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Maestri R, Pinna GD, Robbi E, Cogliati C, Bartoli A, Gambino G, Rengo G, Montano N, La Rovere MT. Impact of optimized transcutaneous auricular vagus nerve stimulation on cardiac autonomic profile in healthy subjects and heart failure patients. Physiol Meas 2024; 45:075007. [PMID: 39016202 DOI: 10.1088/1361-6579/ad5ef6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 07/03/2024] [Indexed: 07/18/2024]
Abstract
Objective.To determine the optimal frequency and site of stimulation for transcutaneous vagus nerve stimulation (tVNS) to induce acute changes in the autonomic profile (heart rate (HR), heart rate variability (HRV)) in healthy subjects (HS) and patients with heart failure (HF).Approach.We designed three single-blind, randomized, cross-over studies: (1) to compare the acute effect of left tVNS at 25 Hz and 10 Hz (n= 29, age 60 ± 7 years), (2) to compare the acute effect of left and right tVNS at the best frequency identified in study 1 (n= 28 age 61 ± 7 years), and (3) to compare the acute effect of the identified optimal stimulation protocol with sham stimulation in HS and HF patients (n= 30, age 59 ± 5 years, andn= 32, age 63 ± 7 years, respectively).Main results.In study 1, left tragus stimulation at 25 Hz was more effective than stimulation at 10 Hz in decreasing HR (-1.0 ± 1.2 bpm,p< 0.001 and -0.5 ± 1.6 bpm, respectively) and inducing vagal effects (significant increase in RMSSD, and HF power). In study 2, the HR reduction was greater with left than right tragus stimulation (-0.9 ± 1.5 bpm,p< 0.01 and -0.3 ± 1.4 bpm, respectively). In study 3 in HS, left tVNS at 25 Hz significantly reduced HR, whereas sham stimulation did not (-1.1 ± 1.2 bpm,p< 0.01 and -0.2 ± 2.9 bpm, respectively). In HF patients, both active and sham stimulation produced negligible effects.Significance.Left tVNS at 25 Hz is effective in acute modulation of cardiovascular autonomic control (HR, HRV) in HS but not in HF patients (NCT05789147).
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Affiliation(s)
- Roberto Maestri
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri, Montescano Institute-IRCCS, Montescano, Italy
| | - Gian Domenico Pinna
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri, Montescano Institute-IRCCS, Montescano, Italy
| | - Elena Robbi
- Department of Cardiology, Istituti Clinici Scientifici Maugeri, Montescano Institute-IRCCS, Montescano, Italy
| | - Chiara Cogliati
- Department of Biomedical and Clinical Sciences, University of Milan and Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Arianna Bartoli
- Department of Biomedical and Clinical Sciences, University of Milan and Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Giuseppina Gambino
- Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy
- Istituti Clinici Scientifici ICS Maugeri, Telese Terme Institute, -IRCCS, Telese, Italy
| | - Nicola Montano
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Maria Teresa La Rovere
- Department of Cardiology, Istituti Clinici Scientifici Maugeri, Montescano Institute-IRCCS, Montescano, Italy
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Aydin MD, Kanat A, Sahin B, Sahin MH, Ergene S, Demirtas R. New experimental finding of dangerous autonomic ganglia changes in cardiac injury following subarachnoid hemorrhage; a reciprocal culprit-victim relationship between the brain and heart. Int J Neurosci 2024; 134:91-102. [PMID: 35658782 DOI: 10.1080/00207454.2022.2086128] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/13/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The vagal, stellate, and cardiac ganglia cells changes following subarachnoid hemorrhage (SAH) may occur. This study aimed to investigate if there is any relation between vagal network/stellate ganglion and intrinsic cardiac ganglia insult following SAH. MATERIALS AND METHODS Twenty-six rabbits were used in this study. Animals were randomly divided as control (GI, n = 5); SHAM 0.75 cc of saline-injected (n = 5) and study with autologous 1.5 cc blood injection into their cisterna magna(GIII, n = 15). All animals were followed for three weeks and then decapitated. Their motor vagal nucleus, nodose, stellate, and intracardiac ganglion cells were estimated by stereological methods and compared statistically. RESULTS Numerical documents of heart-respiratory rates, vagal nerve- ICG, and stellate neuron densities as follows: 276 ± 32/min-22 ± 3/min-10.643 ± 1.129/mm3-4 ± 1/mm3-12 ± 3/mm3 and 2 ± 1/cm3 in the control group; 221 ± 22/min-16 ± 4/min-8.699 ± 976/mm3-24 ± 9/mm3-103 ± 32/mm3 and 11 ± 3/cm3 in the SHAM group; and 191 ± 23/min-17 ± 4/min-9.719 ± 932/mm3-124 ± 31/mm3-1.542 ± 162/mm3 and 32 ± 9/cm3 in the SAH (study) group. The animals with burned neuro-cardiac web had more neurons of stellate ganglia and a less normal neuron density of nodose ganglia (p < 0.005). CONCLUSION Sypathico-parasympathetic imbalance induced vagal nerve-ICG disruption following SAH could be named as Burned Neurocardiac Web syndrome in contrast to broken heart because ICG/parasympathetic network degeneration could not be detected in classic broken heart syndrome. It was noted that cardiac ganglion degeneration is more prominent in animals' severe degenerated neuron density of nodose ganglia. We concluded that the cardiac ganglia network knitted with vagal-sympathetic-somatosensitive fibers has an important in heart function following SAH. The neurodegeneration of the cardiac may occur in SAH, and cause sudden death.Graphical abstract[Formula: see text].
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Affiliation(s)
- Mehmet Dumlu Aydin
- Department of Neurosurgery, Medical Faculty, of Ataturk University, Erzurum, Turkey
| | - Ayhan Kanat
- Department of Neurosurgery, Medical Faculty of Recep Tayyip, Erdogan University, Rize, Turkey
| | - Balkan Sahin
- Department of Neurosurgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Hakan Sahin
- Department of Neurosurgery, Medical Faculty, of Ataturk University, Erzurum, Turkey
| | - Saban Ergene
- Department of Cardiovascular Surgery, Medical Faculty of Recep Tayyip, Erdogan University, Rize, Turkey
| | - Rabia Demirtas
- Department of Pathology, Medical Faculty, of Ataturk University, Erzurum, Turkey
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Vallone F, Dushpanova A, Leali M, Strauss I, Agnesi F, Zinno C, Casieri V, Carrozzo A, Bernini F, Terlizzi D, Carpaneto J, Micera S, Lionetti V. Left cardiac vagotomy rapidly reduces contralateral cardiac vagal electrical activity in anesthetized Göttingen minipigs. Int J Cardiol 2024; 394:131349. [PMID: 37689397 DOI: 10.1016/j.ijcard.2023.131349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/14/2023] [Accepted: 09/05/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND The impact of acute unilateral injury on spontaneous electrical activity in both vagus nerves at the heart level is poorly understood. We investigated the immediate neuroelectrical response after right or left cardiac vagal nerve transection (VNTx) by recording spiking activity of each heart vagus nerve (VN). METHODS Fourteen male Göttingen minipigs underwent sternotomy. Multi-electrode cuffs were implanted below the cut level to record vagal electroneurographic signals during electrocardiographic and hemodynamic monitoring, before and immediately after cardiac VNTx (left: L-cut, n = 6; right: R-cut, n = 8). RESULTS Left cardiac VNTx significantly reduced multi-unit electrical activity (MUA) firing rate in the vagal stump (-30.7% vs pre-cut) and intact right VN (-21.8% vs pre-cut) at the heart level, without affecting heart rate, heart rate variability, or hemodynamics. In contrast, right cardiac VNTx did not acutely alter MUA in either VN but slightly increased (p < 0.022) the root mean square of successive RR interval differences (rMSSD), an index of parasympathetic outflow, without affecting hemodynamics. CONCLUSIONS Our study reveals an early left-lateralized pattern in vagal spiking activity following unilateral cardiac vagotomy. These findings enhance understanding of the neuroelectrical response to vagal injury and provide insights into preserving vagal outflow after unilateral cardiac vagotomy. Importantly, monitoring spiking activity of the cardiac right VN may predict onset of left vagal pathway injury, which is detrimental to cardiac patients and can occur as a complication of catheter ablation for atrial fibrillation.
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Affiliation(s)
- Fabio Vallone
- BioRobotics Institute, Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Anar Dushpanova
- Unit of Translational Critical Care Medicine, Laboratory of Basic and Applied Medical Sciences, Interdisciplinary Research Center "Health Science," Scuola Superiore Sant'Anna, Pisa, Italy; Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Marco Leali
- Unit of Translational Critical Care Medicine, Laboratory of Basic and Applied Medical Sciences, Interdisciplinary Research Center "Health Science," Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ivo Strauss
- Institut für Mikrosystemtechnik, University of Freiburg, IMTEK, Freiburg, Germany
| | - Filippo Agnesi
- BioRobotics Institute, Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ciro Zinno
- BioRobotics Institute, Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Valentina Casieri
- Unit of Translational Critical Care Medicine, Laboratory of Basic and Applied Medical Sciences, Interdisciplinary Research Center "Health Science," Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alessandro Carrozzo
- Unit of Translational Critical Care Medicine, Laboratory of Basic and Applied Medical Sciences, Interdisciplinary Research Center "Health Science," Scuola Superiore Sant'Anna, Pisa, Italy; Department of Cardiac Surgery, ICLAS, GVM Care & Research, Rapallo, Italy
| | | | | | - Jacopo Carpaneto
- BioRobotics Institute, Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Silvestro Micera
- BioRobotics Institute, Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational NeuroEngineering, Centre for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
| | - Vincenzo Lionetti
- Unit of Translational Critical Care Medicine, Laboratory of Basic and Applied Medical Sciences, Interdisciplinary Research Center "Health Science," Scuola Superiore Sant'Anna, Pisa, Italy; BioMedLab, Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana "G. Monasterio", Pisa, Italy.
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Liu MB, Ajijola OA. The promise of cardiac neuromodulation: can computational modelling bridge the gap? J Physiol 2023; 601:3693-3694. [PMID: 37535053 PMCID: PMC10529398 DOI: 10.1113/jp285309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023] Open
Affiliation(s)
- Michael B Liu
- Division of Cardiovascular Medicine, Stanford University, Palo Alto, CA, USA
| | - Olujimi A Ajijola
- UCLA Cardiac Arrhythmia Center, University of California, Los Angeles, CA, USA
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Wu Z, Liao J, Liu Q, Zhou S, Chen M. Chronic vagus nerve stimulation in patients with heart failure: challenge or failed translation? Front Cardiovasc Med 2023; 10:1052471. [PMID: 37534273 PMCID: PMC10390725 DOI: 10.3389/fcvm.2023.1052471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 05/31/2023] [Indexed: 08/04/2023] Open
Abstract
Autonomic imbalance between the sympathetic and parasympathetic nervous systems contributes to the progression of chronic heart failure (HF). Preclinical studies have demonstrated that various neuromodulation strategies may exert beneficial cardioprotective effects in preclinical models of HF. Based on these encouraging experimental data, vagus nerve stimulation (VNS) has been assessed in patients with HF with a reduced ejection fraction. Nevertheless, the main trials conducted thus far have yielded conflicting findings, questioning the clinical efficacy of VNS in this context. This review will therefore focus on the role of the autonomic nervous system in HF pathophysiology and VNS therapy, highlighting the potential reasons behind the discrepancy between preclinical and clinical studies.
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Affiliation(s)
- Zhihong Wu
- Department of Cardiovascular, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jiaying Liao
- Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiming Liu
- Department of Cardiovascular, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shenghua Zhou
- Department of Cardiovascular, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Mingxian Chen
- Department of Cardiovascular, The Second Xiangya Hospital of Central South University, Changsha, China
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Respiratory patterns and baroreflex function in heart failure. Sci Rep 2023; 13:2220. [PMID: 36755066 PMCID: PMC9908869 DOI: 10.1038/s41598-023-29271-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
Little is known on the effects of respiratory patterns on baroreflex function in heart failure (HF). Patients with HF (n = 30, age 61.6 ± 10 years, mean ± SD) and healthy controls (CNT, n = 10, age 58.9 ± 5.6 years) having their R-R interval (RRI, EKG), systolic arterial blood pressure (SBP, Finapres) and respiratory signal (RSP, Respitrace) monitored, were subjected to three recording sessions: free-breathing, fast- (≥ 12 bpm) and slow- (6 bpm) paced breathing. Baroreflex sensitivity (BRS) and power spectra of RRI, SBP, and RSP signals were calculated. During free-breathing, compared to CNT, HF patients showed a significantly greater modulation of respiratory volumes in the very-low-frequency (< 0.04 Hz) range and their BRS was not significantly different from that of CNT. During fast-paced breathing, when very-low-frequency modulations of respiration were reduced, BRS of HF patients was significantly lower than that of CNT and lower than during free breathing. During slow-paced breathing, BRS became again significantly higher than during fast breathing. In conclusion: (1) in free-breathing HF patients is present a greater modulation of respiratory volumes in the very-low-frequency range; (2) in HF patients modulation of respiration in the very-low and low frequency (around 0.1 Hz) ranges contributes to preserve baroreflex-mediated control of heart rate.
