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Circulation: Arrhythmia and Electrophysiology
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Published Online
on September 17, 2009

Circulation: Arrhythmia and Electrophysiology. 2009
Published online before print September 17, 2009, doi: 10.1161/CIRCEP.109.894683
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Original Article

Sudden Infant Death Syndrome in Mice with an Inherited Mutation in RyR2

Nithin Mathur1; Subeena Sood1; Sufen Wang2; Ralph J. van Oort1; Satyam Sarma1; Na Li1; Darlene G. Skapura1; J. Henri Bayle1; Miguel Valderrábano2 and Xander H.T. Wehrens1,3

1 Baylor College of Medicine, Houston, TX;
2 Methodist Hospital & Weill College of Medicine at Cornell University, Houston, TX

* Corresponding author; email: wehrens{at}bcm.edu

Background—Mutations in the cardiac ryanodine receptor gene (RyR2) have been recently identified in victims of sudden infant death syndrome (SIDS). The aim of this study was to determine whether a gain-of-function mutation in RyR2 increases the propensity to cardiac arrhythmias and sudden death in young mice.

Methods and Results—Incidence of sudden death was monitored prospectively in heterozygous knock-in mice with mutation R176Q in RyR2 (R176Q/+). Young R176Q/+ mice exhibited a higher incidence of sudden death compared with wild-type (WT) littermates. Optical mapping of membrane potentials and calcium levels in 1-7 day-old R176Q/+ and WT mice revealed an increased incidence of ventricular ectopy and spontaneous calcium releases in neonatal R176Q/+ mice. Surface ECGs in 3-10 day-old mice showed that R176Q/+ mice developed more ventricular arrhythmias following provocation with epinephrine and caffeine. Intracardiac pacing studies in 12-18 day-old mice revealed the presence of an arrhythmogenic substrate in R176Q/+ compared with WT mice. RT-PCR and Western blotting showed that expression levels of other calcium handling proteins were unaltered suggesting that calcium leak through mutant RyR2 underlies arrhythmogenesis and sudden death in young R176Q/+ mice.

Conclusions—Our findings demonstrate that a gain-of-function mutation in RyR2 confers an increased risk of cardiac arrhythmias and sudden death in young mice, and that young R176Q/+ mice may be used as a model for elucidating the complex interplay between genetic and environmental risk factors associated with SIDS.

Key Words: arrhythmia • electrophysiology • ion channels • calcium • sudden infant death syndrome • focal activity • ryanodine receptors • ventricular arrhythmia