation. The experimental data (from Vornanen and Shepherd 54, with permission) (●) were recorded in guinea pig ventricular myocytes at 35°C utilizing Ca2+ as the charge carrier with a time constant of recovery τ=92ms. The solid curve shows simulated ICa(L) recovery from VDI (no transitions to ModeCa; non-Ca2+ charge carrier) with a time constant of recovery τ=88ms. The gray dashed curve shows simulated ICa(L) recovery from both VDI and CDI (Ca2+ as the charge carrier) with a time-constant of recovery τ=101ms.

The relative contribution of CDI to total ICa(L) inactivation is shown in Fig. 6 for two different times (tearly and tlate) after application of a voltage step. CDI's contribution to inactivation is computed as the ratio of inactivation with Ca2+ as the charge carrier relative to the inactivation when Ba2+ is the charge carrier. The experimental data (solid squares) 55 were recorded at room temperature (23°C) so the time at which the data are sampled is adjusted to 37°C in the simulation (Experiment: tearly=20ms, tlate=200ms; Simulation: tearly=8ms, tlate=80ms). The relative contribution of CDI to total inactivation is both voltage dependent and time dependent. CDI is responsible for a greater percentage of inactivation at negative potentials when VDI is weak and in the period shortly after depolarization. With increased time and voltage, the contribution of CDI to total inactivation decreases and VDI becomes dominant.

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Figure 6
(A and B) Voltage dependence of the contribution of CDI to total inactivation for two different times (early, tearly; late, tlate) after application of a voltage step to varying potentials from a holding potential of −80mV. The plotted values are the ratio of current decay recorded with Ca2+ as the charge carrier relative to that recorded with Ba2+ as the charge carrier. Experiments (from Findlay 55, with permission) (■) were conducted at room temperature (23°C) and simulations (solid line) at 37°C; values of tearly and tlate were adjusted for 37°C in the simulations. (Experiment: tearly=20ms, tlate=200ms; Simulation: tearly=8ms, tlate=80ms). (CF) Relative contributions of Ca2+ through the channel and Ca2+ released from the SR to total CDI during a voltage step. (C) Trace 3 (thin curve) shows simulated ICa(L) in the absence of Ca2+-dependent inactivation, corresponding to current carried by monovalent cations or Ba2+, for a voltage step from −80 to −10mV. Trace 2 (medium curve) shows ICa(L) with Ca2+ as the charge carrier (hence with Ca2+-dependent inactivation) but with no Ca2+ release from the SR (Irel=0) for a voltage step from −80 to 0mV (the 10-mV difference in test potential compared to trace 3 is to reproduce the experimental protocol in panel D for comparison). Trace 1 (thick curve) shows ICa(L) for the same square pulse with Ca2+ as the charge carrier and SR calcium release intact. (D) Experimental recordings of ICa(L) in human atrial myocytes measured at room temperature. Trace 3 is the current through the channel utilizing monovalent cations as the charge carrier tested with a voltage step from −80 to −10mV. Trace 2 shows ICa(L) with Ca2+ as the charge carrier but with SR release blocked with ryanodine during a voltage step from −80 to 0mV. Trace 3 shows ICa(L) with Ca2+ as the charge carrier and SR release intact for the same voltage step. (E) Simulated fraction of Ca2+-induced inactivation that results from Ca2+ released from the SR (gray) or from Ca2+ entering via ICa(L) (black). The formula for determining the relative contribution is from Sun et al. 8 where the ICa(L) dependent fraction=(trace3-trace2)/(trace3-trace1) and the SR dependent fraction=(trace2-trace1)/(trace3-trace1). (F) Experimental fractional contribution of ICa(L)-dependent (black) and SR dependent (white) Ca2+-induced inactivation of ICa(L). Experimental curves in panels D and F are reproduced from Sun et al. 8, with permission.

