We found that sinus bradycardia in members of a large family was associated with a mutation in the gene coding for the pacemaker HCN4 ion channel. Pacemaker channels of the sinoatrial node generate spontaneous activity and mediate cyclic AMP (cAMP)–dependent autonomic modulation of the heart rate. The mutation associated with bradycardia is located near the cAMP-binding site; functional analysis found that mutant channels respond normally to cAMP but are activated at more negative voltages than are wild-type channels. These changes, which mimic those of mild vagal stimulation, slow the heart rate by decreasing the inward diastolic current. Thus, diminished function of pacemaker channels is linked to familial bradycardia.

Familial sinus bradycardia associated with a mutation in the cardiac pacemaker channel / R. Milanesi , M. Baruscotti , T. Gnecchi-Ruscone, D. DiFrancesco. - In: NEW ENGLAND JOURNAL OF MEDICINE. - ISSN 0028-4793. - 354:2(2006 Jan 12), pp. 151-157. [10.1056/NEJMoa052475]

Familial sinus bradycardia associated with a mutation in the cardiac pacemaker channel

R. Milanesi;M. Baruscotti;D. DiFrancesco
2006-01-12

Abstract

We found that sinus bradycardia in members of a large family was associated with a mutation in the gene coding for the pacemaker HCN4 ion channel. Pacemaker channels of the sinoatrial node generate spontaneous activity and mediate cyclic AMP (cAMP)–dependent autonomic modulation of the heart rate. The mutation associated with bradycardia is located near the cAMP-binding site; functional analysis found that mutant channels respond normally to cAMP but are activated at more negative voltages than are wild-type channels. These changes, which mimic those of mild vagal stimulation, slow the heart rate by decreasing the inward diastolic current. Thus, diminished function of pacemaker channels is linked to familial bradycardia.
modulation; heart; node; voltage; camp; acetylcholine; inhibition; activation; disease
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/15910
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