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Fu H, Kong B, Shuai W, Zhu J, Wang X, Tang Y, Huang H, Huang C. Leukocyte Ig-like receptor B4 (Lilrb4a) alleviates cardiac dysfunction and isoproterenol-induced arrhythmogenic remodeling associated with cardiac fibrosis and inflammation. Heart Rhythm 2024:S1547-5271(24)02389-0. [PMID: 38636927 DOI: 10.1016/j.hrthm.2024.04.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Heart failure is usually accompanied by activation of the sympathetic nerve, and excessive activation of the sympathetic nerve promotes cardiac remodeling and cardiac dysfunction. In the isoproterenol (ISO)-induced animal model, it is often accompanied by myocardial hypertrophy, fibrosis, and inflammation. Leukocyte immunoglobulin-like receptor B4a (Lilrb4a), an immunosuppressive regulatory receptor, plays a vital role in cardiovascular disease. However, the effect of Lilrb4a on ventricular arrhythmia in an ISO-induced mouse model remains unclear. OBJECTIVE The purpose of this study was to explore the role and molecular mechanism of Lilrb4a in ISO-induced arrhythmogenic remodeling. METHODS Lilrb4a knockout mice and Lilrb4a overexpression mice were infused with ISO (15 mg/kg per 24 hours, 4 weeks). Echocardiography and histology evaluations of myocardial hypertrophy and cardiac structural remodeling were conducted. Surface electrocardiography and electrophysiologic examination were used to evaluate cardiac electrical remodeling and susceptibility to ventricular arrhythmias. Quantitative reverse transcriptase-polymerase chain reaction analysis and Western blotting were used to detect the expression levels of ion channel proteins and signal pathway proteins. RESULTS The results discovered that ISO induced cardiac hypertrophy, fibrosis, and inflammation and led to electrical remodeling and the occurrence of ventricular arrhythmias. Lilrb4a alleviated cardiac structural and electrical remodeling and protected against the occurrence of ventricular arrhythmias in ISO-induced mice by gain-of-function or loss-of-function approaches. The mechanism is that Lilrb4a inhibited NF-κB signaling and MAPK signaling activation mediated by transforming growth factor kinase 1. CONCLUSION Lilrb4a alleviates cardiac dysfunction and ISO-induced arrhythmogenic remodeling associated with cardiac fibrosis and inflammation through the regulation of NF-κB signaling and MAPK signaling activation.
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Affiliation(s)
- Hui Fu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Bin Kong
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Wei Shuai
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Jun Zhu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Xi Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Yanhong Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - He Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Congxin Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China.
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Tashiro A, Yonetsu T, Aoyama N, Shiheido-Watanabe Y, Niida T, Miyazaki S, Maejima Y, Goya M, Isobe M, Iwata T, Sasano T. Periodontitis was associated with worse clinical outcomes after catheter ablation for paroxysmal atrial fibrillation. Front Cardiovasc Med 2023; 9:1061243. [PMID: 36698924 PMCID: PMC9868319 DOI: 10.3389/fcvm.2022.1061243] [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: 10/04/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Background Periodontitis (PD), a common chronic inflammatory disease, may be associated with the subsequent development of atrial fibrillation (AF) through a mechanism of systemic inflammation. However, little is known about the impact of PD on the recurrence of atrial fibrillation after catheter ablation (CA). Methods A total of 132 patients (age 62.2 ± 10.6 years; 72.7% male) who underwent periodontal examinations and the first CA for paroxysmal atrial fibrillation (PAF) were investigated. Clinical periodontal examination was performed by independent trained periodontists, and patients were diagnosed with PD when the maximum periodontal probing depth was equal to or greater than 4 mm and bleeding on probing was evident. Of these, 71 patients (54%) were categorized as those with PD (PD group) and the other 61 (46%) as those without PD (non-PD group). Pulmonary vein isolation was performed in a standard fashion. Results Kaplan-Meier curve analysis revealed worse atrial arrhythmia recurrence-free survival probabilities after CA for PAF in the PD group than in the non-PD group (64.8% versus 80.3%, respectively; p = 0.024) during a median follow-up period of 3.0 (interquartile range: 1.1-6.4) years. Cox regression analysis revealed PD as a significant predictor of arrhythmia recurrence (hazard ratio: 2.063, 95% confidence interval: 1.018-4.182), after adjusting for age and gender. Conclusion Periodontitis was independently associated with an increased risk of arrhythmia recurrence after the first CA for PAF. Our results may suggest that the periodontal status is potentially a modifiable determinant of the outcomes after PAF ablation, and further prospective studies are warranted.