The rate of transition between ModeV and ModeCa is dependent on the Ca2+ concentration within the subspace ([Ca2+]ss). The relative contribution to CDI of Ca2+ that enters the subspace via ICa(L) versus that which enters the subspace via SR release is explored in Figure 6CF. In the simulation and experiment 8 (Figure 6CD, respectively), cells are clamped from holding potential to −10mV for the trace where Ca2+ is not the charge carrier (trace 3) and from holding potential to 0mV for the two traces where Ca2+ is the charge carrier (traces 1 and 2). In the experiment (Figure 6D, trace 2), SR Ca2+ release is blocked with the application of ryanodine that we simulate by setting Irel=0 (Figure 6C, trace 2). In summary, trace 1 represents total ICa(L) inactivation (VDI+CDI from ICa(L) and Irel), trace 2 represents ICa(L) inactivation in the absence of SR release (VDI+CDI from ICa(L) only), and trace 3 represents pure VDI (no CDI). Figure 6EF show the percent contribution to CDI from SR release ((trace 2-trace 1)/(trace 3-trace 1)) compared to the percent contribution to CDI from Ca2+ entering via ICa(L) ((trace 3-trace 2)/(trace 3-trace 1)). It is clear that Ca2+ released from the SR dominates CDI initially, then, as Ca2+ decreases due to SR reuptake of Ca2+, the SR dependent contribution declines with participation from Ca2+ entry via ICa(L) dominating. For the simulated time period shown in Figure 6E RyRs open quickly, inactivate, and then remain almost fully inactivated; thus, there is very little steady-state SR-dependent contribution to CDI, as appears to be the case in the SR-dependent experimental curve of Figure 6F. Reasons for this observed difference can be attributed to the fact that the experimental data were recorded in human atrial cells at room temperature (23°C). Despite these differences, the behavior of the model follows that of the experiment, especially during the initial phase following depolarization when a sharp decline in current is observed, correlating with the large increase in [Ca2+]ss during the period of SR Ca2+ release and dominance of SR-dependent inactivation (Figure 6C, trace 1, and E, SR-dependent curve). This initial fast decline is followed by a much slower decrease in current (Figure 6C, trace 1), a combination of VDI and CDI from Ca2+ entry via ICa(L). The crossover of the SR-dependent and ICa(L)-dependent CDI curves occurs 36ms after depolarization in the simulation and 55ms after depolarization in the experiment.


RyR model in the subspace: graded release, fractional release, and variable gain

Communication between L-type Ca2+ channels and RyRs occurs in local diadic spaces and the stochastic opening of a single L-type Ca2+ channel can trigger the opening of several local RyRs. The magnitude of Ca2+ entry via ICa(L) determines the number of RyR openings, thus small ICa(L) results in small SR release compared to large ICa(L) resulting in large SR release. This phenomenon is known as graded release or graded response and is reproduced by the model as shown in Figure 7A. Note that in our macroscopic formulation the spatial distribution of RyRs is not represented and the ratio of RyR channels that open in response to a given ICa(L) is introduced to recreate the macroscopic properties of global release.

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Figure 7
(A) Graded release of SR Ca2+. In the simulation, voltage is clamped from −80mV to the test potential. The solid trace shows normalized peak ICa(L) and the dashed trace shows normalized peak [Ca2+]i. (B) Fractional SR release as a function of SR content. [Ca2+]JSR is clamped at each value for 20s. to allow RyR states to reach a new equilibrium, then the clamp is removed and a stimulus is applied. [Ca2+]JSR,t is total JSR Ca2+ (free+Ca2+ bound CASQ2) and is integrated over the interval from the time of stimulus to the peak of the CaT. (C) Voltage-dependent variable gain of SR Ca2+ release. The right panel shows experimentally measured dependence of Δ[Ca2+]i (difference between the peak [Ca2+]i and resting [Ca2+]i) on ICa(L) for different Vm values (indicated on curve) in guinea pig ventricular mocytes (from Beuckelmann and Wier 57, with permission). The corresponding simulated data are shown in the left panel. Note that for the same amplitude of ICa(L), a larger release occurs at negative potentials.

The model exhibits a steep nonlinear dependence of fractional SR release as a function of JSR Ca2+ content as shown in Figure 7B, in agreement with experiments 56. In the model, the rate of transition between inactivated and closed states is modulated by Ca2+-bound CASQ2 and when SR content is low, channels are unavailable for opening.