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Zhu X, Wang S, Cheng Y, Gu H, Zhang X, Teng M, Zhang Y, Wang J, Hua W, Lu X. Physiological ischemic training improves cardiac function through the attenuation of cardiomyocyte apoptosis and the activation of the vagus nerve in chronic heart failure. Front Neurosci 2023; 17:1174455. [PMID: 37152604 PMCID: PMC10157045 DOI: 10.3389/fnins.2023.1174455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Purpose This study investigated the functional outcomes of patients with chronic heart failure (CHF) after physiological ischemic training (PIT), identified the optimal PIT protocol, evaluated its cardioprotective effects and explored the underlying neural mechanisms. Methods Patients with CHF were randomly divided into experimental group (n = 25, PIT intervention + regular treatment) and control group (n = 25, regular treatment). The outcomes included the left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP) and cardiopulmonary parameters. LVEF and cardiac biomarkers in CHF rats after various PIT treatments (different in intensity, frequency, and course of treatment) were measured to identify the optimal PIT protocol. The effect of PIT on cardiomyocyte programmed cell death was investigated by western blot, flow cytometry and fluorescent staining. The neural mechanism involved in PIT-induced cardioprotective effect was assessed by stimulation of the vagus nerve and muscarinic M2 receptor in CHF rats. Results LVEF and VO2max increased while BNP decreased in patients subjected to PIT. The optimal PIT protocol in CHF rats was composed of five cycles of 5 min ischemia followed by 5 min reperfusion on remote limbs for 8 weeks. LVEF and cardiac biomarker levels were significantly improved, and cardiomyocyte apoptosis was inhibited. However, these cardioprotective effects disappeared after subjecting CHF rats to vagotomy or muscarinic M2 receptor inhibition. Conclusion PIT improved functional outcomes in CHF patients. The optimal PIT protocol required appropriate intensity, reasonable frequency, and adequate treatment course. Under these conditions, improvement of cardiac function in CHF was confirmed through cardiomyocyte apoptosis reduction and vagus nerve activation.
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Affiliation(s)
- Xiuhua Zhu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shenrui Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yihui Cheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hongmei Gu
- Department of Cardiology, Nantong Geriatric Rehabilitation Hospital, Branch of Affiliated Hospital of Nantong University, Nantong, China
| | - Xiu Zhang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Meiling Teng
- Children’s Healthcare Department, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Yingjie Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiayue Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wenjie Hua
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao Lu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Xiao Lu,
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Popa IP, Haba MȘC, Mărănducă MA, Tănase DM, Șerban DN, Șerban LI, Iliescu R, Tudorancea I. Modern Approaches for the Treatment of Heart Failure: Recent Advances and Future Perspectives. Pharmaceutics 2022; 14:pharmaceutics14091964. [PMID: 36145711 PMCID: PMC9503448 DOI: 10.3390/pharmaceutics14091964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Heart failure (HF) is a progressively deteriorating medical condition that significantly reduces both the patients’ life expectancy and quality of life. Even though real progress was made in the past decades in the discovery of novel pharmacological treatments for HF, the prevention of premature deaths has only been marginally alleviated. Despite the availability of a plethora of pharmaceutical approaches, proper management of HF is still challenging. Thus, a myriad of experimental and clinical studies focusing on the discovery of new and provocative underlying mechanisms of HF physiopathology pave the way for the development of novel HF therapeutic approaches. Furthermore, recent technological advances made possible the development of various interventional techniques and device-based approaches for the treatment of HF. Since many of these modern approaches interfere with various well-known pathological mechanisms in HF, they have a real ability to complement and or increase the efficiency of existing medications and thus improve the prognosis and survival rate of HF patients. Their promising and encouraging results reported to date compel the extension of heart failure treatment beyond the classical view. The aim of this review was to summarize modern approaches, new perspectives, and future directions for the treatment of HF.
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Affiliation(s)
- Irene Paula Popa
- Cardiology Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Mihai Ștefan Cristian Haba
- Cardiology Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Minela Aida Mărănducă
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Daniela Maria Tănase
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700115 Iași, Romania
| | - Dragomir N. Șerban
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Lăcrămioara Ionela Șerban
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Radu Iliescu
- Department of Pharmacology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Ionuț Tudorancea
- Cardiology Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Correspondence:
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Proteomics Reveals Long-Term Alterations in Signaling and Metabolic Pathways Following Both Myocardial Infarction and Chemically Induced Denervation. Neurochem Res 2022; 47:2416-2430. [PMID: 35716295 DOI: 10.1007/s11064-022-03636-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
Myocardial infraction (MI) is the principal risk factor for the onset of heart failure (HF). Investigations regarding the physiopathology of MI progression to HF have revealed the concerted engagement of other tissues, such as the autonomic nervous system and the medulla oblongata (MO), giving rise to systemic effects, important in the regulation of heart function. Cardiac sympathetic afferent denervation following application of resiniferatoxin (RTX) attenuates cardiac remodelling and restores cardiac function following MI. While the physiological responses are well documented in numerous species, the underlying molecular responses during the initiation and progression from MI to HF remains unclear. We obtained multi-tissue time course proteomics with a murine model of HF induced by MI in conjunction with RTX application. We isolated tissue sections from the left ventricle (LV), MO, cervical spinal cord and cervical vagal nerves at four time points over a 12-week study. Bioinformatic analyses consistently revealed a high statistical enrichment for metabolic pathways in all tissues and treatments, implicating a central role of mitochondria in the tissue-cellular response to both MI and RTX. In fact, the additional functional pathways found to be enriched in these tissues, involving the cytoskeleton, vesicles and signal transduction, could be downstream of responses initiated by mitochondria due to changes in neuronal pulse frequency after a shock such as MI or the modification of such frequency communication from the heart to the brain after RTX application. Development of future experiments, based on our proteomic results, should enable the dissection of more precise mechanisms whereby metabolic changes in neuronal and cardiac tissues can effectively ameliorate the negative physiological effects of MI via RTX application.
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Harper AA, Adams DJ. Electrical properties and synaptic transmission in mouse intracardiac ganglion neurons in situ. Physiol Rep 2021; 9:e15056. [PMID: 34582125 PMCID: PMC8477906 DOI: 10.14814/phy2.15056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/25/2021] [Accepted: 09/08/2021] [Indexed: 12/19/2022] Open
Abstract
The intrinsic cardiac nervous system represents the final site of signal integration for neurotransmission to the myocardium to enable local control of cardiac performance. The electrophysiological characteristics and ganglionic transmission of adult mouse intrinsic cardiac ganglion (ICG) neurons were investigated using a whole-mount ganglion preparation of the excised right atrial ganglion plexus and intracellular microelectrode recording techniques. The passive and active electrical properties of ICG neurons and synaptic transmission including synaptic response strength and efficacy as a function of stimulation frequency were examined. The resting membrane potential and input resistance of ICG neurons were -47.9 ± 4.0 mV and 197.2 ± 81.5 MΩ, respectively. All neurons had somatic action potentials with overshoots of >+15 mV and after-hyperpolarizations having an average of 10 mV amplitude and ~45 ms half duration. Phasic discharge activities were recorded from the majority of neurons studied and several types of excitatory synaptic responses were recorded following inputs from the vagus or interganglionic nerve trunk(s). Most postganglionic neurons (>75%) received a strong, suprathreshold synaptic input and reliably followed high-frequency repetitive nerve stimulation up to at least 50 Hz. Nerve-evoked synaptic transmission was blocked by extracellular Cd2+ , ω-conotoxin CVIE, or α-conotoxin RegIIA, a selective α3-containing nicotinic acetylcholine receptor antagonist. Synaptic transmission and the electrical properties of murine ICG neurons contribute to the pattern of discharge which regulates chronotropic, dromotropic, and inotropic elements of cardiac function.
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Affiliation(s)
- Alexander A. Harper
- Illawarra Health and Medical Research Institute (IHMRI)University of WollongongWollongongNew South WalesAustralia
| | - David J. Adams
- Illawarra Health and Medical Research Institute (IHMRI)University of WollongongWollongongNew South WalesAustralia
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Targosova K, Kucera M, Kilianova Z, Slobodova L, Szmicsekova K, Hrabovska A. Cardiac nicotinic receptors show β-subunit-dependent compensatory changes. Am J Physiol Heart Circ Physiol 2021; 320:H1975-H1984. [PMID: 33769917 DOI: 10.1152/ajpheart.00995.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Nicotinic receptors (NRs) play an important role in the cholinergic regulation of heart functions, and converging evidence suggests a diverse repertoire of NR subunits in the heart. A recent hypothesis about the plasticity of β NR subunits suggests that β2-subunits and β4-subunits may substitute for each other. In our study, we assessed the hypothetical β-subunit interchangeability in the heart at the level of mRNA. Using two mutant mice strains lacking β2 or β4 NR subunits, we examined the relative expression of NR subunits and other key cholinergic molecules. We investigated the physiology of isolated hearts perfused by Langendorff's method at basal conditions and after cholinergic and/or adrenergic stimulation. Lack of β2 NR subunit was accompanied with decreased relative expression of β4-subunits and α3-subunits. No other cholinergic changes were observed at the level of mRNA, except for increased M3 and decreased M4 muscarinic receptors. Isolated hearts lacking β2 NR subunit showed different dynamics in heart rate response to indirect cholinergic stimulation. In hearts lacking β4 NR subunit, increased levels of β2-subunits were observed together with decreased mRNA for acetylcholine-synthetizing enzyme and M1 and M4 muscarinic receptors. Changes in the expression levels in β4-/- hearts were associated with increased basal heart rate and impaired response to a high dose of acetylcholine upon adrenergic stimulation. In support of the proposed plasticity of cardiac NRs, our results confirmed subunit-dependent compensatory changes to missing cardiac NRs subunits with consequences on isolated heart physiology.NEW & NOTEWORTHY In the present study, we observed an increase in mRNA levels of the β2 NR subunit in β4-/- hearts but not vice versa, thus supporting the hypothesis of β NR subunit plasticity that depends on the specific type of missing β-subunit. This was accompanied with specific cholinergic adaptations. Nevertheless, isolated hearts of β4-/- mice showed increased basal heart rate and a higher sensitivity to a high dose of acetylcholine upon adrenergic stimulation.
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Affiliation(s)
- Katarina Targosova
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia
| | - Matej Kucera
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia
| | - Zuzana Kilianova
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia.,Department of Pharmacology, Slovak Medical University in Bratislava, Bratislava, Slovakia
| | - Lubica Slobodova
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia.,Department of Pharmacology, Slovak Medical University in Bratislava, Bratislava, Slovakia
| | - Kristina Szmicsekova
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia
| | - Anna Hrabovska
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia.,Department of Pharmacology, Slovak Medical University in Bratislava, Bratislava, Slovakia.,Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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12
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Tebar WR, Ritti-Dias RM, Mota J, Saraiva BTC, Damato TM, Delfino LD, Farah BQ, Vanderlei LCM, Christofaro DGD. Relationship of Cardiac Autonomic Modulation with Cardiovascular Parameters in Adults, According to Body Mass Index and Physical Activity. J Cardiovasc Transl Res 2021; 14:975-983. [PMID: 33483920 DOI: 10.1007/s12265-021-10101-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/10/2021] [Indexed: 12/20/2022]
Abstract
This study aimed to analyze the relationship between cardiac autonomic modulation (CAM) and cardiovascular parameters (blood pressure and resting heart rate) in a sample of 256 adults, grouped by body mass index and sufficient moderate-to-vigorous physical activity (≥150 min/week). The sample showed different cardiovascular parameters and CAM according to body mass index, but not according to physical activity. Adults who are overweight and physically active presented higher relationship between CAM and blood pressure than those who are insufficiently active, similarly to normal weight groups. Recommended levels of physical activity may play an important role in the relationship of HRV with cardiovascular parameters in overweight adults, regardless of sex, age, socioeconomic level, and central fat. Trial registration: Registered at ClinicalTrials.gov (NCT03986879). Graphical abstract.
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Affiliation(s)
- William R Tebar
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil.
| | | | - Jorge Mota
- Faculdade de Desporto da Universidade do Porto, Porto, Portugal
| | - Bruna T C Saraiva
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil
| | - Tatiana M Damato
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil
| | - Leandro D Delfino
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil
| | - Breno Q Farah
- Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Luiz Carlos M Vanderlei
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil
| | - Diego G D Christofaro
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil
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13
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Oikawa S, Kai Y, Mano A, Ohata H, Kurabayashi A, Tsuda M, Kakinuma Y. Non-neuronal cardiac acetylcholine system playing indispensable roles in cardiac homeostasis confers resiliency to the heart. J Physiol Sci 2021; 71:2. [PMID: 33461483 PMCID: PMC10717922 DOI: 10.1186/s12576-020-00787-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 12/07/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND We previously established that the non-neuronal cardiac cholinergic system (NNCCS) is equipped with cardiomyocytes synthesizes acetylcholine (ACh), which is an indispensable endogenous system, sustaining cardiac homeostasis and regulating an inflammatory status, by transgenic mice overexpressing choline acetyltransferase (ChAT) gene in the heart. However, whole body biological significances of NNCCS remain to be fully elucidated. METHODS AND RESULTS To consolidate the features, we developed heart-specific ChAT knockdown (ChATKD) mice using 3 ChAT-specific siRNAs. The mice developed cardiac dysfunction. Factors causing it included the downregulation of cardiac glucose metabolism along with decreased signal transduction of Akt/HIF-1alpha/GLUT4, leading to poor glucose utilization, impairment of glycolytic metabolites entering the tricarboxylic (TCA) cycle, the upregulation of reactive oxygen species (ROS) production with an attenuated scavenging potency, and the downregulated nitric oxide (NO) production via NOS1. ChATKD mice revealed a decreased vagus nerve activity, accelerated aggression, more accentuated blood basal corticosterone levels with depression-like phenotypes, several features of which were accompanied by cardiac dysfunction. CONCLUSION The NNCCS plays a crucial role in cardiac homeostasis by regulating the glucose metabolism, ROS synthesis, NO levels, and the cardiac vagus nerve activity. Thus, the NNCCS is suggested a fundamentally crucial system of the heart.
