Abstract-CalciumKey Words: hypertrophy Ⅲ calcium Ⅲ gene therapy C alcium cycling in the heart is triggered by calcium influx through L-type calcium channels. 1 Such calcium channels are present and functionally important not only in cardiac myocytes but also in diverse smooth muscles and in neurons. Enhancement of calcium-regulated signaling pathways contributes to the development of left ventricular hypertrophy (LVH). 2 Thus, calcium channel inhibition represents a logical approach to treatment of LVH. Gene therapy allows for more directed and organ-specific delivery and thus may avoid undesired systemic effects, which may account in part for the limited clinical benefit observed with these agents. 3 L-type calcium channels are heteromultimers of various subunits. The accessory  subunit (LTCC) not only favors the trafficking of the calcium channel to the surface membrane, but also enhances the probability of channel opening 4 -7 resulting in increased calcium current. Interestingly, upregulation of a splice variant of the LTCC ( 2a ) has been previously described in failing human cardiomyocytes. 8 Whether or not  subunits are upregulated in hypertrophy, we hypothesized that suppression of LTCC might represent an attractive means to inhibit calcium influx, attenuate calciumdependent signaling and ultimately prevent or treat LVH.Using RNA interference technology to selectively modulate the expression of the gene of interest, we studied the physiological effects of LTCC modulation in native cardiac cells, and the effects in a cellular model of hypertrophy. To further investigate the effects of LTCC downregulation in cardiac hypertrophy, we performed in vivo gene transfer of an "advanced" generation lentiviral vector capable of permanently modulating the expression of LTCC. A rat pressureoverload LVH model was implemented to test the potential beneficial effect of modulating the expression of the L-type calcium channel accessory  subunit.
Materials and MethodsFor a detailed Materials and Methods, please see the online data supplement available at http://circres.ahajournals.org.
Short Hairpin RNA Design and Vector ProductionA series of short interference RNA duplexes (siRNAs) against the D2 conserved domain 9 of LTCC were designed according to published algorithms 10 and synthesized. The three most active sequences and one scrambled, nonsilencing (NS) sequence were designed into a short hairpin RNA (shRNA) oligonucleotide. These three active shRNAs and one NS-shRNA sequence were screened Original