Another property that myocytes exhibit is variable gain. Gain is the ratio between the amount of Ca2+ released from the SR and the amount of Ca2+ entry into the myocyte that triggers SR release. In myocytes, it has been observed that for the same amount of triggering Ca2+, the magnitude of release can vary as a function of the transmembrane potential. For example, in Figure 7A, the magnitude of ICa(L) at Vm=−10mV and at Vm=+30mV is approximately the same, but there is a large difference in the magnitude of the Ca2+ transient at these two potentials, with the negative potential exhibiting a larger SR Ca2+ release. In Figure 7C we show the simulated relationship between [Ca2+]i and ICa(L) over a range of Vm values (indicated on the curve) and compare the model results to experimentally measured data in guinea pig ventricular myocytes 57. From the shape of the curve, it is clear that for the same magnitude of ICa(L) the amount of SR release is greater at negative potentials. At 0mV, the gain of SR Ca2+ release is 15.4 as computed with the following formula , where is the Ca2+ flux from the SR and is the Ca2+ flux through ICa(L), integrated over the period from the beginning of the voltage clamp to the peak of the CaT. This value for gain is comparable to values measured in rabbit 56 and canine 58.


ICa(L) during the action potential

An essential property of the L-type Markov model is the ability to recreate measured ICa(L) amplitude and morphology during the AP. Fig. 8 shows an experimentally measured ICa(L) (nifedipine-sensitive current) 59 compared to a simulated ICa(L) during the application of an identical AP clamp waveform (10 APs at 1Hz). The experiment was conducted in a guinea pig ventricular myocyte at 37°C with SR Ca2+ release intact. Note that both the simulated and measured ICa(L) exhibit a peak value of ∼6 pA/pF, a period of rapid inactivation, and a current magnitude during the AP plateau of ∼3 pA/pF.

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Figure 8
ICa(L) during the action potential in the presence of SR Ca2+ release. The upper panels show the AP clamp waveform from Grantham and Cannell 59 used to generate the corresponding ICa(L) (lower panels). The experimental ICa(L) (nifedipine-sensitive current; lower left panel) is measured in guinea pig ventricular myocyte at 36°C. Experimental traces are reproduced from Grantham and Cannell 59, with permission.

Rate dependence of APD, [Na+]i, and [Ca2+]i

Figure 9A compares simulated AP and [Ca2+]i transient during the AP to their experimental counterparts 60. For this comparison, the amplitudes of the AP and [Ca2+]i are not provided in the experimental tracings because the measured AP and [Ca2+]i are expressed as fluorescence ratios of the voltage-sensitive dye RH237 and Ca2+-sensitive dye Rhod-2. However, important temporal relationships between the AP and the [Ca2+]i transient are observed in both the simulation and experiment, including a 5-ms delay between the AP upstroke and the initiation of release, a 25-ms delay between the AP upstroke and the time of peak [Ca2+]i transient, and a time constant of decay of the [Ca2+]i transient of ∼150ms.

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Figure 9
(A) Simulated AP and Ca2+ transient (left) compared to experimentally recorded AP and Ca2+ transient (right) in guinea pig ventricular myocyte at 37°C. The experiment is a simultaneous optical recording using the voltage-sensitive dye RH237 and Ca2+ sensitive indicator Rhod-2 (from Choi and Salama 60, with permission). (B) APD adaptation, [Na+]i rate dependence, and [Ca2+]i rate dependence. The figure shows the steady-state relationship (achieved after 5min of pacing) between cycle length and APD (■). Corresponding changes in [Ca2+]i,max (▴), [Ca2+]i,diastolic (▵), and [Na+]i (●) are also shown.

Simulated changes to APD, [Na+]i, peak [Ca2+]i, and diastolic [Ca2+]i as a function of rate are summarized in Figure 9B. APD adaptation 61, [Na+]i accumulation 62, and the positive force-frequency relationship (increase in peak [Ca2+]i with increasing rate) 62 are consistent with experimental comparisons made in a previous publication 32.