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Affiliation(s)
- Shino Oikawa
- Department of Bioregulatory Science (Physiology), Nippon Medical School, Graduate School of Medicine, Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Yuko Kai
- Department of Bioregulatory Science (Physiology), Nippon Medical School, Graduate School of Medicine, Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Asuka Mano
- Department of Bioregulatory Science (Physiology), Nippon Medical School, Graduate School of Medicine, Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Hisayuki Ohata
- Department of Bioregulatory Science (Physiology), Nippon Medical School, Graduate School of Medicine, Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Atsushi Kurabayashi
- Department of Pathology, Kochi Medical School, Nankoku, Kochi, 783-8505, Japan
| | - Masayuki Tsuda
- Institute for Laboratory Animal Research, Kochi Medical School, Nankoku, Kochi, 783-8505, Japan
| | - Yoshihiko Kakinuma
- Department of Bioregulatory Science (Physiology), Nippon Medical School, Graduate School of Medicine, Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.
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14
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Baine S, Thomas J, Bonilla I, Ivanova M, Belevych A, Li J, Veeraraghavan R, Radwanski PB, Carnes C, Gyorke S. Muscarinic-dependent phosphorylation of the cardiac ryanodine receptor by protein kinase G is mediated by PI3K-AKT-nNOS signaling. J Biol Chem 2020; 295:11720-11728. [PMID: 32580946 PMCID: PMC7450129 DOI: 10.1074/jbc.ra120.014054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/20/2020] [Indexed: 12/30/2022] Open
Abstract
Post-translational modifications of proteins involved in calcium handling in myocytes, such as the cardiac ryanodine receptor (RyR2), critically regulate cardiac contractility. Recent studies have suggested that phosphorylation of RyR2 by protein kinase G (PKG) might contribute to the cardioprotective effects of cholinergic stimulation. However, the specific mechanisms underlying these effects remain unclear. Here, using murine ventricular myocytes, immunoblotting, proximity ligation as-says, and nitric oxide imaging, we report that phosphorylation of Ser-2808 in RyR2 induced by the muscarinic receptor agonist carbachol is mediated by a signaling axis comprising phosphoinositide 3-phosphate kinase, Akt Ser/Thr kinase, nitric oxide synthase 1, nitric oxide, soluble guanylate cyclase, cyclic GMP (cGMP), and PKG. We found that this signaling pathway is compartmentalized in myocytes, as it was distinct from atrial natriuretic peptide receptor-cGMP-PKG-RyR2 Ser-2808 signaling and independent of muscarinic-induced phosphorylation of Ser-239 in vasodilator-stimulated phosphoprotein. These results provide detailed insights into muscarinic-induced PKG signaling and the mediators that regulate cardiac RyR2 phosphorylation critical for cardiovascular function.
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Affiliation(s)
- Stephen Baine
- College of Pharmacy, Ohio State University, Columbus, Ohio, USA
| | - Justin Thomas
- College of Pharmacy, Ohio State University, Columbus, Ohio, USA
| | - Ingrid Bonilla
- Department of Physiology and Cell Biology, Ohio State University, Columbus, Ohio, USA
| | - Marina Ivanova
- Department of Physiology and Cell Biology, Ohio State University, Columbus, Ohio, USA
| | - Andriy Belevych
- Department of Physiology and Cell Biology, Ohio State University, Columbus, Ohio, USA
| | - Jiaoni Li
- Department of Biomedical Engineering, Ohio State University, Columbus, Ohio, USA
| | | | | | - Cynthia Carnes
- College of Pharmacy, Ohio State University, Columbus, Ohio, USA
| | - Sandor Gyorke
- Department of Biomedical Engineering, Ohio State University, Columbus, Ohio, USA
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15
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Bretherton B, Atkinson L, Murray A, Clancy J, Deuchars S, Deuchars J. Effects of transcutaneous vagus nerve stimulation in individuals aged 55 years or above: potential benefits of daily stimulation. Aging (Albany NY) 2020; 11:4836-4857. [PMID: 31358702 PMCID: PMC6682519 DOI: 10.18632/aging.102074] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 06/28/2019] [Indexed: 12/23/2022]
Abstract
Ageing is associated with attenuated autonomic function. Transcutaneous vagal nerve stimulation (tVNS) improved autonomic function in healthy young participants. We therefore investigated the effects of a single session of tVNS (studies 1 and 2) and tVNS administered daily for two weeks (study 3) in volunteers aged ≥ 55 years. tVNS was performed using modified surface electrodes on the tragus and connected to a transcutaneous electrical nerve stimulation (TENS) machine. Study 1: participants (n=14) received a single session of tVNS and sham. Study 2: all participants (n=51) underwent a single session of tVNS. Study 3: participants (n=29) received daily tVNS for two weeks. Heart rate variability and baroreflex sensitivity were derived. Quality of life (QoL), mood and sleep were assessed in study 3. tVNS promoted increases in measures of vagal tone and was associated with greater increases in baroreflex sensitivity than sham. Two weeks of daily tVNS improved measures of autonomic function, and some aspects of QoL, mood and sleep. Importantly, findings showed that improvements in measures of autonomic balance were more pronounced in participants with greater baseline sympathetic prevalence. This suggests it may be possible to identify individuals who are likely to encounter significant benefits from tVNS.
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Affiliation(s)
- Beatrice Bretherton
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Lucy Atkinson
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Aaron Murray
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Jennifer Clancy
- School of Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Susan Deuchars
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Jim Deuchars
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
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16
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Sobowale CO, Hori Y, Ajijola OA. Neuromodulation Therapy in Heart Failure: Combined Use of Drugs and Devices. J Innov Card Rhythm Manag 2020; 11:4151-4159. [PMID: 32724706 PMCID: PMC7377644 DOI: 10.19102/icrm.2020.110705] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/20/2020] [Indexed: 12/11/2022] Open
Abstract
Heart failure (HF) is the fastest-growing cardiovascular disease globally. The autonomic nervous system plays an important role in the regulation and homeostasis of cardiac function but, once there is HF, it takes on a detrimental role in cardiac function that makes it a rational target. In this review, we cover the remodeling of the autonomic nervous system in HF and the latest treatments available targeting it.
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Affiliation(s)
- Christopher O Sobowale
- UCLA Cardiac Arrhythmia Center, UCLA Neurocardiology Research Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Yuichi Hori
- UCLA Cardiac Arrhythmia Center, UCLA Neurocardiology Research Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Olujimi A Ajijola
- UCLA Cardiac Arrhythmia Center, UCLA Neurocardiology Research Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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17
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Park JH, Gorky J, Ogunnaike B, Vadigepalli R, Schwaber JS. Investigating the Effects of Brainstem Neuronal Adaptation on Cardiovascular Homeostasis. Front Neurosci 2020; 14:470. [PMID: 32508573 PMCID: PMC7251082 DOI: 10.3389/fnins.2020.00470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 04/16/2020] [Indexed: 01/01/2023] Open
Abstract
Central coordination of cardiovascular function is accomplished, in part, by the baroreceptor reflex, a multi-input multi-output physiological control system that regulates the activity of the parasympathetic and sympathetic nervous systems via interactions among multiple brainstem nuclei. Recent single-cell analyses within the brain revealed that individual neurons within and across brain nuclei exhibit distinct transcriptional states contributing to neuronal function. Such transcriptional heterogeneity complicates the task of understanding how neurons within and across brain nuclei organize and function to process multiple inputs and coordinate cardiovascular functions within the larger context of the baroreceptor reflex. However, prior analysis of brainstem neurons revealed that single-neuron transcriptional heterogeneity reflects an adaptive response to synaptic inputs and that neurons organize into distinct subtypes with respect to synaptic inputs received. Based on these results, we hypothesize that adaptation of neuronal subtypes support robust biological function through graded cellular responses. We test this hypothesis by examining the functional impact of neuronal adaptation on parasympathetic activity within the context of short-term baroreceptor reflex regulation. In this work, we extend existing quantitative closed-loop models of the baroreceptor reflex by incorporating into the model distinct input-driven neuronal subtypes and neuroanatomical groups that modulate parasympathetic activity. We then use this extended model to investigate, via simulation, the functional role of neuronal adaptation under conditions of health and systolic heart failure. Simulation results suggest that parasympathetic activity can be modulated appropriately by the coordination of distinct neuronal subtypes to maintain normal cardiovascular functions under systolic heart failure conditions. Moreover, differing degrees of adaptation of these neuronal subtypes contribute to cardiovascular behaviors corresponding to distinct clinical phenotypes of heart failure, such as exercise intolerance. Further, our results suggest that an imbalance between sympathetic and parasympathetic activity regulating ventricular contractility contributes to exercise intolerance in systolic heart failure patients, and restoring this balance can improve the short-term cardiovascular performance of these patients.
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Affiliation(s)
- James H Park
- Department of Pathology, Anatomy and Cell Biology, Jefferson Medical College, Daniel Baugh Institute for Functional Genomics and Computational Biology, Thomas Jefferson University, Philadelphia, PA, United States.,Department of Chemical and Biochemical Engineering, University of Delaware, Newark, DE, United States.,Institute for Systems Biology, Seattle, WA, United States
| | - Jonathan Gorky
- Department of Pathology, Anatomy and Cell Biology, Jefferson Medical College, Daniel Baugh Institute for Functional Genomics and Computational Biology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Babatunde Ogunnaike
- Department of Chemical and Biochemical Engineering, University of Delaware, Newark, DE, United States
| | - Rajanikanth Vadigepalli
- Department of Pathology, Anatomy and Cell Biology, Jefferson Medical College, Daniel Baugh Institute for Functional Genomics and Computational Biology, Thomas Jefferson University, Philadelphia, PA, United States
| | - James S Schwaber
- Department of Pathology, Anatomy and Cell Biology, Jefferson Medical College, Daniel Baugh Institute for Functional Genomics and Computational Biology, Thomas Jefferson University, Philadelphia, PA, United States
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18
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McDonald H, Peart J, Kurniawan ND, Galloway G, Royce SG, Samuel CS, Chen C. Hexarelin targets neuroinflammatory pathways to preserve cardiac morphology and function in a mouse model of myocardial ischemia-reperfusion. Biomed Pharmacother 2020; 127:110165. [PMID: 32403043 DOI: 10.1016/j.biopha.2020.110165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/15/2020] [Accepted: 04/13/2020] [Indexed: 11/17/2022] Open
Abstract
Acute myocardial ischemia and reperfusion injury (IRI) underly the detrimental effects of coronary heart disease on the myocardium. Despite the ongoing advances in reperfusion therapies, there remains a lack of effective therapeutic strategies for preventing IRI. Growth hormone secretagogues (GHS) have been demonstrated to improve cardiac function, attenuate inflammation and modulate the autonomic nervous system (ANS) in models of cardiovascular disease. Recently, we demonstrated a reduction in infarct size after administration of hexarelin (HEX), in a murine model of myocardial infarction. In the present study we employed a reperfused ischemic (IR) model, to determine whether HEX would continue to have a cardioprotective influence in a model of higher clinical relevance. Myocardial ischemia was induced by transient ligation of the left descending coronary artery (tLAD) in C57BL/6 J mice followed by HEX (0.3 mg/kg/day; n = 20) or vehicle (VEH) (n = 18) administration for 21 days, first administered immediately prior-to reperfusion. IR-injured and sham mice were subjected to high-field magnetic resonance imaging to assess left ventricular (LV) function, with HEX-treated mice demonstrating a significant improvement in LV function compared with VEH-treated mice. A significant decrease in interstitial collagen, TGF-β1 expression and myofibroblast differentiation was also seen in the HEX-treated mice after 21 days. HEX treatment shifted the ANS balance towards a parasympathetic predominance; combined with a significant decrease in cardiac troponin-I and TNF-α levels, these findings were suggestive of an anti-inflammatory action on the myocardium mediated via HEX. In this model of IR, HEX appeared to rebalance the deregulated ANS and activate vagal anti-inflammatory pathways to prevent adverse remodelling and LV dysfunction. There are limited interventions focusing on IRI that have been successful in improving clinical outcome in acute myocardial infarction (AMI) patients, this study provides compelling evidence towards the translational potential of HEX where all others have largely failed.
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Affiliation(s)
- H McDonald
- School of Biomedical Science, University of Queensland, Brisbane, Australia
| | - J Peart
- Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - N D Kurniawan
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
| | - G Galloway
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
| | - S G Royce
- Cardiovascular Disease Program, Biomedical Discovery Institute and Department of Pharmacology, Australia; Central Clinical School, Monash University, Victoria, Australia
| | - C S Samuel
- Cardiovascular Disease Program, Biomedical Discovery Institute and Department of Pharmacology, Australia
| | - C Chen
- School of Biomedical Science, University of Queensland, Brisbane, Australia.
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19
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Radcliffe EJ, Pearman CM, Watkins A, Lawless M, Kirkwood GJ, Saxton SN, Eisner DA, Trafford AW. Chronic vagal nerve stimulation has no effect on tachycardia-induced heart failure progression or excitation-contraction coupling. Physiol Rep 2020; 8:e14321. [PMID: 31961064 PMCID: PMC6971309 DOI: 10.14814/phy2.14321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/25/2019] [Accepted: 11/28/2019] [Indexed: 12/13/2022] Open
Abstract
Autonomic dysregulation plays a key role in the development and progression of heart failure (HF). Vagal nerve stimulation (VNS) may be a promising therapeutic approach. However, the outcomes from clinical trials evaluating VNS in HF have been mixed, and the mechanisms underlying this treatment remain poorly understood. Intermittent high-frequency VNS (pulse width 300 µs, 30 Hz stimulation, 30 s on, and 300 s off) was used in healthy sheep and sheep in which established HF had been induced by 4 weeks rapid ventricular pacing to assess (a) the effects of VNS on intrinsic cardiac vagal tone, (b) whether VNS delays the progression of established HF, and (c) whether high-frequency VNS affects the regulation of cardiomyocyte calcium handling in health and disease. VNS had no effect on resting heart rate or intrinsic vagal tone in the healthy heart. Although fewer VNS-treated animals showed subjective signs of heart failure at 6 weeks, overall VNS did not slow the progression of clinical or echocardiographic signs of HF. Chronic VNS did not affect left ventricular cardiomyocyte calcium handling in healthy sheep. Rapid ventricular pacing decreased the L-type calcium current and calcium transient amplitude, but chronic VNS did not rescue dysfunctional calcium handling. Overall, high-frequency VNS did not prevent progression of established HF or influence cellular excitation-contraction coupling. However, a different model of HF or selection of different stimulation parameters may have yielded different results. These results highlight the need for greater insight into VNS dosing and parameter selection and a deeper understanding of its physiological effects.
