Volume 5, Issue 3, Pages (March 2008)

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Volume 5, Issue 3, Pages 427-435 (March 2008) Gain of function in IKs secondary to a mutation in KCNE5 associated with atrial fibrillation Lasse S. Ravn, MD, Yoshiyasu Aizawa, MD, Guido D. Pollevick, PhD, Jacob Hofman-Bang, PhD, Jonathan M. Cordeiro, PhD, Ulrik Dixen, PhD, Gorm Jensen, DMSc, Yuesheng Wu, MS, Elena Burashnikov, BS, Stig Haunso, DMSc, Alejandra Guerchicoff, PhD, Dan Hu, MD, PhD, Jesper H. Svendsen, DMSc, Michael Christiansen, MD, Charles Antzelevitch, PhD, FHRS Heart Rhythm Volume 5, Issue 3, Pages 427-435 (March 2008) DOI: 10.1016/j.hrthm.2007.12.019 Copyright © 2008 Heart Rhythm Society Terms and Conditions

Figure 1 Mutation screening of KCNE5. A: DNA sequence chromatogram showing the wild type (WT) and the corresponding amino acid sequence. B: DNA sequence chromatogram showing the heterozygous mutation (in bold) and the corresponding amino acid sequence. A heterozygous substitution of T for C in nucleotide 193 predicts substitution of phenylalanine (TTC) for leucine (CTC) in codon 65 (L65F). C: ECG of the proband recorded during normal sinus rhythm between episodes of atrial fibrillation. Heart Rhythm 2008 5, 427-435DOI: (10.1016/j.hrthm.2007.12.019) Copyright © 2008 Heart Rhythm Society Terms and Conditions

Figure 2 Representative current trace recorded from IKs/CHO cells transiently transfected with KCNE5–WT.A: Current from stable cell line of IKs/CHO. B: Current from IKs/CHO transfected with 0.15 μg KCNE5-WT. C: Current from IKs/CHO transfected with 0.3 μg KCNE5-WT. D: Current from IKs/CHO transfected with 1.5 μg KCNE5-WT. Pulse protocol is shown in the inset in the center right. Heart Rhythm 2008 5, 427-435DOI: (10.1016/j.hrthm.2007.12.019) Copyright © 2008 Heart Rhythm Society Terms and Conditions

Figure 3 Current-voltage relationship of developing and tail currents in the absence and presence of 0.15 to 1.5 μg KCNE5-WT. A: Current-voltage relationship of peak developing current. B: Current-voltage relationship of tail current measured upon repolarization to −40 mV. C: Bar graphs showing current densities of peak developing current measured during test pulse to +60 mV. D: Bar graphs showing current densities of tail current measured upon repolarization to −40 mV following a test pulse to +60 mV. *P <.05; **P <.01 vs IKs. Heart Rhythm 2008 5, 427-435DOI: (10.1016/j.hrthm.2007.12.019) Copyright © 2008 Heart Rhythm Society Terms and Conditions

Figure 4 Current-voltage relationship of developing and tail currents in the absence and presence of 1.5 μg KCNE5-WT or KCNE5-L65F. A: Representative current trace of IKs/CHO cells transfected with 1.5 μg WT KCNE5. B: Representative current trace of IKs/CHO cells transfected with 1.5 μg L65F KCNE5. Pulse protocol is shown in the inset in the center right. C: Current-voltage relationship of peak developing current. D: Current-voltage relationship of tail current measured upon repolarization to −40 mV. *P <.05 vs IKs+KCNE5-WT. Heart Rhythm 2008 5, 427-435DOI: (10.1016/j.hrthm.2007.12.019) Copyright © 2008 Heart Rhythm Society Terms and Conditions

Figure 5 Effect of 0.3 and 1.5 μg KCNE5-WT or KCNE5-L65F on IKs.A: Bar graph showing density of peak developing current recorded during a test pulse to +60 mV. B: Bar graph showing density of tail currents recorded during repolarization to −40 mV following a test pulse to +60 mV. Statistical significance determined using analysis of variance. *P <.05; **P <.01. Heart Rhythm 2008 5, 427-435DOI: (10.1016/j.hrthm.2007.12.019) Copyright © 2008 Heart Rhythm Society Terms and Conditions

Figure 6 Current-voltage relationship of developing and tail currents in cells cotransfected with equal amounts of KCNE5-WT and KCNE5-L65F. A: Representative current trace of IKs/CHO cells transfected with 0.75 μg WT KCNE5 and 0.75 μg L65F KCNE5.B: Representative current trace of IKs/CHO cells transfected with 1.5 μg WT KCNE5 and 1.5 μg L65F KCNE5.C: Current-voltage relationship of peak developing current. D: Current-voltage relationship of tail current measured upon repolarization to −40 mV. E: Bar graph showing density of peak developing current recorded during a test pulse to +60 mV (IKs; IKs+1.5 μg KCNE5-WT; IKs+0.75 μg KCNE5-WT+0.75 μg KCNE5-L65F; IKs+1.5 μg KCNE5-WT+1.5 μg KCNE5-L65F). F: Bar graph showing density of tail currents recorded during repolarization to −40 mV following a test pulse to +60 mV (IKs; IKs+1.5 μg KCNE5-WT; IKs+0.75 μg KCNE5-WT+0.75 μg KCNE5-L65F; IKs+1.5 μg KCNE5-WT+1.5 μg KCNE5-L65F). Heart Rhythm 2008 5, 427-435DOI: (10.1016/j.hrthm.2007.12.019) Copyright © 2008 Heart Rhythm Society Terms and Conditions