APD and [Ca2+]i restitution

Figure 10AB, show restitution properties of the myocyte model. The myocyte is paced at a constant cycle length until steady state. Then a premature stimulus is applied with a coupling interval DI (diastolic interval, DI=0 is APD90 of the last paced AP). Figure 10A shows the last paced beat (CL=500) and five APs with the associated ICa(L) and [Ca2+]i for five DI values (50ms, 150ms, 250ms, 350ms, and 450ms). Note that at DI=50ms a normal [Ca2+]i transient fails to occur despite a large ICa(L) (i.e., a large triggering source). Also, note that the CaT at DI=450ms is larger then the CaT generated at steady state at CL=500ms. This is because the DI+APD90 is longer than the initial CL=500ms and the SR has had a longer time to fill and the RyR has had more time to recover from inactivation resulting in a larger release and CaT.

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Figure 10
Restitution properties. The myocyte is paced at a constant cycle length for 5min followed by a premature stimulus applied at varying diastolic intervals (DI). (A) Representative changes to AP, ICa(L), and [Ca2+]i for five different DIs (50ms, 150ms, 250ms, 350ms, and 450ms) after pacing at CL=500ms. (B) Summary of restitution behavior for a myocyte paced at three different cycle lengths (CL=300, 500, and 1000ms). Δ[Ca2+]i is the difference between peak [Ca2+]i and the [Ca2+]i just before application of the premature stimulus.

Restitution data for three different pacing cycle lengths (CL=1000ms, 500ms, and 300ms) are shown in Figure 10B. At very short DI, dV/dtmax is slow due to incomplete recovery of INa. This results in decreased Vmax and a larger driving force for ICa(L), increasing the current at these short DIs. Although the triggering source is large (Peak ICa(L)), RyR channels remain inactivated preventing release. Only when RyR channels have recovered from inactivation does release occur. The duration of this interval where no SR release can occur is dependent on the pacing frequency (Peak RyR Open Probability and Peak Irel). This phenomenon is related to recovery of SR Ca2+ content 63 and the relationship between bound CASQ2 and RyR recovery 46,63. At fast rates, the increased amount of Ca2+ in the cytosol (Δ[Ca2+]i) leads to faster recovery of SR calcium content (Peak [Ca2+]JSR) and faster recovery of RyR and Irel (Peak Irel). At very long DI, it can be observed that the magnitude of Irel is strongly dependent on SR content when Peak RyR Open Probability and Peak ICa(L) are similar in magnitude for all three CLs.


Currents during the AP at fast and slow pacing

Steady-state AP, [Ca2+]i, [Ca2+]ss, and the significant currents that determine APD and AP morphology are shown in Fig. 11 for two different pacing frequencies. At rapid rate (CL=300ms, gray curve) ICa(L) exhibits a larger peak and plateau compared to slow rate (CL=1000ms, black curve) (B). Although there is a greater CDI at CL=300ms due to the larger Ca2+ transient, the lower AP plateau increases the driving force for ICa(L), resulting in a larger current. The lower plateau and shortened APD (A) are mostly due to the large IKs current that accumulates at fast rate (F).

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Figure 11
Action potential (AP), calcium transient ([Ca2+]i), ICa(L), subspace calcium transient ([Ca2+]ss), INaCa, INaK, INaCa,ss, IK1, IKr, and IKs for two different pacing frequencies, CL=1000ms (black curve) and CL=300ms (gray curve).

The Na+-Ca2+ exchanger within the subspace (INaCa,ss; D) provides little triggering Ca2+ compared to that provided by ICa(L) and upon release of Ca2+ from the SR (and the subsequent increase in subspace Ca2+) quickly shifts to the forward mode to remove Ca2+. At fast rates when [Ca2+]ss (H) is elevated, INaCa,ss remains in the forward mode during most of the AP plateau.


L-type Ca2+ channel state residencies during the AP

The time course of L-type Ca2+ channel state residencies during the AP at fast and slow rates is shown in Fig. 12 (see Fig. 1 for the state diagram of the channel). At the slow rate (CL=1000ms, black curve), almost all the channels are able to fully recover to the closed states in ModeV (Figure 12B) before the pacing stimulus, whereas at the rapid rate (CL=300ms, gray curve) ∼15% of the channels are still in ModeCa at the time of stimulus (Figure 12BG, arrows). Despite a greater number of channels locked in ModeCa, the magnitude of ICa(L) is larger at rapid rate due to the reduced Vm and increase in driving force. Upon depolarization, channels quickly move to the open state (Figure 12C). From the open state, channels inactivate via either fast VDI (IVf, Figure 12D) or slow VDI (IVs, Figure 12E). Upon the initiation of SR Ca2+ release, channels transition from ModeV to ModeCa and inactivate by CDI (Figure 12GJ); IVfCa and IVsCa contain channels that have inactivated via both VDI and CDI.