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Affiliation(s)
- Emma J. Radcliffe
- Unit of Cardiac PhysiologyInstitute of Cardiovascular SciencesManchester Academic Health Sciences CentreThe University of ManchesterManchesterUK
| | - Charles M. Pearman
- Unit of Cardiac PhysiologyInstitute of Cardiovascular SciencesManchester Academic Health Sciences CentreThe University of ManchesterManchesterUK
| | - Amy Watkins
- Unit of Cardiac PhysiologyInstitute of Cardiovascular SciencesManchester Academic Health Sciences CentreThe University of ManchesterManchesterUK
| | - Michael Lawless
- Unit of Cardiac PhysiologyInstitute of Cardiovascular SciencesManchester Academic Health Sciences CentreThe University of ManchesterManchesterUK
| | - Graeme J. Kirkwood
- Unit of Cardiac PhysiologyInstitute of Cardiovascular SciencesManchester Academic Health Sciences CentreThe University of ManchesterManchesterUK
| | - Sophie N. Saxton
- Unit of Cardiac PhysiologyInstitute of Cardiovascular SciencesManchester Academic Health Sciences CentreThe University of ManchesterManchesterUK
| | - David A. Eisner
- Unit of Cardiac PhysiologyInstitute of Cardiovascular SciencesManchester Academic Health Sciences CentreThe University of ManchesterManchesterUK
| | - Andrew W. Trafford
- Unit of Cardiac PhysiologyInstitute of Cardiovascular SciencesManchester Academic Health Sciences CentreThe University of ManchesterManchesterUK
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20
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Kulkarni K, Merchant FM, Kassab MB, Sana F, Moazzami K, Sayadi O, Singh JP, Heist EK, Armoundas AA. Cardiac Alternans: Mechanisms and Clinical Utility in Arrhythmia Prevention. J Am Heart Assoc 2019; 8:e013750. [PMID: 31617437 PMCID: PMC6898836 DOI: 10.1161/jaha.119.013750] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Kanchan Kulkarni
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
| | | | - Mohamad B. Kassab
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
| | - Furrukh Sana
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
| | - Kasra Moazzami
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
| | - Omid Sayadi
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
| | - Jagmeet P. Singh
- Cardiology DivisionCardiac Arrhythmia ServiceMassachusetts General HospitalBostonMA
| | - E. Kevin Heist
- Cardiology DivisionCardiac Arrhythmia ServiceMassachusetts General HospitalBostonMA
| | - Antonis A. Armoundas
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
- Institute for Medical Engineering and ScienceMassachusetts Institute of TechnologyCambridgeMA
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21
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Koba S, Hisatome I, Watanabe T. Augmented fear bradycardia in rats with heart failure. J Physiol Sci 2019; 69:875-883. [PMID: 31363992 PMCID: PMC10717697 DOI: 10.1007/s12576-019-00698-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 07/23/2019] [Indexed: 02/07/2023]
Abstract
In congestive heart failure (CHF), while resting parasympathetic activity becomes reduced, parasympathetically-mediated responses to stressors have not been described. This study aimed to (1) elucidate the effect of CHF on fear bradycardia, a parasympathetically-mediated response, and (2) examine if brain oxidative stress of CHF mediates fear bradycardia. White noise sound (WNS) exposure to conscious rats induced freezing behavior and elicited bradycardia. WNS exposure-elicited bradycardia was greater in rats with CHF than in controls. Superoxide dismutase mimetics administered in the lateral/ventrolateral midbrain periaqueductal gray (l/vlPAG), a region that contributes to the generation of fear bradycardia, had no effect on the bradycardia response in control and CHF rats. Dihydroethidium staining in situ showed that superoxide generation in the l/vlPAG of CHF rats was increased as compared to controls. These results demonstrate that CHF leads to the augmentation of fear bradycardia. Moreover, oxidative stress in the l/vlPAG of CHF unlikely mediates the augmented fear bradycardia.
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Affiliation(s)
- Satoshi Koba
- Division of Integrative Physiology, Faculty of Medicine, Tottori University, Nishi-cho 86, Yonago, Tottori, 683-8503, Japan.
| | - Ichiro Hisatome
- Division of Regenerative Medicine and Therapeutics, Graduate School of Medical Science, Tottori University, Nishi-cho 86, Yonago, Tottori, 683-8503, Japan
| | - Tatsuo Watanabe
- Division of Integrative Physiology, Faculty of Medicine, Tottori University, Nishi-cho 86, Yonago, Tottori, 683-8503, Japan
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22
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Lee SW, Anderson A, Guzman PA, Nakano A, Tolkacheva EG, Wickman K. Atrial GIRK Channels Mediate the Effects of Vagus Nerve Stimulation on Heart Rate Dynamics and Arrhythmogenesis. Front Physiol 2018; 9:943. [PMID: 30072916 PMCID: PMC6060443 DOI: 10.3389/fphys.2018.00943] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/27/2018] [Indexed: 01/09/2023] Open
Abstract
Diminished parasympathetic influence is central to the pathogenesis of cardiovascular diseases, including heart failure and hypertension. Stimulation of the vagus nerve has shown promise in treating cardiovascular disease, prompting renewed interest in understanding the signaling pathway(s) that mediate the vagal influence on cardiac physiology. Here, we evaluated the contribution of G protein-gated inwardly rectifying K+ (GIRK/Kir3) channels to the effect of vagus nerve stimulation (VNS) on heart rate (HR), HR variability (HRV), and arrhythmogenesis in anesthetized mice. As parasympathetic fibers innervate both atria and ventricle, and GIRK channels contribute to the cholinergic impact on atrial and ventricular myocytes, we collected in vivo electrocardiogram recordings from mice lacking either atrial or ventricular GIRK channels, during VNS. VNS decreased HR and increased HRV in control mice, in a muscarinic receptor-dependent manner. This effect was preserved in mice lacking ventricular GIRK channels, but was nearly completely absent in mice lacking GIRK channels in the atria. In addition, atrial-specific ablation of GIRK channels conferred resistance to arrhythmic episodes induced by VNS. These data indicate that atrial GIRK channels are the primary mediators of the impact of VNS on HR, HRV, and arrhythmogenesis in the anesthetized mouse.
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Affiliation(s)
- Steven W. Lee
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States
| | - Allison Anderson
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, United States
| | - Pilar A. Guzman
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, United States
| | - Atsushi Nakano
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Elena G. Tolkacheva
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States
| | - Kevin Wickman
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, United States
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Elstad M, O’Callaghan EL, Smith AJ, Ben-Tal A, Ramchandra R. Cardiorespiratory interactions in humans and animals: rhythms for life. Am J Physiol Heart Circ Physiol 2018. [DOI: 10.1152/ajpheart.00701.2017] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The cardiorespiratory system exhibits oscillations from a range of sources. One of the most studied oscillations is heart rate variability, which is thought to be beneficial and can serve as an index of a healthy cardiovascular system. Heart rate variability is dampened in many diseases including depression, autoimmune diseases, hypertension, and heart failure. Thus, understanding the interactions that lead to heart rate variability, and its physiological role, could help with prevention, diagnosis, and treatment of cardiovascular diseases. In this review, we consider three types of cardiorespiratory interactions: respiratory sinus arrhythmia (variability in heart rate at the frequency of breathing), cardioventilatory coupling (synchronization between the heart beat and the onset of inspiration), and respiratory stroke volume synchronization (the constant phase difference between the right and the left stroke volumes over one respiratory cycle). While the exact physiological role of these oscillations continues to be debated, the redundancies in the mechanisms responsible for its generation and its strong evolutionary conservation point to the importance of cardiorespiratory interactions. The putative mechanisms driving cardiorespiratory oscillations as well as the physiological significance of these oscillations will be reviewed. We suggest that cardiorespiratory interactions have the capacity to both dampen the variability in systemic blood flow as well as improve the efficiency of work done by the heart while maintaining physiological levels of arterial CO2. Given that reduction in variability is a prognostic indicator of disease, we argue that restoration of this variability via pharmaceutical or device-based approaches may be beneficial in prolonging life.
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Affiliation(s)
- Maja Elstad
- Division of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Erin L. O’Callaghan
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Alex J. Smith
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Alona Ben-Tal
- Institute of Natural and Mathematical Sciences, Massey University, Auckland, New Zealand
| | - Rohit Ramchandra
- Department of Physiology, The University of Auckland, Auckland, New Zealand
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Major BC, Le Nguyen KD, Lundberg KB, Fredrickson BL. Well-Being Correlates of Perceived Positivity Resonance: Evidence From Trait and Episode-Level Assessments. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2018; 44:1631-1647. [PMID: 29756547 DOI: 10.1177/0146167218771324] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Positivity resonance is a type of interpersonal connection characterized by shared positivity, mutual care and concern, and behavioral and biological synchrony. Perceived positivity resonance is hypothesized to be associated with well-being. In three studies ( N = 175, N = 120, N = 173), perceived positivity resonance was assessed at the trait level (Study 1) or the episode level, using the Day Reconstruction Method (Studies 2 and 3). Primary analyses reveal that perceived positivity resonance is associated with flourishing mental health, depressive symptoms, loneliness, and illness symptoms. These associations largely remain statistically significant when controlling for daily pleasant emotions or social interaction more generally. Ancillary analyses in Studies 2 and 3 support the construct validity of the episode-level assessment of perceived positivity resonance. The overall pattern of results is consistent with Positivity Resonance Theory. Discussion centers on avenues for future research and the need for behavioral interventions.
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Affiliation(s)
- Brett C Major
- 1 The University of North Carolina at Chapel Hill, USA
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25
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Kulkarni K, Xie X, Fernandez de Velasco EM, Anderson A, Martemyanov KA, Wickman K, Tolkacheva EG. The influences of the M2R-GIRK4-RGS6 dependent parasympathetic pathway on electrophysiological properties of the mouse heart. PLoS One 2018; 13:e0193798. [PMID: 29668674 PMCID: PMC5905881 DOI: 10.1371/journal.pone.0193798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/20/2018] [Indexed: 02/07/2023] Open
Abstract
A large body of work has established the prominent roles of the atrial M2R-IKACh signaling pathway, and the negative regulatory protein RGS6, in modulating critical aspects of parasympathetic influence on cardiac function, including pace-making, heart rate (HR) variability (HRV), and atrial arrhythmogenesis. Despite increasing evidence of its innervation of the ventricles, and the expression of M2R, IKACh channel subunits, and RGS6 in ventricle, the effects of parasympathetic modulation on ventricular electrophysiology are less clear. The main objective of our study was to investigate the contribution of M2R-IKACh signaling pathway elements in murine ventricular electrophysiology, using in-vivo ECG measurements, isolated whole-heart optical mapping and constitutive knockout mice lacking IKACh (Girk4–/–) or RGS6 (Rgs6-/-). Consistent with previous findings, mice lacking GIRK4 exhibited diminished HR and HRV responses to the cholinergic agonist carbachol (CCh), and resistance to CCh-induced arrhythmic episodes. In line with its role as a negative regulator of atrial M2R-IKACh signaling, loss of RGS6 correlated with a mild resting bradycardia, enhanced HR and HRV responses to CCh, and increased propensity for arrhythmic episodes. Interestingly, ventricles from mice lacking GIRK4 or RGS6 both exhibited increased action potential duration (APD) at baseline, and APD was prolonged by CCh across all genotypes. Similarly, CCh significantly increased the slope of APD restitution in all genotypes. There was no impact of genotype or CCh on either conduction velocity or heterogeneity. Our data suggests that altered parasympathetic signaling through the M2R-IKACh pathway can affect ventricular electrophysiological properties distinct from its influence on atrial physiology.
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Affiliation(s)
- Kanchan Kulkarni
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Xueyi Xie
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, United States of America
| | | | - Allison Anderson
- Department of Pharmacology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Kirill A. Martemyanov
- Department of Neuroscience, The Scripps Research Institute, Jupiter, Florida, United States of America
| | - Kevin Wickman
- Department of Pharmacology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Elena G. Tolkacheva
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, United States of America
- * E-mail:
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26
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Ashton JL, Burton RAB, Bub G, Smaill BH, Montgomery JM. Synaptic Plasticity in Cardiac Innervation and Its Potential Role in Atrial Fibrillation. Front Physiol 2018; 9:240. [PMID: 29615932 PMCID: PMC5869186 DOI: 10.3389/fphys.2018.00240] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 03/06/2018] [Indexed: 12/30/2022] Open
Abstract
Synaptic plasticity is defined as the ability of synapses to change their strength of transmission. Plasticity of synaptic connections in the brain is a major focus of neuroscience research, as it is the primary mechanism underpinning learning and memory. Beyond the brain however, plasticity in peripheral neurons is less well understood, particularly in the neurons innervating the heart. The atria receive rich innervation from the autonomic branch of the peripheral nervous system. Sympathetic neurons are clustered in stellate and cervical ganglia alongside the spinal cord and extend fibers to the heart directly innervating the myocardium. These neurons are major drivers of hyperactive sympathetic activity observed in heart disease, ventricular arrhythmias, and sudden cardiac death. Both pre- and postsynaptic changes have been observed to occur at synapses formed by sympathetic ganglion neurons, suggesting that plasticity at sympathetic neuro-cardiac synapses is a major contributor to arrhythmias. Less is known about the plasticity in parasympathetic neurons located in clusters on the heart surface. These neuronal clusters, termed ganglionated plexi, or “little brains,” can independently modulate neural control of the heart and stimulation that enhances their excitability can induce arrhythmia such as atrial fibrillation. The ability of these neurons to alter parasympathetic activity suggests that plasticity may indeed occur at the synapses formed on and by ganglionated plexi neurons. Such changes may not only fine-tune autonomic innervation of the heart, but could also be a source of maladaptive plasticity during atrial fibrillation.
