Local levels of cAMP regulate the precise opening of the ryanodine receptor complex—which releases calcium at the start of a heartbeat. Loss or inhibition of phosphodiesterase 4D enzymatic activity leads to calcium leak, heart failure and arrhythmia.
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Katie Ris
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Molkentin, J. Locating heart failure. Nat Med 11, 1284–1285 (2005). https://doi.org/10.1038/nm1205-1284
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DOI: https://doi.org/10.1038/nm1205-1284
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