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Affiliation(s)
- Akira Tashiro
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taishi Yonetsu
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan,*Correspondence: Taishi Yonetsu, ; orcid.org/0000-0002-1798-5008
| | - Norio Aoyama
- Department of Periodontology, Kanagawa Dental University, Yokosuka, Japan
| | - Yuka Shiheido-Watanabe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Niida
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhiro Maejima
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiko Goya
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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Pessente GD, Sacilotto L, Calil ZO, Olivetti NQS, Wulkan F, de Oliveira TGM, Pedrosa AAA, Wu TC, Hachul DT, Scanavacca MI, Krieger JE, Darrieux FCDC, Pereira ADC. Effect of Occurrence of Lamin A/C (LMNA) Genetic Variants in a Cohort of 101 Consecutive Apparent “Lone AF” Patients: Results and Insights. Front Cardiovasc Med 2022; 9:823717. [PMID: 35449878 PMCID: PMC9016147 DOI: 10.3389/fcvm.2022.823717] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveMutations in the Lamin A/C(LMNA) gene are commonly associated with cardiac manifestations, such as dilated cardiomyopathy (DCM) and conduction system disease. However, the overall spectrum and penetrance of rare LMNA variants are unknown. The present study described the presence of LMNAvariants in patients with “lone atrial fibrillation (AF)” as their sole clinical presentation.MethodsOne-hundred and one consecutive patients with “lone AF” criteria were initially screened by genetic testing. Genetic variants were classified according to the American College of Genetic and Genomic criteria. All subjects were evaluated through clinical and familial history, ECG, 24-h Holter monitoring, echocardiogram, cardiac magnetic resonance, treatment response, and the present relatives of LMNA carriers. In addition, whole-exome data from 49,960 UK Biobank (UKB) participants were analyzed to describe the overall penetrance of rare LMNA missense and loss of function (LOF) variants.ResultsThree missense variants in LMNA were identified in probands with AF as their first and unique clinical manifestation. Other five first-degree relatives, after the screening, also presented LMNA gene variants. Among 49,960 analyzed UKB participants, 331 carried rare LMNA missense or LOF variant. Participants who carried a rare LMNA variant were significantly associated with higher odds of arrhythmic events and of an abnormal ECG in the per-protocol ECG exam (p = 0.03 and p = 0.05, respectively).ConclusionAlthough a rare occurrence, our findings emphasize the possibility of an initial presentation of apparently “lone AF” in LMNA gene variant carriers.
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Affiliation(s)
- Gabrielle D'Arezzo Pessente
- Laboratory of Genetics and Molecular Cardiology (LGMC) - Heart Institute (Institute Coração, University of São Paulo Medical School, São Paulo, Brazil
- Arrhythmia Unit - Heart Institute (Institute Coração), University of São Paulo Medical School, São Paulo, Brazil
| | - Luciana Sacilotto
- Arrhythmia Unit - Heart Institute (Institute Coração), University of São Paulo Medical School, São Paulo, Brazil
| | - Zaine Oliveira Calil
- Arrhythmia Unit - Heart Institute (Institute Coração), University of São Paulo Medical School, São Paulo, Brazil
| | | | - Fanny Wulkan
- Laboratory of Genetics and Molecular Cardiology (LGMC) - Heart Institute (Institute Coração, University of São Paulo Medical School, São Paulo, Brazil
| | - Théo Gremen Mimary de Oliveira
- Laboratory of Genetics and Molecular Cardiology (LGMC) - Heart Institute (Institute Coração, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Tan Chen Wu
- Arrhythmia Unit - Heart Institute (Institute Coração), University of São Paulo Medical School, São Paulo, Brazil
| | - Denise Tessariol Hachul
- Arrhythmia Unit - Heart Institute (Institute Coração), University of São Paulo Medical School, São Paulo, Brazil
| | - Maurício Ibrahim Scanavacca
- Arrhythmia Unit - Heart Institute (Institute Coração), University of São Paulo Medical School, São Paulo, Brazil
| | - José Eduardo Krieger
- Laboratory of Genetics and Molecular Cardiology (LGMC) - Heart Institute (Institute Coração, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Alexandre da Costa Pereira
- Laboratory of Genetics and Molecular Cardiology (LGMC) - Heart Institute (Institute Coração, University of São Paulo Medical School, São Paulo, Brazil
- *Correspondence: Alexandre da Costa Pereira
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Baba M, Yoshida K, Naruse Y, Hattori A, Yui Y, Kimata A, Ito Y, Tsumagari Y, Tsuneoka H, Shinoda Y, Harunari T, Hanaki Y, Hasebe H, Misaki M, Abe D, Nogami A, Ieda M, Takeyasu N. Predictors of Recurrence after Catheter Ablation of Paroxysmal Atrial Fibrillation in Different Follow-Up Periods. MEDICINA-LITHUANIA 2020; 56:medicina56090465. [PMID: 32932837 PMCID: PMC7557836 DOI: 10.3390/medicina56090465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/28/2020] [Accepted: 09/09/2020] [Indexed: 11/24/2022]
Abstract
