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Belletti R, Romero L, Martinez-Mateu L, Cherry EM, Fenton FH, Saiz J. Arrhythmogenic Effects of Genetic Mutations Affecting Potassium Channels in Human Atrial Fibrillation: A Simulation Study. Front Physiol 2021; 12:681943. [PMID: 34135774 PMCID: PMC8201780 DOI: 10.3389/fphys.2021.681943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/05/2021] [Indexed: 11/16/2022] Open
Abstract
Genetic mutations in genes encoding for potassium channel protein structures have been recently associated with episodes of atrial fibrillation in asymptomatic patients. The aim of this study is to investigate the potential arrhythmogenicity of three gain-of-function mutations related to atrial fibrillation-namely, KCNH2 T895M, KCNH2 T436M, and KCNE3-V17M-using modeling and simulation of the electrophysiological activity of the heart. A genetic algorithm was used to tune the parameters' value of the original ionic currents to reproduce the alterations experimentally observed caused by the mutations. The effects on action potentials, ionic currents, and restitution properties were analyzed using versions of the Courtemanche human atrial myocyte model in different tissues: pulmonary vein, right, and left atrium. Atrial susceptibility of the tissues to spiral wave generation was also investigated studying the temporal vulnerability. The presence of the three mutations resulted in an overall more arrhythmogenic substrate. Higher current density, action potential duration shortening, and flattening of the restitution curves were the major effects of the three mutations at the single-cell level. The genetic mutations at the tissue level induced a higher temporal vulnerability to the rotor's initiation and progression, by sustaining spiral waves that perpetuate until the end of the simulation. The mutation with the highest pro-arrhythmic effects, exhibiting the widest sustained VW and the smallest meandering rotor's tip areas, was KCNE3-V17M. Moreover, the increased susceptibility to arrhythmias and rotor's stability was tissue-dependent. Pulmonary vein tissues were more prone to rotor's initiation, while in left atrium tissues rotors were more easily sustained. Re-entries were also progressively more stable in pulmonary vein tissue, followed by the left atrium, and finally the right atrium. The presence of the genetic mutations increased the susceptibility to arrhythmias by promoting the rotor's initiation and maintenance. The study provides useful insights into the mechanisms underlying fibrillatory events caused by KCNH2 T895M, KCNH2 T436M, and KCNE3-V17M and might aid the planning of patient-specific targeted therapies.
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Affiliation(s)
- Rebecca Belletti
- Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
| | - Lucia Romero
- Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
| | - Laura Martinez-Mateu
- Departamento de Teoría de la Señal y Comunicaciones y Sistemas Telemáticos y Computación, Universidad Rey Juan Carlos, Madrid, Spain
| | - Elizabeth M. Cherry
- School of Computational Science and Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Flavio H. Fenton
- School of Physics, Georgia Institute of Technology, Atlanta, GA, United States
| | - Javier Saiz
- Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
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Kim TY, Jeng P, Hwang J, Pfeiffer Z, Patel D, Cooper LL, Kossidas K, Centracchio J, Peng X, Koren G, Qu Z, Choi BR. Short-Long Heart Rate Variation Increases Dispersion of Action Potential Duration in Long QT Type 2 Transgenic Rabbit Model. Sci Rep 2019; 9:14849. [PMID: 31619700 PMCID: PMC6795902 DOI: 10.1038/s41598-019-51230-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/24/2019] [Indexed: 01/21/2023] Open
Abstract
The initiation of polymorphic ventricular tachycardia in long QT syndrome type 2 (LQT2) has been associated with a characteristic ECG pattern of short-long RR intervals. We hypothesize that this characteristic pattern increases APD dispersion in LQT2, thereby promoting arrhythmia. We investigated APD dispersion and its dependence on two previous cycle lengths (CLs) in transgenic rabbit models of LQT2, LQT1, and their littermate controls (LMC) using random stimulation protocols. The results show that the short-long RR pattern was associated with a larger APD dispersion in LQT2 but not in LQT1 rabbits. The multivariate analyses of APD as a function of two previous CLs (APDn = C + α1CLn−1 + α2CLn−2) showed that α1 (APD restitution slope) is largest and heterogeneous in LQT2 but uniform in LQT1, enhancing APD dispersion under long CLn−1 in LQT2. The α2 (short-term memory) was negative in LQT2 while positive in LQT1, and the spatial pattern of α1 was inversely correlated to α2 in LQT2, which explains why a short-long combination causes a larger APD dispersion in LQT2 but not in LQT1 rabbits. In conclusion, short-long RR pattern increased APD dispersion only in LQT2 rabbits through heterogeneous APD restitution and the short-term memory, underscoring the genotype-specific triggering of arrhythmias in LQT syndrome.
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Affiliation(s)
- Tae Yun Kim
- Cardiovascular Research Center, Division of Cardiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Paul Jeng
- Cardiovascular Research Center, Division of Cardiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - JungMin Hwang
- College of Pharmacy, University of Rhode Island, Kingston, RI, USA
| | - Zachary Pfeiffer
- Cardiovascular Research Center, Division of Cardiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Divyang Patel
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Leroy L Cooper
- Biology Department, Vassar College, Poughkeepsie, NY, USA
| | - Konstantinos Kossidas
- Cardiovascular Research Center, Division of Cardiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jason Centracchio
- Cardiovascular Research Center, Division of Cardiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Xuwen Peng
- Department of Comparative Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Gideon Koren
- Cardiovascular Research Center, Division of Cardiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Zhilin Qu
- Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Bum-Rak Choi
- Cardiovascular Research Center, Division of Cardiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
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Ginks MR, Shetty AK, Lambiase PD, Duckett SG, Bostock J, Peacock JL, Rhode KS, Bucknall C, Gill J, Taggart P, Leclercq C, Carr-White GS, Razavi R, Rinaldi CA. Benefits of Endocardial and Multisite Pacing Are Dependent on the Type of Left Ventricular Electric Activation Pattern and Presence of Ischemic Heart Disease. Circ Arrhythm Electrophysiol 2012; 5:889-97. [DOI: 10.1161/circep.111.967505] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Matthew R. Ginks
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Anoop K. Shetty
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Pier D. Lambiase
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Simon G. Duckett
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Julian Bostock
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Janet L. Peacock
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Kawal S. Rhode
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Cliff Bucknall
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Jaswinder Gill
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Peter Taggart
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Christophe Leclercq
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Gerald S. Carr-White
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - Reza Razavi
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
| | - C. Aldo Rinaldi
- From the St. Thomas’ Hospital (M.R.G., A.K.S., J.B., C.B., J.G., G.S.C.-W., A.R.), The Heart Hospital (P.D.L.), University College Hospital (P.D.L., P.T.), and King’s College, London, United Kingdom (S.G.D., J.L.P., K.S.R., R.R.); and University Hospital, Rennes, France (C.L.)
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