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Figure 12
State residencies of the L-type Ca2+ channel during the time course of the action potential for two different pacing frequencies, CL=1000ms (black curve) and CL=300ms (gray curve). For identification of the channel states, refer to Fig. 1.

At rapid rate, a greater percentage of channels become inactivated by CDI due to the elevated [Ca2+]i. For the rapid rate, at t =100ms after the time of stimulus, ∼10% of the channels are inactivated solely by CDI, 40% solely by VDI, and 40% via both CDI and VDI. This is compared to 5%, 55%, and 30%, respectively, at the slow rate. The remaining 10% of channels are in either the closed or open states.


RyR channel state residencies during the AP

The time course of RyR channel state residencies during the AP at fast (CL=300ms, gray curve) and slow rate (CL=1000ms, black curve) is shown in Fig. 13 (see Figure 2B for the state diagram of RyR). Upon depolarization and elevation of [Ca2+]ss by Ca2+ entry via ICa(L), channels move rapidly from the closed state (Figure 13D) to the open state (Figure 13C) (Ca2+-dependent activation). Channels then transition into the near inactivated states (I4 and I5, Figure 13F) due to the high concentration of Ca2+ in the subspace following SR release (Ca2+-dependent inactivation). After AP repolarization, channels move from inactivated states I4 and I5 to I1, I2, and I3 (Figure 13FE) as subspace Ca2+ decreases. From I1, I2, and I3, channels then recover to the closed states (Figure 13D) as the SR stores recover. This recovery from inactivated to closed states is dependent on the concentration of Ca2+ bound CASQ2. As can be seen in Figure 13D, the delay of recovery from inactivation is longer at slow rates than at fast rates. This is due to increased Ca2+ loading of the myocyte at rapid rate, which allows faster recovery of Ca2+-bound CASQ2 and, in turn, faster recovery of RyR from inactivation after AP repolarization.

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Figure 13
State residencies of the RyR channel during the time course of the action potential for two different pacing frequencies, CL=1000ms (black curve) and CL=300ms (gray curve). For identification of the channel states, refer to Figure 2B.

It can be observed that the RyR open probability (Figure 13C) at rapid rate is smaller than that at slow rate, but the maximum SR Ca2+ flux is greater (Figure 13B). The reason for the decreased open probability is that 55% of the channels remain inactivated at rapid rate (Figure 13E, arrow), primarily due to the decreased time for recovery between beats. Despite the decreased open probability, Irel is larger due to the larger SR Ca2+ stores ([Ca2+]JSR) that result from rapid pacing (see Figure 11J). Increased [Ca2+]ss (Figure 11H) at rapid rate (due to increased Irel, Figure 13B) increases the percentage of RyR channels that are activated by Ca2+ (rightward transition on the state diagram) and the percentage of channels that are inactivated by Ca2+ (upward transition on the state diagram). Hence, at rapid rate more channels reside in I4 and I5 compared to slow rate (Figure 13F).


Timothy syndrome and loss of CaV1.2 VDI

The CaV1.2 mutation G406R, linked to the Timonthy syndrome, almost completely removes VDI of ICa(L). In Figure 14A we show steady-state inactivation curves of ICa(L) for the control model (black trace) and for G406R (gray trace) compared to experimentally measured values (symbols). Analysis of mRNA in heart and brain tissue by Splawski et al. 13 showed that ∼23% of CaV1.2 channels contain the exon 8A in which the mutation G406R occurs. For this reason we show AP (Figure 14B), ICa(L) (C), and CaT (D) for three scenarios—wild-type (WT, black traces), heterozygous expression (11.5% G406R CaV1.2 channels, dashed gray traces), and homozygous (23% G406R CaV1.2 channels, gray traces). The G406R mutation results in ICa(L) current with a larger peak (Figure 14C, arrow) due to the loss of fast VDI. Recovery of current during the late phase of the AP corresponds with the decline of the CaT. This recovery from CDI results in an increased depolarizing ICa(L) current that prolongs APD (clinically observed as prolongation of QT interval on the ECG) and increases myocyte Ca2+. The increase of [Ca2+]i results from both increased Ca2+ entry via ICa(L) and reduced diastolic interval, a time during which excess Ca2+ is removed by the Na+-Ca2+ exchanger.