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Affiliation(s)
- Jesse L Ashton
- Department of Physiology, University of Auckland, Auckland, New Zealand
| | | | - Gil Bub
- Department of Physiology, McGill University, Montreal, QC, Canada
| | - Bruce H Smaill
- Department of Physiology, University of Auckland, Auckland, New Zealand.,Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
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27
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Neuromodulation Therapies for Cardiac Disease. Neuromodulation 2018. [DOI: 10.1016/b978-0-12-805353-9.00129-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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da Silva Gonçalves Bós D, Van Der Bruggen CEE, Kurakula K, Sun XQ, Casali KR, Casali AG, Rol N, Szulcek R, Dos Remedios C, Guignabert C, Tu L, Dorfmüller P, Humbert M, Wijnker PJM, Kuster DWD, van der Velden J, Goumans MJ, Bogaard HJ, Vonk-Noordegraaf A, de Man FS, Handoko ML. Contribution of Impaired Parasympathetic Activity to Right Ventricular Dysfunction and Pulmonary Vascular Remodeling in Pulmonary Arterial Hypertension. Circulation 2017; 137:910-924. [PMID: 29167228 DOI: 10.1161/circulationaha.117.027451] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 10/31/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND The beneficial effects of parasympathetic stimulation have been reported in left heart failure, but whether it would be beneficial for pulmonary arterial hypertension (PAH) remains to be explored. Here, we investigated the relationship between parasympathetic activity and right ventricular (RV) function in patients with PAH, and the potential therapeutic effects of pyridostigmine (PYR), an oral drug stimulating the parasympathetic activity through acetylcholinesterase inhibition, in experimental pulmonary hypertension (PH). METHODS Heart rate recovery after a maximal cardiopulmonary exercise test was used as a surrogate for parasympathetic activity. RV ejection fraction was assessed in 112 patients with PAH. Expression of nicotinic (α-7 nicotinic acetylcholine receptor) and muscarinic (muscarinic acetylcholine type 2 receptor) receptors, and acetylcholinesterase activity were evaluated in RV (n=11) and lungs (n=7) from patients with PAH undergoing heart/lung transplantation and compared with tissue obtained from controls. In addition, we investigated the effects of PYR (40 mg/kg per day) in experimental PH. PH was induced in male rats by SU5416 (25 mg/kg subcutaneously) injection followed by 4 weeks of hypoxia. In a subgroup, sympathetic/parasympathetic modulation was assessed by power spectral analysis. At week 6, PH status was confirmed by echocardiography, and rats were randomly assigned to vehicle or treatment (both n=12). At the end of the study, echocardiography was repeated, with additional RV pressure-volume measurements, along with lung, RV histological, and protein analyses. RESULTS Patients with PAH with lower RV ejection fraction (<41%) had a significantly reduced heart rate recovery in comparison with patients with higher RV ejection fraction. In PAH RV samples, α-7 nicotinic acetylcholine receptor was increased and acetylcholinesterase activity was reduced versus controls. No difference in muscarinic acetylcholine type 2 receptor expression was observed. Chronic PYR treatment in PH rats normalized the cardiovascular autonomic function, demonstrated by an increase in parasympathetic activity and baroreflex sensitivity. PYR improved survival, increased RV contractility, and reduced RV stiffness, RV hypertrophy, RV fibrosis, RV inflammation, and RV α-7 nicotinic acetylcholine receptor and muscarinic acetylcholine type 2 receptor expression, as well. Furthermore, PYR reduced pulmonary vascular resistance, RV afterload, and pulmonary vascular remodeling, which was associated with reduced local and systemic inflammation. CONCLUSIONS RV dysfunction is associated with reduced systemic parasympathetic activity in patients with PAH, with an inadequate adaptive response of the cholinergic system in the RV. Enhancing parasympathetic activity by PYR improved survival, RV function, and pulmonary vascular remodeling in experimental PH.
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Affiliation(s)
| | | | - Kondababu Kurakula
- VU University Medical Center / Amsterdam Cardiovascular Sciences, The Netherlands.. Department of Molecular Cell Biology, Laboratory of Experimental Cardiology, Leiden University Medical Center, The Netherlands (K.K., M.-J.G.)
| | - Xiao-Qing Sun
- Department of Pulmonology (D.d.S.G.B., C.E.V.D.B., X.-Q.S., N.R., R.S., H.-J.B., A.V.-N. F.S.d.M.)
| | - Karina R Casali
- Institute of Science and Technology, Universidade Federal de São Paulo, Brazil (K.R.C., A.G.C.)
| | - Adenauer G Casali
- Institute of Science and Technology, Universidade Federal de São Paulo, Brazil (K.R.C., A.G.C.)
| | - Nina Rol
- Department of Pulmonology (D.d.S.G.B., C.E.V.D.B., X.-Q.S., N.R., R.S., H.-J.B., A.V.-N. F.S.d.M.)
| | - Robert Szulcek
- Department of Pulmonology (D.d.S.G.B., C.E.V.D.B., X.-Q.S., N.R., R.S., H.-J.B., A.V.-N. F.S.d.M.)
| | - Cris Dos Remedios
- Heart & Lung Transplant Unit, St. Vincent's Hospital and Bosch Institute, University of Sydney, Australia (C.d.R.)
| | - Christophe Guignabert
- University of Paris-Sud, Université Paris-Saclay, Le Kremlin Bicêtre, France (C.G., L.T., P.D., M.H.).,INSERM UMR_S 999, Le Plessis-Robinson, France (C.G., L.T., P.D., M.H.)
| | - Ly Tu
- University of Paris-Sud, Université Paris-Saclay, Le Kremlin Bicêtre, France (C.G., L.T., P.D., M.H.).,INSERM UMR_S 999, Le Plessis-Robinson, France (C.G., L.T., P.D., M.H.)
| | - Peter Dorfmüller
- University of Paris-Sud, Université Paris-Saclay, Le Kremlin Bicêtre, France (C.G., L.T., P.D., M.H.).,INSERM UMR_S 999, Le Plessis-Robinson, France (C.G., L.T., P.D., M.H.)
| | - Marc Humbert
- University of Paris-Sud, Université Paris-Saclay, Le Kremlin Bicêtre, France (C.G., L.T., P.D., M.H.).,INSERM UMR_S 999, Le Plessis-Robinson, France (C.G., L.T., P.D., M.H.)
| | | | | | | | - Marie-José Goumans
- VU University Medical Center / Amsterdam Cardiovascular Sciences, The Netherlands.. Department of Molecular Cell Biology, Laboratory of Experimental Cardiology, Leiden University Medical Center, The Netherlands (K.K., M.-J.G.)
| | - Harm-Jan Bogaard
- Department of Pulmonology (D.d.S.G.B., C.E.V.D.B., X.-Q.S., N.R., R.S., H.-J.B., A.V.-N. F.S.d.M.)
| | - Anton Vonk-Noordegraaf
- Department of Pulmonology (D.d.S.G.B., C.E.V.D.B., X.-Q.S., N.R., R.S., H.-J.B., A.V.-N. F.S.d.M.)
| | - Frances S de Man
- Department of Pulmonology (D.d.S.G.B., C.E.V.D.B., X.-Q.S., N.R., R.S., H.-J.B., A.V.-N. F.S.d.M.)
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29
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Yang XF, Immordino-Yang MH. Culture and cardiac vagal tone independently influence emotional expressiveness. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s40167-017-0048-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Ichige MHA, Pereira MG, Brum PC, Michelini LC. Experimental Evidences Supporting the Benefits of Exercise Training in Heart Failure. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 999:181-206. [PMID: 29022264 DOI: 10.1007/978-981-10-4307-9_11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Heart Failure (HF), a common end point for many cardiovascular diseases, is a syndrome with a very poor prognosis. Although clinical trials in HF have achieved important outcomes in reducing mortality, little is known about functional mechanisms conditioning health improvement in HF patients. In parallel with clinical studies, basic science has been providing important discoveries to understand the mechanisms underlying the pathophysiology of HF, as well as to identify potential targets for the treatment of this syndrome. In spite of being the end-point of cardiovascular derangements caused by different etiologies, autonomic dysfunction, sympathetic hyperactivity, oxidative stress, inflammation and hormonal activation are common factors involved in the progression of this syndrome. Together these causal factors create a closed link between three important organs: brain, heart and the skeletal muscle. In the past few years, we and other groups have studied the beneficial effects of aerobic exercise training as a safe therapy to avoid the progression of HF. As summarized in this chapter, exercise training, a non-pharmacological tool without side effects, corrects most of the HF-induced neurohormonal and local dysfunctions within the brain, heart and skeletal muscles. These adaptive responses reverse oxidative stress, reduce inflammation, ameliorate neurohormonal control and improve both cardiovascular and skeletal muscle function, thus increasing the quality of life and reducing patients' morbimortality.
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Affiliation(s)
- Marcelo H A Ichige
- Department of Physiology & Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Marcelo G Pereira
- Department of Biodynamics of Human Body Movement, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
| | - Patrícia C Brum
- Department of Biodynamics of Human Body Movement, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil. .,National Institute for Science & Technology - INCT (In)activity & Exercise, CNPq - Niterói (RJ), Rio de Janeiro, Brazil.
| | - Lisete C Michelini
- Department of Physiology & Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil.,National Institute for Science & Technology - INCT (In)activity & Exercise, CNPq - Niterói (RJ), Rio de Janeiro, Brazil
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31
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Berg T. M-currents (Kv7.2-7.3/KCNQ2-KCNQ3) Are Responsible for Dysfunctional Autonomic Control in Hypertensive Rats. Front Physiol 2016; 7:584. [PMID: 27965589 PMCID: PMC5126116 DOI: 10.3389/fphys.2016.00584] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 11/14/2016] [Indexed: 01/19/2023] Open
Abstract
Autonomic dysfunctions play important roles in hypertension, heart failure and arrhythmia, often with a detrimental and fatal effect. The present study analyzed if these dysfunctions involved M-channels (members of the Kv7/KNCQ family) in spontaneously hypertensive rats (SHR). Cardiac output and heart rate (HR) were recorded by a flow probe on the ascending aorta in anesthetized SHR and normotensive rats (WKY), and blood pressure (BP) by a femoral artery catheter. Total peripheral vascular resistance (TPR) was calculated. XE-991 (Kv7.1-7.4-inhibitor) reduced resting HR in WKY but only after reserpine in SHR. XE-991 increased TPR and BP baseline in both strains. Retigabine (Kv7.2-7.5-opener) reduced HR, TPR and BP, also after reserpine. Depolarization induced by 3,4-diaminopyridine (3,4-DAP), a voltage-sensitive K+ channel (Kv) inhibitor, activated release of both acetylcholine and norepinephrine, thus activating an initial, cholinergic bradycardia in SHR, followed by sustained, norepinephrine-dependant tachycardia in both strains. XE-991 augmented the initial 3,4-DAP-induced bradycardia and eliminated the late tachycardia in SHR, but not in WKY. The increased bradycardia was eliminated by hexamethonium and methoctramine (M2muscarinic receptor antagonist) but not reserpine. Retigabine eliminated the increased bradycardia observed in reserpinized SHR. XE-991 also increased 3,4-DAP-stimulated catecholamine release, but not after hexamethonium or reserpine. Conclusions: M-currents hampered parasympathetic ganglion excitation and, through that, vagal control of HR, in SHR but not WKY. M-currents also opposed catecholamine release in SHR but not in WKY. M-currents represented a vasodilatory component in resting TPR-control, with no strain-related difference detected. Excessive M-currents may represent the underlying cause of autonomic dysfunctions in hypertension.
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Affiliation(s)
- Torill Berg
- Division of Physiology, Department of Molecular Medicine, Institute for Basic Medical Sciences, University of Oslo Oslo, Norway
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Ichige MHA, Santos CR, Jordão CP, Ceroni A, Negrão CE, Michelini LC. Exercise training preserves vagal preganglionic neurones and restores parasympathetic tonus in heart failure. J Physiol 2016; 594:6241-6254. [PMID: 27444212 PMCID: PMC5088253 DOI: 10.1113/jp272730] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 07/08/2016] [Indexed: 01/01/2023] Open
Abstract
KEY POINTS Heart Failure (HF) is accompanied by reduced ventricular function, activation of compensatory neurohormonal mechanisms and marked autonomic dysfunction characterized by exaggerated sympathoexcitation and reduced parasympathetic activity. With 6 weeks of exercise training, HF-related loss of choline acetyltransferase (ChAT)-positive vagal preganglionic neurones is avoided, restoring the parasympathetic tonus to the heart, and the immunoreactivity of dopamine β-hydroxylase-positive premotor neurones that drive sympathetic outflow to the heart is reduced. Training-induced correction of autonomic dysfunction occurs even with the persistence of abnormal ventricular function. Strong positive correlation between improved parasympathetic tonus to the heart and increased ChAT immunoreactivity in vagal preganglionic neurones after training indicates this is a crucial mechanism to restore autonomic function in heart failure. ABSTRACT Exercise training is an efficient tool to attenuate sympathoexcitation, a hallmark of heart failure (HF). Although sympathetic modulation in HF is widely studied, information regarding parasympathetic control is lacking. We examined the combined effects of sympathetic and vagal tonus to the heart in sedentary (Sed) and exercise trained (ET) HF rats and the contribution of respective premotor and preganglionic neurones. Wistar rats submitted to coronary artery ligation or sham surgery were assigned to training or sedentary protocols for 6 weeks. After haemodynamic, autonomic tonus (atropine and atenolol i.v.) and ventricular function determinations, brains were collected for immunoreactivity assays (choline acetyltransferase, ChATir; dopamine β-hydroxylase, DBHir) and neuronal counting in the dorsal motor nucleus of vagus (DMV), nucleus ambiguus (NA) and rostroventrolateral medulla (RVLM). HF-Sed vs. SHAM-Sed exhibited decreased exercise capacity, reduced ejection fraction, increased left ventricle end diastolic pressure, smaller positive and negative dP/dt, decreased intrinsic heart rate (IHR), lower parasympathetic and higher sympathetic tonus, reduced preganglionic vagal neurones and ChATir in the DMV/NA, and increased RVLM DBHir. Training increased treadmill performance, normalized autonomic tonus and IHR, restored the number of DMV and NA neurones and corrected ChATir without affecting ventricular function. There were strong positive correlations between parasympathetic tonus and ChATir in NA and DMV. RVLM DBHir was also normalized by training, but there was no change in neurone number and no correlation with sympathetic tonus. Training-induced preservation of preganglionic vagal neurones is crucial to normalize parasympathetic activity and restore autonomic balance to the heart even in the persistence of cardiac dysfunction.