Background and objectives: Pulmonary vein (PV) reconnection is a major reason for recurrence after catheter ablation of paroxysmal atrial fibrillation (PAF). However, the timing of the recurrence varies between patients, and recurrence >1 year after ablation is not uncommon. We sought to elucidate the characteristics of atrial fibrillation (AF) that recurred in different follow-up periods. Materials and Methods: Study subjects comprised 151 consecutive patients undergoing initial catheter ablation of PAF. Left atrial volume index (LAVi) and atrial/brain natriuretic peptide (ANP/BNP) levels were systematically measured annually over 3 years until AF recurred. Results: Study subjects were classified into four groups: non-recurrence group (n = 84), and short-term- (within 1 year) (n = 30), mid-term- (1–3 years) (n = 26), and long-term-recurrence group (>3 years) (n = 11). The short-term-recurrence group was characterized by a higher prevalence of diabetes mellitus (hazard ratio 2.639 (95% confidence interval, 1.174–5.932), p = 0.019 by the Cox method), frequent AF episodes (≥1/week) before ablation (4.038 (1.545–10.557), p = 0.004), and higher BNP level at baseline (per 10 pg/mL) (1.054 (1.029–1.081), p < 0.0001). The mid-term-recurrence group was associated with higher BNP level (1.163 (1.070–1.265), p = 0.0004), larger LAVi (mL/m2) (1.033 (1.007–1.060), p = 0.013), and longer AF cycle length at baseline (per 10 ms) (1.194 (1.058–1.348), p = 0.004). In the long-term-recurrence group, the ANP and BNP levels were low throughout follow-up, as with those in the non-recurrence group, and AF cycle length was shorter (0.694 (0.522–0.924), p = 0.012) than those in the other recurrence groups. Conclusions: Distinct characteristics of AF were found according to the time to first recurrence after PAF ablation. The presence of secondary factors beyond PV reconnections could be considered as mechanisms for the recurrence of PAF in each follow-up period.
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Affiliation(s)
- Masako Baba
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Kentaro Yoshida
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
- Correspondence:
| | - Yoshihisa Naruse
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Ai Hattori
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Yoshiaki Yui
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Akira Kimata
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Yoko Ito
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Yasuaki Tsumagari
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Hidekazu Tsuneoka
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Yasutoshi Shinoda
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Tomohiko Harunari
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Yuichi Hanaki
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Hideyuki Hasebe
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Masako Misaki
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Daisuke Abe
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Akihiko Nogami
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
| | - Noriyuki Takeyasu
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan; (M.B.); (Y.N.); (A.H.); (Y.Y.); (A.K.); (Y.I.); (Y.T.); (H.T.); (Y.S.); (T.H.); (Y.H.); (M.M.); (D.A.); (N.T.)
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (H.H.); (A.N.); (M.I.)
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Xu C, Zhang R, Xia Y, Xiong L, Yang W, Wang P. Annotation of susceptibility SNPs associated with atrial fibrillation. Aging (Albany NY) 2020; 12:16981-16998. [PMID: 32902410 PMCID: PMC7521544 DOI: 10.18632/aging.103615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 06/18/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Genome-wide association studies (GWAS) and the candidate gene based association studies have identified a panel of variants associated with atrial fibrillation (AF), however, most of the identified single nucleotide polymorphisms (SNPs) were found located within intergenic or intronic genomic regions, and whether the positive SNPs have a real biological function is unknown, and the real disease causing gene need to be studied. RESULTS The current results of the genetic studies including common variants identified by GWAS (338 index SNPs) and candidate gene based association studies (40 SNPs) were summarized. CONCLUSION Our study suggests the relationship between genetic variants and possible targeted genes, and provides insight into potential genetic pathways underlying AF incidence and development. The results may provide an encyclopedia of AF susceptibility SNPs and shed light on the functional mechanisms of AF variants identified through genetic studies. METHODS We summarized AF susceptibility SNPs identified by GWAS and candidate gene based association studies, and give a comprehensive functional annotation of all these AF susceptibility loci. by genomic annotation, microRNA binding prediction, promoter activity analysis, enhancer activity analysis, transcription factors binding activity prediction, expression quantitative trait loci (eQTL) analysis, long-range transcriptional regulatory function analysis, gene ontology and pathway enrichment analysis.