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Figure 14
(A) Steady-state voltage-dependent inactivation curves of CaV1.2 for wild-type (WT, black) and mutation G406R (gray). The experimental data (symbols) (from Splawski et al. 13, with permission) were recorded in the absence of Ca2+. (B) Steady-state APs at CL=1000ms for WT myocyte (black trace), a myocyte with 11.5% G406R channels (dashed trace), and with 23% G406R channels (gray trace). (C) Corresponding ICa(L) (arrow indicates peak of ICa(L) for WT) and (D) calcium transient, CaT.


Discussion

In this study we present detailed kinetic models of CaV1.2 and RyR that interact within a subcellular restricted space. These models were incorporated into the LRd model of the mammalian ventricular cell with the following results: 1), The model of CaV1.2 reproduces experimental single channel data (mean open time, latency to first opening) and macroscopic current data (VDI, CDI, recovery from inactivation, ICa(L) during the AP). 2), The CaV1.2-RyR interaction in the subspace reproduces graded SR Ca2+ release and voltage-dependent variable gain of release. 3), The model accurately reproduces adaptation of APD to changes in rate, rate dependence of [Na+]i and the Ca2+ transient (force-frequency relationship), and restitution properties of APD and the Ca2+ transient during premature stimuli. 4), CDI of CaV1.2 is sensitive to Ca2+ that enters the subspace from L-type Ca2+ channels and from SR release. The relative contributions of these Ca2+ sources to total CDI vary with time after depolarization, with transition from early SR Ca2+ dominance to late L-type Ca2+ dominance, as seen experimentally. 5), The relative contribution of CDI to total inactivation of ICa(L) is greater at negative potentials when VDI is weak. 6), CDI is greater at rapid rates due to elevated subspace Ca2+. 7), Suppression of VDI due to the CaV1.2 mutation G406R results in APD prolongation and increased [Ca2+]i.

Divalent cations and ICa(L) inactivation

In the ICa(L) model development we utilized extensive experimental data obtained with divalent cations other than Ca2+ (i.e., Ba2+, Mg2+, Sr2+, Cd2+) as the charge carrier to eliminate CDI. There has been some evidence to indicate that these substitutions (specifically Ba2+) for Ca2+ may also cause some inactivation of the channel 64. The mechanism by which other divalent cations cause inactivation is not known. Making the assumption that divalent cations other than Ca2+ can be used to indicate pure VDI can lead to an overestimation of the magnitude of VDI compared to CDI. To avoid this potential pitfall, studies of VDI have been conducted utilizing monovalent cations as the charge carrier 65,66. However, in these studies isoproternol (ISO) was used to amplify the current for facilitation of measurement. In experiments conducted by Findlay in the absence of ISO 67, the current through ICa(L) carried by Ba2+, Sr2+, and Na+ all exhibited similar inactivation kinetics, implying that Ba2+ and other divalent cations are suitable substitutes for determining VDI when ISO is absent. All simulations in this study were conducted under such basal conditions, in the absence of β-adrenergic effects.