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Affiliation(s)
- Marcelo H A Ichige
- Department of Physiology and Biophysics, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Carla R Santos
- Department of Physiology and Biophysics, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Camila P Jordão
- Heart Institute, University of Sao Paulo, Medical School, Sao Paulo, SP, Brazil
| | - Alexandre Ceroni
- Department of Physiology and Biophysics, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Carlos E Negrão
- Heart Institute, University of Sao Paulo, Medical School, Sao Paulo, SP, Brazil
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Lisete C Michelini
- Department of Physiology and Biophysics, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil.
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Smith FM, Vermeulen M, Cardinal R. Long-term spinal cord stimulation modifies canine intrinsic cardiac neuronal properties and ganglionic transmission during high-frequency repetitive activation. Physiol Rep 2016; 4:4/13/e12855. [PMID: 27401459 PMCID: PMC4945838 DOI: 10.14814/phy2.12855] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 06/16/2016] [Indexed: 12/28/2022] Open
Abstract
Long‐term spinal cord stimulation (SCS) applied to cranial thoracic SC segments exerts antiarrhythmic and cardioprotective actions in the canine heart in situ. We hypothesized that remodeling of intrinsic cardiac neuronal and synaptic properties occur in canines subjected to long‐term SCS, specifically that synaptic efficacy may be preferentially facilitated at high presynaptic nerve stimulation frequencies. Animals subjected to continuous SCS for 5–8 weeks (long‐term SCS: n = 17) or for 1 h (acute SCS: n = 4) were compared with corresponding control animals (long‐term: n = 15, acute: n = 4). At termination, animals were anesthetized, the heart was excised and neurones from the right atrial ganglionated plexus were identified and studied in vitro using standard intracellular microelectrode technique. Main findings were as follows: (1) a significant reduction in whole cell membrane input resistance and acceleration of the course of AHP decay identified among phasic neurones from long‐term SCS compared with controls, (2) significantly more robust synaptic transmission to rundown in long‐term SCS during high‐frequency (10–40 Hz) presynaptic nerve stimulation while recording from either phasic or accommodating postsynaptic neurones; this was associated with significantly greater posttrain excitatory postsynaptic potential (EPSP) numbers in long‐term SCS than control, and (3) synaptic efficacy was significantly decreased by atropine in both groups. Such changes did not occur in acute SCS. In conclusion, modification of intrinsic cardiac neuronal properties and facilitation of synaptic transmission at high stimulation frequency in long‐term SCS could improve physiologically modulated vagal inputs to the heart.
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Affiliation(s)
- Frank M Smith
- Department of Medical Neuroscience, Faculty of Medicine Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel Vermeulen
- Department of Pharmacology, Faculté de médecine Université de Montréal and Centre de recherche Hôpital du Sacré-Cœur de Montréal, Montréal, Quebec, Canada
| | - René Cardinal
- Department of Pharmacology, Faculté de médecine Université de Montréal and Centre de recherche Hôpital du Sacré-Cœur de Montréal, Montréal, Quebec, Canada
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34
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Ho HT, Belevych AE, Liu B, Bonilla IM, Radwański PB, Kubasov IV, Valdivia HH, Schober K, Carnes CA, Györke S. Muscarinic Stimulation Facilitates Sarcoplasmic Reticulum Ca Release by Modulating Ryanodine Receptor 2 Phosphorylation Through Protein Kinase G and Ca/Calmodulin-Dependent Protein Kinase II. Hypertension 2016; 68:1171-1178. [PMID: 27647848 DOI: 10.1161/hypertensionaha.116.07666] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 08/21/2016] [Indexed: 01/01/2023]
Abstract
Although the effects and the underlying mechanism of sympathetic stimulation on cardiac Ca handling are relatively well established both in health and disease, the modes of action and mechanisms of parasympathetic modulation are poorly defined. Here, we demonstrate that parasympathetic stimulation initiates a novel mode of excitation-contraction coupling that enhances the efficiency of cardiac sarcoplasmic reticulum Ca store utilization. This efficient mode of excitation-contraction coupling involves reciprocal changes in the phosphorylation of ryanodine receptor 2 at Ser-2808 and Ser-2814. Specifically, Ser-2808 phosphorylation was mediated by muscarinic receptor subtype 2 and activation of PKG (protein kinase G), whereas dephosphorylation of Ser-2814 involved activation of muscarinic receptor subtype 3 and decreased reactive oxygen species-dependent activation of CaMKII (Ca/calmodulin-dependent protein kinase II). The overall effect of these changes in phosphorylation of ryanodine receptor 2 is an increase in systolic Ca release at the low sarcoplasmic reticulum Ca content and a paradoxical reduction in aberrant Ca leak. Accordingly, cholinergic stimulation of cardiomyocytes isolated from failing hearts improved Ca cycling efficiency by restoring altered ryanodine receptor 2 phosphorylation balance.
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Affiliation(s)
- Hsiang-Ting Ho
- From the Department of Physiology and Cell Biology (H.-T.H., A.E.B., B.L., P.B.R., S.G.), College of Pharmacy (I.M.B., P.B.R., C.A.C.), and College of Veterinary Medicine (K.S.), The Ohio State University, Columbus; Davis Heart and Lung Research Institute, Columbus, OH (H.-T.H., A.E.B., B.L., I.M.B., P.B.R., C.A.C., S.G.); Department of Medicine, Duke University, Durham, NC (H.-T.H.); Laboratory of Neuromuscular Physiology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Petersburg, Russia (I.V.K.); and Center for Arrhythmia Research, Cardiovascular Division of the Department of Internal Medicine, University of Michigan, Ann Arbor (H.H.V.)
| | - Andriy E Belevych
- From the Department of Physiology and Cell Biology (H.-T.H., A.E.B., B.L., P.B.R., S.G.), College of Pharmacy (I.M.B., P.B.R., C.A.C.), and College of Veterinary Medicine (K.S.), The Ohio State University, Columbus; Davis Heart and Lung Research Institute, Columbus, OH (H.-T.H., A.E.B., B.L., I.M.B., P.B.R., C.A.C., S.G.); Department of Medicine, Duke University, Durham, NC (H.-T.H.); Laboratory of Neuromuscular Physiology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Petersburg, Russia (I.V.K.); and Center for Arrhythmia Research, Cardiovascular Division of the Department of Internal Medicine, University of Michigan, Ann Arbor (H.H.V.)
| | - Bin Liu
- From the Department of Physiology and Cell Biology (H.-T.H., A.E.B., B.L., P.B.R., S.G.), College of Pharmacy (I.M.B., P.B.R., C.A.C.), and College of Veterinary Medicine (K.S.), The Ohio State University, Columbus; Davis Heart and Lung Research Institute, Columbus, OH (H.-T.H., A.E.B., B.L., I.M.B., P.B.R., C.A.C., S.G.); Department of Medicine, Duke University, Durham, NC (H.-T.H.); Laboratory of Neuromuscular Physiology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Petersburg, Russia (I.V.K.); and Center for Arrhythmia Research, Cardiovascular Division of the Department of Internal Medicine, University of Michigan, Ann Arbor (H.H.V.)
| | - Ingrid M Bonilla
- From the Department of Physiology and Cell Biology (H.-T.H., A.E.B., B.L., P.B.R., S.G.), College of Pharmacy (I.M.B., P.B.R., C.A.C.), and College of Veterinary Medicine (K.S.), The Ohio State University, Columbus; Davis Heart and Lung Research Institute, Columbus, OH (H.-T.H., A.E.B., B.L., I.M.B., P.B.R., C.A.C., S.G.); Department of Medicine, Duke University, Durham, NC (H.-T.H.); Laboratory of Neuromuscular Physiology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Petersburg, Russia (I.V.K.); and Center for Arrhythmia Research, Cardiovascular Division of the Department of Internal Medicine, University of Michigan, Ann Arbor (H.H.V.)
| | - Przemysław B Radwański
- From the Department of Physiology and Cell Biology (H.-T.H., A.E.B., B.L., P.B.R., S.G.), College of Pharmacy (I.M.B., P.B.R., C.A.C.), and College of Veterinary Medicine (K.S.), The Ohio State University, Columbus; Davis Heart and Lung Research Institute, Columbus, OH (H.-T.H., A.E.B., B.L., I.M.B., P.B.R., C.A.C., S.G.); Department of Medicine, Duke University, Durham, NC (H.-T.H.); Laboratory of Neuromuscular Physiology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Petersburg, Russia (I.V.K.); and Center for Arrhythmia Research, Cardiovascular Division of the Department of Internal Medicine, University of Michigan, Ann Arbor (H.H.V.)
| | - Igor V Kubasov
- From the Department of Physiology and Cell Biology (H.-T.H., A.E.B., B.L., P.B.R., S.G.), College of Pharmacy (I.M.B., P.B.R., C.A.C.), and College of Veterinary Medicine (K.S.), The Ohio State University, Columbus; Davis Heart and Lung Research Institute, Columbus, OH (H.-T.H., A.E.B., B.L., I.M.B., P.B.R., C.A.C., S.G.); Department of Medicine, Duke University, Durham, NC (H.-T.H.); Laboratory of Neuromuscular Physiology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Petersburg, Russia (I.V.K.); and Center for Arrhythmia Research, Cardiovascular Division of the Department of Internal Medicine, University of Michigan, Ann Arbor (H.H.V.)
| | - Héctor H Valdivia
- From the Department of Physiology and Cell Biology (H.-T.H., A.E.B., B.L., P.B.R., S.G.), College of Pharmacy (I.M.B., P.B.R., C.A.C.), and College of Veterinary Medicine (K.S.), The Ohio State University, Columbus; Davis Heart and Lung Research Institute, Columbus, OH (H.-T.H., A.E.B., B.L., I.M.B., P.B.R., C.A.C., S.G.); Department of Medicine, Duke University, Durham, NC (H.-T.H.); Laboratory of Neuromuscular Physiology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Petersburg, Russia (I.V.K.); and Center for Arrhythmia Research, Cardiovascular Division of the Department of Internal Medicine, University of Michigan, Ann Arbor (H.H.V.)
| | - Karsten Schober
- From the Department of Physiology and Cell Biology (H.-T.H., A.E.B., B.L., P.B.R., S.G.), College of Pharmacy (I.M.B., P.B.R., C.A.C.), and College of Veterinary Medicine (K.S.), The Ohio State University, Columbus; Davis Heart and Lung Research Institute, Columbus, OH (H.-T.H., A.E.B., B.L., I.M.B., P.B.R., C.A.C., S.G.); Department of Medicine, Duke University, Durham, NC (H.-T.H.); Laboratory of Neuromuscular Physiology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Petersburg, Russia (I.V.K.); and Center for Arrhythmia Research, Cardiovascular Division of the Department of Internal Medicine, University of Michigan, Ann Arbor (H.H.V.)
| | - Cynthia A Carnes
- From the Department of Physiology and Cell Biology (H.-T.H., A.E.B., B.L., P.B.R., S.G.), College of Pharmacy (I.M.B., P.B.R., C.A.C.), and College of Veterinary Medicine (K.S.), The Ohio State University, Columbus; Davis Heart and Lung Research Institute, Columbus, OH (H.-T.H., A.E.B., B.L., I.M.B., P.B.R., C.A.C., S.G.); Department of Medicine, Duke University, Durham, NC (H.-T.H.); Laboratory of Neuromuscular Physiology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Petersburg, Russia (I.V.K.); and Center for Arrhythmia Research, Cardiovascular Division of the Department of Internal Medicine, University of Michigan, Ann Arbor (H.H.V.)
| | - Sándor Györke
- From the Department of Physiology and Cell Biology (H.-T.H., A.E.B., B.L., P.B.R., S.G.), College of Pharmacy (I.M.B., P.B.R., C.A.C.), and College of Veterinary Medicine (K.S.), The Ohio State University, Columbus; Davis Heart and Lung Research Institute, Columbus, OH (H.-T.H., A.E.B., B.L., I.M.B., P.B.R., C.A.C., S.G.); Department of Medicine, Duke University, Durham, NC (H.-T.H.); Laboratory of Neuromuscular Physiology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Petersburg, Russia (I.V.K.); and Center for Arrhythmia Research, Cardiovascular Division of the Department of Internal Medicine, University of Michigan, Ann Arbor (H.H.V.).
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35
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Abstract
Cardiac control is mediated via a series of reflex control networks involving somata in the (i) intrinsic cardiac ganglia (heart), (ii) intrathoracic extracardiac ganglia (stellate, middle cervical), (iii) superior cervical ganglia, (iv) spinal cord, (v) brainstem, and (vi) higher centers. Each of these processing centers contains afferent, efferent, and local circuit neurons, which interact locally and in an interdependent fashion with the other levels to coordinate regional cardiac electrical and mechanical indices on a beat-to-beat basis. This control system is optimized to respond to normal physiological stressors (standing, exercise, and temperature); however, it can be catastrophically disrupted by pathological events such as myocardial ischemia. In fact, it is now recognized that autonomic dysregulation is central to the evolution of heart failure and arrhythmias. Autonomic regulation therapy is an emerging modality in the management of acute and chronic cardiac pathologies. Neuromodulation-based approaches that target select nexus points of this hierarchy for cardiac control offer unique opportunities to positively affect therapeutic outcomes via improved efficacy of cardiovascular reflex control. As such, understanding the anatomical and physiological basis for such control is necessary to implement effectively novel neuromodulation therapies. © 2016 American Physiological Society. Compr Physiol 6:1635-1653, 2016.
