Calcium extrusion is critical for cardiac morphogenesis and rhythm in embryonic zebrafish hearts

<jats:p>Calcium entry into myocytes drives contraction of the embryonic heart. To prepare for the next contraction, myocytes must extrude calcium from intracellular space via the Na<jats:sup>+</jats:sup>/Ca<jats:sup>2+</jats:sup>exchanger (NCX1) or sequester it into the sarcoplasmic reticulum, via the sarcoplasmic reticulum Ca<jats:sup>2+</jats:sup>-ATPase2 (SERCA2). In mammals, defective calcium extrusion correlates with increased intracellular calcium levels and may be relevant to heart failure and sarcoplasmic dysfunction in adults. We report here that mutation of the cardiac-specific NCX1 (<jats:italic>NCX1h</jats:italic>) gene causes embryonic lethal cardiac arrhythmia in zebrafish<jats:italic>tremblor</jats:italic>(<jats:italic>tre</jats:italic>) embryos. The<jats:italic>tre</jats:italic>ventricle is nearly silent, whereas the atrium manifests a variety of arrhythmias including fibrillation. Calcium extrusion defects in<jats:italic>tre</jats:italic>mutants correlate with severe disruptions in sarcomere assembly, whereas mutations in the L-type calcium channel that abort calcium entry do not produce this phenotype. Knockdown of<jats:italic>SERCA2</jats:italic>activity by morpholino-mediated translational inhibition or pharmacological inhibition causes embryonic lethality due to defects in cardiac contractility and morphology but, in contrast to<jats:italic>tre</jats:italic>mutation, does not produce arrhythmia. Analysis of intracellular calcium levels indicates that homozygous<jats:italic>tre</jats:italic>embryos develop calcium overload, which may contribute to the degeneration of cardiac function in this mutant. Thus, the inhibition of NCX1h versus SERCA2 activity differentially affects the pathophysiology of rhythm in the developing heart and suggests that relative levels of NCX1 and SERCA2 function are essential for normal development.</jats:p>