ICa(L): Ca2+ versus voltage dependent inactivation

There has been some debate as to which mechanism dominates inactivation of L-type Ca2+ channels, VDI, or CDI. In our simulations, we show that in the absence of CDI, VDI can cause >80% inactivation of the current (Figure 3B) for voltage clamps to positive potentials. Experimental data of steady-state inactivation from Linz and Meyer 66 show that in the absence of CDI only 50% of the channels are inactivated due to VDI for voltage clamps to positive potentials. The primary reason for differences between our simulation and the Linz and Meyer experiments is their use of ISO in the solution. In a series of studies 51,67,68,69, Findlay demonstrated that when β-adrenergic stimulation effects were induced by the addition of ISO to the bath solution, the contribution of VDI to total inactivation was greatly reduced and CDI became dominant. Findlay proposed a “switch” whereby phosphorylation of the channel turns off rapid VDI and CDI becomes dominant 55. Our simulations are conducted in the absence of β-adrenergic stimulation and are in agreement with Findlay experiments conducted in the absence of ISO. In Figure 6AB, we show that the relative contributions of CDI and VDI to total inactivation are both voltage and time dependent. We also show that the relative contribution of CDI and VDI to total inactivation is rate dependent (Fig. 12); specifically the contribution of CDI to total inactivation increases with increased rate due to the elevation of total [Ca2+] within the myocyte. Loss of VDI, as shown in simulations of the CaV1.2 mutation G406R (Fig. 14), leads to APD prolongation and an increase in [Ca2+]i. It is clear that both VDI and CDI are important mechanisms of ICa(L) inactivation. The loss of either of these mechanisms of inactivation can lead to APD prolongation and calcium overload, resulting in increased susceptibility to arrhythmia.

It has been well established that CDI of ICa(L) occurs by Ca2+ binding to a constitutively bound calmodulin molecule on the C-terminus of the CaV1.2 α1 subunit 22,23,70. But there has been some evidence that Ca2+ in the pore of the channel or Ca2+ very near the channel pore can also cause CDI 71. We formulated CDI as a function of both ICa(L) (representing Ca2+ passing through the channel pore) and [Ca2+]ss (Ca2+ that can bind to the C-terminus inactivation site). However, extensive experimental data were fitted by the model with CDI dependence on [Ca2+]ss alone, suggesting a minor role for pore Ca2+ compared to subspace Ca2+ in ICa(L) inactivation.


ICa(L) selectivity filter

The L-type Ca2+ channel is permeable to both monovalent and divalent cations, but there has been some evidence to suggest that when Ca2+ is present, the channel is selective almost exclusively for Ca2+ and does not allow passage of other ions 72,73. In our model of ICa(L) the channel is permeable to Ca2+, K+, and Na+ with membrane permeabilities of 1.215×10−3 cm/s, 4.34×10−7 cm/s, and 1.515×10−6 cm/s, respectively. We conducted simulations where the permeability of Na+ and K+ through ICa(L) was eliminated but discovered that the resultant AP morphology did not fit experimentally recorded guinea pig APs.


ICa(L) facilitation

L-type Ca2+ channels exhibit a property whereby the channel current magnitude increases with successive depolarizations. This property is known as facilitation and is thought to play a role in generating positive force frequency. ICa(L) facilitation is not reproduced by the model presented here, but the model still exhibits a positive force frequency relationship due to [Ca2+]i loading at fast rate. Recent experimental evidence has shown that ICa(L) facilitation is a result of CaMKII activation 23,24,74,75,76. CaMKII is sensitive to frequency changes in [Ca2+]i and when activated, can phosphorylate several targets including CaV1.2, SERCA, and RyRs. A recent model of the canine ventricular AP incorporated the CaMKII signaling pathways and its effects on the AP and Ca2+ transient 9. Modification of this signaling pathway for inclusion in the guinea pig myocyte model could be done in future development to incorporate ICa(L) facilitation. ICa(L) is also augmented by β-adrenergic stimulation 77. The simulations in this study are conducted under basal conditions in the absence of β-adrenergic effects. Models of the β-adrenergic signaling pathway 78 could also be adapted and incorporated in the cell model for studies of cellular behavior under various levels of β-adrenergic tone.


Gain and local control of SR Ca2+ release

Local control theory of SR Ca2+ release says that the individual discrete openings of single L-type Ca2+ channels signal the opening of nearby RyRs, the Ca2+ from which can recruit adjacent RyRs leading to SR release. This concept is important for understanding variable gain of SR release, where it is observed that for the same magnitude of ICa(L), a larger release is achieved at negative potentials than at positive potentials. The idea is that at negative potentials fewer CaV1.2 channels open but because the driving force for Ca2+ is large, a large amount of Ca2+ enters through the open channels creating sufficient local Ca2+ lev