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Affiliation(s)
- Jeffrey L Ardell
- Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California, USA
| | - John Andrew Armour
- Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California, USA
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Ardell JL, Andresen MC, Armour JA, Billman GE, Chen PS, Foreman RD, Herring N, O'Leary DS, Sabbah HN, Schultz HD, Sunagawa K, Zucker IH. Translational neurocardiology: preclinical models and cardioneural integrative aspects. J Physiol 2016; 594:3877-909. [PMID: 27098459 DOI: 10.1113/jp271869] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/14/2016] [Indexed: 12/15/2022] Open
Abstract
Neuronal elements distributed throughout the cardiac nervous system, from the level of the insular cortex to the intrinsic cardiac nervous system, are in constant communication with one another to ensure that cardiac output matches the dynamic process of regional blood flow demand. Neural elements in their various 'levels' become differentially recruited in the transduction of sensory inputs arising from the heart, major vessels, other visceral organs and somatic structures to optimize neuronal coordination of regional cardiac function. This White Paper will review the relevant aspects of the structural and functional organization for autonomic control of the heart in normal conditions, how these systems remodel/adapt during cardiac disease, and finally how such knowledge can be leveraged in the evolving realm of autonomic regulation therapy for cardiac therapeutics.
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Affiliation(s)
- J L Ardell
- University of California - Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, CA, USA.,UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, CA, USA
| | - M C Andresen
- Department of Physiology and Pharmacology, Oregon Health and Science University, Portland, OR, USA
| | - J A Armour
- University of California - Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, CA, USA.,UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, CA, USA
| | - G E Billman
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, OH, USA
| | - P-S Chen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - R D Foreman
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - N Herring
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - D S O'Leary
- Department of Physiology, Wayne State University, Detroit, MI, USA
| | - H N Sabbah
- Department of Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - H D Schultz
- Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - K Sunagawa
- Department of Cardiovascular Medicine, Kyushu University, Fukuoka, Japan
| | - I H Zucker
- Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
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Abstract
It has been known for many decades that multiple abnormalities of the autonomic nervous system (ANS) are present in heart failure (HF). Moreover, many of the effective therapies currently used to treat HF have either direct or indirect effects on the ANS. While therapies that block over-activity of the sympathetic nervous system are now standard of care, much less well studied are therapies aimed at augmenting the parasympathetic nervous system. This review will cover recent and ongoing investigations targeting modulation of the ANS, especially highlighting new and ongoing studies directed toward augmenting parasympathetic mechanisms.
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Affiliation(s)
- Mark E Dunlap
- MetroHealth Campus of Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
| | - Anju Bhardwaj
- MetroHealth Campus of Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA
| | - Paul J Hauptman
- Saint Louis University School of Medicine, St. Louis, MO, USA
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38
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Lee SW, Li Q, Libbus I, Xie X, KenKnight BH, Garry MG, Tolkacheva EG. Chronic cyclic vagus nerve stimulation has beneficial electrophysiological effects on healthy hearts in the absence of autonomic imbalance. Physiol Rep 2016; 4:e12786. [PMID: 27173672 PMCID: PMC4873636 DOI: 10.14814/phy2.12786] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 04/13/2016] [Indexed: 11/24/2022] Open
Abstract
Cardiovascular disease degrades the regulatory function of the autonomic nervous system. Cyclic vagus nerve stimulation (VNS) is an already FDA-approved therapy for drug-resistant epilepsy and depression, and has been shown to normalize autonomic function and improve objective measures of heart function and subjective measures of heart failure symptoms. However, it remains unclear whether VNS may induce negative effects in patients with potentially healthy hearts where VNS can be used for epileptic patients. Hence, this study aims to investigate the effects of VNS on the hearts of healthy rats with normal autonomic balance. Sprague-Dawley rats were implanted with stimulators and randomized to either Sham or VNS groups. Rats in VNS group received 10 weeks of chronic intermittent VNS via stimulation of the right cervical vagus nerve. Echocardiography was performed at Baseline (prior to VNS), Week 2, and Week 9. After 10 weeks, high-resolution optical mapping was performed in ex vivo perfused hearts to evaluate the electrophysiological remodeling that occurs in the heart as a result of the VNS therapy. Chronic VNS modified the electrophysiological properties of healthy rat hearts by reducing the action potential duration at 50% (APD50) and 80% (APD80) repolarization. Chronic VNS also affected the restitution properties of the heart at the APD50 level and increased myocardial conduction velocity (CV). VNS did not induce any significant changes to ventricular ejection fraction (EF) and spatial dispersion of APD, thus indicating that VNS did not negatively affect cardiac function. VNS also reduced the susceptibility to ventricular arrhythmias (ventricular fibrillation [VF] and ventricular tachycardia [VT]) during ex vivo programmed electrical stimulation. In summary, chronic application of cyclic VNS induces changes to the electrophysiological properties of healthy rat hearts. The observed decrease in APD and increase in CV suggest that the beneficial effects of VNS do not require the presence of existing autonomic imbalance.
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Affiliation(s)
- Steven W Lee
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Qinglu Li
- Lillehei Heart Institute, University of Minnesota, Minneapolis, Minnesota
| | | | - Xueyi Xie
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Bruce H KenKnight
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota Cyberonics Inc., Houston, Texas
| | - Mary G Garry
- Lillehei Heart Institute, University of Minnesota, Minneapolis, Minnesota
| | - Elena G Tolkacheva
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota
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39
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Beaumont E, Wright GL, Southerland EM, Li Y, Chui R, KenKnight BH, Armour JA, Ardell JL. Vagus nerve stimulation mitigates intrinsic cardiac neuronal remodeling and cardiac hypertrophy induced by chronic pressure overload in guinea pig. Am J Physiol Heart Circ Physiol 2016; 310:H1349-59. [PMID: 26993230 DOI: 10.1152/ajpheart.00939.2015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/17/2016] [Indexed: 02/06/2023]
Abstract
Our objective was to determine whether chronic vagus nerve stimulation (VNS) mitigates pressure overload (PO)-induced remodeling of the cardioneural interface. Guinea pigs (n = 48) were randomized to right or left cervical vagus (RCV or LCV) implant. After 2 wk, chronic left ventricular PO was induced by partial (15-20%) aortic constriction. Of the 31 animals surviving PO induction, 10 were randomized to RCV VNS, 9 to LCV VNS, and 12 to sham VNS. VNS was delivered at 20 Hz and 1.14 ± 0.03 mA at a 22% duty cycle. VNS commenced 10 days after PO induction and was maintained for 40 days. Time-matched controls (n = 9) were evaluated concurrently. Echocardiograms were obtained before and 50 days after PO. At termination, intracellular current-clamp recordings of intrinsic cardiac (IC) neurons were studied in vitro to determine effects of therapy on soma characteristics. Ventricular cardiomyocyte sizes were assessed with histology along with immunoblot analysis of selected proteins in myocardial tissue extracts. In sham-treated animals, PO increased cardiac output (34%, P < 0.004), as well as systolic (114%, P < 0.04) and diastolic (49%, P < 0.002) left ventricular volumes, a hemodynamic response prevented by VNS. PO-induced enhancements of IC synaptic efficacy and muscarinic sensitivity of IC neurons were mitigated by chronic VNS. Increased myocyte size, which doubled in PO (P < 0.05), was mitigated by RCV. PO hypertrophic myocardium displayed decreased glycogen synthase (GS) protein levels and accumulation of the phosphorylated (inactive) form of GS. These PO-induced changes in GS were moderated by left VNS. Chronic VNS targets IC neurons accompanying PO to obtund associated adverse cardiomyocyte remodeling.
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Affiliation(s)
- Eric Beaumont
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee
| | - Gary L Wright
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee
| | - Elizabeth M Southerland
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee
| | - Ying Li
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee
| | - Ray Chui
- Molecular, Cellular, and Integrative Physiology Program, University of California, Los Angeles, California
| | | | - J Andrew Armour
- UCLA Neurocardiology Research Center of Excellence and UCLA Cardiac Arrhythmia Center, Los Angeles, California
| | - Jeffrey L Ardell
- Molecular, Cellular, and Integrative Physiology Program, University of California, Los Angeles, California; UCLA Neurocardiology Research Center of Excellence and UCLA Cardiac Arrhythmia Center, Los Angeles, California
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40
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Olshansky B. Vagus nerve modulation of inflammation: Cardiovascular implications. Trends Cardiovasc Med 2016; 26:1-11. [DOI: 10.1016/j.tcm.2015.03.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/30/2015] [Accepted: 03/30/2015] [Indexed: 12/26/2022]
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Berg T. Voltage-Sensitive K(+) Channels Inhibit Parasympathetic Ganglion Transmission and Vagal Control of Heart Rate in Hypertensive Rats. Front Neurol 2015; 6:260. [PMID: 26696959 PMCID: PMC4672051 DOI: 10.3389/fneur.2015.00260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 11/25/2015] [Indexed: 01/19/2023] Open
Abstract
Parasympathetic withdrawal plays an important role in the autonomic dysfunctions in hypertension. Since hyperpolarizing, voltage-sensitive K+ channels (KV) hamper transmitter release, elevated KV-activity may explain the disturbed vagal control of heart rate (HR) in hypertension. Here, the KV inhibitor 3,4-diaminopyridine was used to demonstrate the impact of KV on autonomic HR control. Cardiac output and HR were recorded by a flow probe on the ascending aorta in anesthetized, normotensive (WKY), and spontaneously hypertensive rats (SHR), and blood pressure by a femoral artery catheter. 3,4-diaminopyridine induced an initial bradycardia, which was greater in SHR than in WKY, followed by sustained tachycardia in both strains. The initial bradycardia was eliminated by acetylcholine synthesis inhibitor (hemicholinium-3) and nicotinic receptor antagonist/ganglion blocker (hexamethonium), and reversed to tachycardia by muscarinic receptor (mAchR) antagonist (atropine). The latter was abolished by sympatho-inhibition (reserpine). Reserpine also eliminated the late, 3,4-diaminopyridine-induced tachycardia in WKY, but induced a sustained atropine-sensitive bradycardia in SHR. Inhibition of the parasympathetic component with hemicholinium-3, hexamethonium, or atropine enhanced the late tachycardia in SHR, whereas hexamethonium reduced the tachycardia in WKY. In conclusion, 3,4-diaminopyridine-induced acetylcholine release, and thus enhanced parasympathetic ganglion transmission, with subsequent mAchR activation and bradycardia. 3,4-diaminopyridine also activated tachycardia, initially by enhancing sympathetic ganglion transmission, subsequently by activation of norepinephrine release from sympathetic nerve terminals. The 3,4-diaminopyridine-induced parasympathetic activation was stronger and more sustained in SHR, demonstrating an enhanced inhibitory control of KV on parasympathetic ganglion transmission. This enhanced KV activity may explain the dysfunctional vagal HR control in SHR.
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Affiliation(s)
- Torill Berg
- Division of Physiology, Department of Molecular Medicine, Institute for Basic Medical Sciences, University of Oslo , Oslo , Norway
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42
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Kupper N, Denollet J, Widdershoven J, Kop WJ. Cardiovascular Reactivity to Mental Stress and Mortality in Patients With Heart Failure. JACC-HEART FAILURE 2015; 3:373-382. [DOI: 10.1016/j.jchf.2014.12.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 12/10/2014] [Accepted: 12/23/2014] [Indexed: 10/23/2022]
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Eddie D, Vaschillo E, Vaschillo B, Lehrer P. Heart rate variability biofeedback: Theoretical basis, delivery, and its potential for the treatment of substance use disorders. ADDICTION RESEARCH & THEORY 2015; 23:266-272. [PMID: 28077937 PMCID: PMC5222529 DOI: 10.3109/16066359.2015.1011625] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Heart rate variability biofeedback (HRV BFB) is a biobehavioural clinical intervention that is gaining growing empirical support for the treatment of a number of psychological disorders, several of which are highly comorbid with substance use disorders (SUDs). The present article reviews the autonomic nervous system bases of two key processes implicated in the formation and maintenance of addictive pathology-affect dysregulation and craving-and asks if HRV BFB may be an effective intervention to ameliorate autonomic nervous system dysregulation in these processes, and as such, prove to be an effective intervention for SUDs. A detailed description of HRV BFB and its delivery is provided. Preliminary evidence suggests HRV BFB may be an effective addendum to current first-line SUD treatments, though no firm conclusions can be drawn at this time; more research is needed.
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Affiliation(s)
- David Eddie
- Center of Alcohol Studies, Rutgers, the State University of New Jersey, Piscataway, USA
| | - Evgeny Vaschillo
- Center of Alcohol Studies, Rutgers, the State University of New Jersey, Piscataway, USA
| | - Bronya Vaschillo
- Center of Alcohol Studies, Rutgers, the State University of New Jersey, Piscataway, USA
| | - Paul Lehrer
- Robert Wood Johnson Medical School, Rutgers, the State University of New Jersey, Piscataway, USA
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44
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Pyridostigmine restores cardiac autonomic balance after small myocardial infarction in mice. PLoS One 2014; 9:e104476. [PMID: 25133392 PMCID: PMC4136726 DOI: 10.1371/journal.pone.0104476] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 07/14/2014] [Indexed: 12/19/2022] Open
Abstract
The effect of pyridostigmine (PYR) - an acetylcholinesterase inhibitor - on hemodynamics and cardiac autonomic control, was never studied in conscious myocardial infarcted mice. Telemetry transmitters were implanted into the carotid artery under isoflurane anesthesia. Seven to ten days after recovery from the surgery, basal arterial pressure and heart rate were recorded, while parasympathetic and sympathetic tone (ΔHR) was evaluated by means of methyl atropine and propranolol. After the basal hemodynamic recording the mice were subjected to left coronary artery ligation for producing myocardial infarction (MI), or sham operation, and implantation of minipumps filled with PYR or saline. Separate groups of anesthetized (isoflurane) mice previously (4 weeks) subjected to MI, or sham coronary artery ligation, were submitted to cardiac function examination. The mice exhibited an infarct length of approximately 12%, no change in arterial pressure and increased heart rate only in the 1st week after MI. Vagal tone decreased in the 1st week, while the sympathetic tone was increased in the 1st and 4th week after MI. PYR prevented the increase in heart rate but did not affect the arterial pressure. Moreover, PYR prevented the increase in sympathetic tone throughout the 4 weeks. Concerning the parasympathetic tone, PYR not only impaired its attenuation in the 1st week, but enhanced it in the 4th week. MI decreased ejection fraction and increased diastolic and systolic volume. Therefore, the pharmacological increase of peripheral acetylcholine availability by means of PYR prevented tachycardia, increased parasympathetic and decreased sympathetic tone after MI in mice.
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45
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Clancy JA, Mary DA, Witte KK, Greenwood JP, Deuchars SA, Deuchars J. Non-invasive vagus nerve stimulation in healthy humans reduces sympathetic nerve activity. Brain Stimul 2014; 7:871-7. [PMID: 25164906 DOI: 10.1016/j.brs.2014.07.031] [Citation(s) in RCA: 291] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 07/09/2014] [Accepted: 07/10/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vagus nerve stimulation (VNS) is currently used to treat refractory epilepsy and is being investigated as a potential therapy for a range of conditions, including heart failure, tinnitus, obesity and Alzheimer's disease. However, the invasive nature and expense limits the use of VNS in patient populations and hinders the exploration of the mechanisms involved. OBJECTIVE We investigated a non-invasive method of VNS through electrical stimulation of the auricular branch of the vagus nerve distributed to the skin of the ear--transcutaneous VNS (tVNS) and measured the autonomic effects. METHODS The effects of tVNS parameters on autonomic function in 48 healthy participants were investigated using heart rate variability (HRV) and microneurography. tVNS was performed using a transcutaneous electrical nerve stimulation (TENS) machine and modified surface electrodes. Participants visited the laboratory once and received either active (200 μs, 30 Hz; n = 34) or sham (n = 14) stimulation. RESULTS Active tVNS significantly increased HRV in healthy participants (P = 0.026) indicating a shift in cardiac autonomic function toward parasympathetic predominance. Microneurographic recordings revealed a significant decrease in frequency (P = 0.0001) and incidence (P = 0.0002) of muscle sympathetic nerve activity during tVNS. CONCLUSION tVNS can increase HRV and reduce sympathetic nerve outflow, which is desirable in conditions characterized by enhanced sympathetic nerve activity, such as heart failure. tVNS can therefore influence human physiology and provide a simple and inexpensive alternative to invasive VNS.
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Affiliation(s)
| | - David A Mary
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK
| | - Klaus K Witte
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK
| | | | - Susan A Deuchars
- School of Biomedical Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Jim Deuchars
- School of Biomedical Sciences, University of Leeds, Leeds LS2 9JT, UK.
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Dergacheva O, Dyavanapalli J, Piñol RA, Mendelowitz D. Chronic intermittent hypoxia and hypercapnia inhibit the hypothalamic paraventricular nucleus neurotransmission to parasympathetic cardiac neurons in the brain stem. Hypertension 2014; 64:597-603. [PMID: 24958501 DOI: 10.1161/hypertensionaha.114.03603] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obstructive sleep apnea is associated with chronic intermittent hypoxia/hypercapnia (CIHH) episodes during sleep that heighten sympathetic and diminish parasympathetic activity to the heart. Although one population of neurons in the paraventricular nucleus of the hypothalamus strongly influences sympathetic tone and has increased activity after CIHH, little is known about the role of this pathway to parasympathetic neurons and how this network is altered in CIHH. We hypothesized that CIHH inhibits the excitatory pathway from the paraventricular nucleus of the hypothalamus to parasympathetic cardiac vagal neurons in the brain stem. To test this hypothesis, channelrhodopsin was selectively expressed, using viral vectors, in neurons in the paraventricular nucleus of the hypothalamus and channelrhodopsin-expressing fibers were photoactivated to evoke postsynaptic currents in cardiac vagal neurons in brain stem slices. Excitatory postsynaptic currents were diminished in animals exposed to CIHH. The paired-pulse and prolonged facilitation of the postsynaptic current amplitudes and frequencies evoked by paired and bursts of photoactivation of channelrhodopsin fibers, respectively, occurred in unexposed rats but were blunted in CIHH animals. In response to an acute challenge of hypoxia/hypercapnia, the amplitude of postsynaptic events was unchanged during, but increased after hypoxia/hypercapnia in unexposed animals. In contrast, postsynaptic currents were inhibited during hypoxia/hypercapnia in rats exposed to CIHH. In conclusion, the excitatory pathway to cardiac vagal neurons is diminished in response to both acute and chronic exposures to hypoxia/hypercapnia. This could elicit a reduced cardioprotective parasympathetic activity and an enhanced risk of adverse cardiovascular events in episodes of apnea and chronic obstructive sleep apnea.
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Affiliation(s)
- Olga Dergacheva
- From the Department of Pharmacology and Physiology, Department of Anesthesiology and Critical Care Medicine, The George Washington University, Washington, DC
| | - Jhansi Dyavanapalli
- From the Department of Pharmacology and Physiology, Department of Anesthesiology and Critical Care Medicine, The George Washington University, Washington, DC
| | - Ramón A Piñol
- From the Department of Pharmacology and Physiology, Department of Anesthesiology and Critical Care Medicine, The George Washington University, Washington, DC
| | - David Mendelowitz
- From the Department of Pharmacology and Physiology, Department of Anesthesiology and Critical Care Medicine, The George Washington University, Washington, DC.
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Lujan HL, Janbaih H, DiCarlo SE. Structural remodeling of the heart and its premotor cardioinhibitory vagal neurons following T(5) spinal cord transection. J Appl Physiol (1985) 2014; 116:1148-55. [PMID: 24610530 PMCID: PMC4097824 DOI: 10.1152/japplphysiol.01285.2013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 02/28/2014] [Indexed: 12/24/2022] Open
Abstract
Midthoracic spinal cord injury (SCI) is associated with enhanced cardiac sympathetic activity and reduced cardiac parasympathetic activity. The enhanced cardiac sympathetic activity is associated with sympathetic structural plasticity within the stellate ganglia, spinal cord segments T1-T4, and heart. However, changes to cardiac parasympathetic centers rostral to an experimental SCI are relatively unknown. Importantly, reduced vagal activity is a predictor of high mortality. Furthermore, this autonomic dysregulation promotes progressive left ventricular (LV) structural remodeling. Accordingly, we hypothesized that midthoracic spinal cord injury is associated with structural plasticity in premotor (preganglionic parasympathetic neurons) cardioinhibitory vagal neurons located within the nucleus ambiguus as well as LV structural remodeling. To test this hypothesis, dendritic arborization and morphology (cholera toxin B immunohistochemistry and Sholl analysis) of cardiac projecting premotor cardioinhibitory vagal neurons located within the nucleus ambiguus were determined in intact (sham transected) and thoracic level 5 transected (T5X) rats. In addition, LV chamber size, wall thickness, and collagen content (Masson trichrome stain and structural analysis) were determined. Midthoracic SCI was associated with structural changes within the nucleus ambiguus and heart. Specifically, following T5 spinal cord transection, there was a significant increase in cardiac parasympathetic preganglionic neuron dendritic arborization, soma area, maximum dendritic length, and number of intersections/animal. This parasympathetic structural remodeling was associated with a profound LV structural remodeling. Specifically, T5 spinal cord transection increased LV chamber area, reduced LV wall thickness, and increased collagen content. Accordingly, results document a dynamic interaction between the heart and its parasympathetic innervation.
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Affiliation(s)
- Heidi L Lujan
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan
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Arbel Y, Shenhar-Tsarfaty S, Waiskopf N, Finkelstein A, Halkin A, Revivo M, Berliner S, Herz I, Shapira I, Keren G, Soreq H, Banai S. Decline in serum cholinesterase activities predicts 2-year major adverse cardiac events. Mol Med 2014; 20:38-45. [PMID: 24395570 PMCID: PMC3951463 DOI: 10.2119/molmed.2013.00139] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 12/19/2013] [Indexed: 01/17/2023] Open
Abstract
Parasympathetic activity influences long-term outcome in patients with cardiovascular disease, but the underlying mechanism(s) linking parasympathetic activity and the occurrence of major adverse cardiovascular events (MACEs) are incompletely understood. The aim of this pilot study was to evaluate the association between serum cholinesterase activities as parasympathetic biomarkers and the risk for the occurrence of MACEs. Cholinergic status was determined by measuring the cumulative capacity of serum acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) to hydrolyze the AChE substrate acetylthiocholine. Cholinergic status was evaluated in randomly selected patients undergoing cardiac catheterization. The patients were divided into two groups of 100 patients in each group, with or without occurrence of MACEs during a follow-up period of 40 months. Cox regression models adjusted for potential clinical, metabolic and inflammatory confounders served to evaluate association with clinical outcome. We found that patients with MACE presented lower cholinergic status and AChE values at catheterization (1,127 ± 422 and 359 ± 153 nmol substrate hydrolyzed per minute per milliliter, respectively) than no-MACE patients (1,760 ± 546 and 508 ± 183 nmol substrate hydrolyzed per minute per milliliter, p < 0.001 and p < 0.001, respectively), whose levels were comparable to those of matched healthy controls (1,622 ± 303 and 504 ± 126 nmol substrate hydrolyzed per minute per milliliter, respectively). In a multivariate analysis, patients with AChE or total cholinergic status values below median showed conspicuously elevated risk for MACE (hazard ratio 1.85 [95% confidence interval [CI] 1.09-3.15, p = 0.02] and 2.21 [95% CI 1.22-4.00, p = 0.009]) compared with those above median, even after adjusting for potential confounders. We conclude that parasympathetic dysfunction expressed as reduced serum AChE and AChE activities in patients compared to healthy controls can together reflect impaired parasympathetic activity. This impairment predicts the risk of MACE up to 40 months in such patients. Monitoring these parasympathetic parameters might help in the risk stratification of patients with cardiovascular disease.
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Affiliation(s)
- Yaron Arbel
- Department of Cardiology, Tel Aviv Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shani Shenhar-Tsarfaty
- Department of Biological Chemistry, The Life Sciences Institute and the Edmond and Lily Safra Center of Brain Science, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nir Waiskopf
- Department of Biological Chemistry, The Life Sciences Institute and the Edmond and Lily Safra Center of Brain Science, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ariel Finkelstein
- Department of Cardiology, Tel Aviv Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Halkin
- Department of Cardiology, Tel Aviv Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Miri Revivo
- Department of Cardiology, Tel Aviv Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomo Berliner
- Internal Medicine “E,” Tel Aviv Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Itzhak Herz
- Department of Cardiology, Tel Aviv Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Itzhak Shapira
- Department of Cardiology, Tel Aviv Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gad Keren
- Department of Cardiology, Tel Aviv Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hermona Soreq
- Department of Biological Chemistry, The Life Sciences Institute and the Edmond and Lily Safra Center of Brain Science, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shmuel Banai
- Department of Cardiology, Tel Aviv Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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49
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De Ferrari GM. Vagal Stimulation in Heart Failure. J Cardiovasc Transl Res 2014; 7:310-20. [DOI: 10.1007/s12265-014-9540-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 01/03/2014] [Indexed: 01/09/2023]
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50
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Strilakou AA, Tsakiris ST, Kalafatakis KG, Stylianaki AT, Karkalousos PL, Koulouris AV, Mourouzis IS, Liapi CA. Carnitine modulates crucial myocardial adenosine triphosphatases and acetylcholinesterase enzyme activities in choline-deprived rats. Can J Physiol Pharmacol 2014; 92:78-84. [PMID: 24383876 DOI: 10.1139/cjpp-2013-0165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Choline is an essential nutrient, and choline deficiency has been associated with cardiovascular morbidity. Choline is also the precursor of acetylcholine (cholinergic component of the heart's autonomic nervous system), whose levels are regulated by acetylcholinesterase (AChE). Cardiac contraction-relaxation cycles depend on ion gradients established by pumps like the adenosine triphosphatases (ATPases) Na(+)/K(+)-ATPase and Mg(2+)-ATPase. This study aimed to investigate the impact of dietary choline deprivation on the activity of rat myocardial AChE (cholinergic marker), Na(+)/K(+)-ATPase, and Mg(2+)-ATPase, and the possible effects of carnitine supplementation (carnitine, structurally relevant to choline, is used as an adjunct in treating cardiac diseases). Adult male albino Wistar rats were distributed among 4 groups, and were fed a standard or choline-deficient diet for one month with or without carnitine in their drinking water (0.15% w/v). The enzyme activities were determined spectrophotometrically in the myocardium homogenate. Choline deficiency seems to affect the activity of the aforementioned parameters, but only the combination of choline deprivation and carnitine supplementation increased myocardial Na(+)/K(+)-ATPase activity along with a concomitant decrease in the activities of Mg(2+)-ATPase and AChE. The results suggest that carnitine, in the setting of choline deficiency, modulates cholinergic myocardial neurotransmission and the ATPase activity in favour of cardiac work efficiency.
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Affiliation(s)
- Athina A Strilakou
- a Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens GR-11527, Greece
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