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Affiliation(s)
- Chengqi Xu
- College of Life Science and Technology, Center for Human Genome Research and Cardio-X Institute, Huazhong University of Science and Technology, Wuhan 430074, P. R. China
| | - Rongfeng Zhang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, P. R. China
| | - Yunlong Xia
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, P. R. China
| | - Liang Xiong
- Department of Clinical Laboratory, Liyuan Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, P. R. China
| | - Wei Yang
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, The Second Hospital of Jilin University, Changchun 130041, P. R. China
| | - Pengyun Wang
- Department of Clinical Laboratory, Liyuan Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, P. R. China
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Huang X, Li Y, Zhang J, Wang X, Li Z, Li G. The molecular genetic basis of atrial fibrillation. Hum Genet 2020; 139:1485-1498. [PMID: 32617797 DOI: 10.1007/s00439-020-02203-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/26/2020] [Indexed: 12/15/2022]
Abstract
As the most common cardiac arrhythmia, atrial fibrillation (AF) is a major risk factor for stroke, heart failure, and premature death with considerable associated costs. However, no available treatment options have optimal benefit-harm profiles currently, reflecting an incomplete understanding of the biological mechanisms underlying this complex arrhythmia. Recently, molecular epidemiological studies, especially genome-wide association studies, have emphasized the substantial genetic component of AF etiology. A comprehensive mapping of the genetic underpinnings for AF can expand our knowledge of AF mechanism and further facilitate the process of locating novel therapeutics for AF. Here we provide a state-of-the-art review of the molecular genetics of AF incorporating evidence from linkage analysis and candidate gene, as well as genome-wide association studies of common variations and rare copy number variations; potential epigenetic modifications (e.g., DNA methylation, histone modification, and non-coding RNAs) are also involved. We also outline the challenges in mechanism investigation and potential future directions in this article.
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Affiliation(s)
- Xin Huang
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, 466 Newport Middle Road, Haizhu District, Guangzhou, 510317, Guangdong, China
| | - Yuhui Li
- Department of Cardiology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Junguo Zhang
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, 466 Newport Middle Road, Haizhu District, Guangzhou, 510317, Guangdong, China
| | - Xiaojie Wang
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, 466 Newport Middle Road, Haizhu District, Guangzhou, 510317, Guangdong, China
| | - Ziyi Li
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, 466 Newport Middle Road, Haizhu District, Guangzhou, 510317, Guangdong, China
| | - Guowei Li
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, 466 Newport Middle Road, Haizhu District, Guangzhou, 510317, Guangdong, China. .,Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University Hamilton, 1280 Main St West, Hamilton, ON, L8S 4L8, Canada.
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Luo R, Zheng C, Yang H, Chen X, Jiang P, Wu X, Yang Z, Shen X, Li X. Identification of potential candidate genes and pathways in atrioventricular nodal reentry tachycardia by whole-exome sequencing. Clin Transl Med 2020; 10:238-257. [PMID: 32508047 PMCID: PMC7240861 DOI: 10.1002/ctm2.25] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 12/15/2022] Open
Abstract
Background Atrioventricular nodal reentry tachycardia (AVNRT) is the most common manifestation of paroxysmal supraventricular tachycardia (PSVT). Increasing data have indicated familial clustering and participation of genetic factors in AVNRT, and no pathogenic genes related to AVNRT have been reported. Methods Whole‐exome sequencing (WES) was performed in 82 patients with AVNRT and 100 controls. Reference genes, genome‐wide association analysis, gene‐based collapsing, and pathway enrichment analysis were performed. A protein‐protein interaction (PPI) network was then established; WES database in the UK Biobank and one only genetic study of AVNRT in Denmark were used for external data validation. Results Among 95 reference genes, 126 rare variants in 48 genes were identified in the cases (minor allele frequency < 0.001). Gene‐based collapsing analysis and pathway enrichment analysis revealed six functional pathways related to AVNRT as with neuronal system/neurotransmitter release cycles and ion channel/cardiac conduction among the top 30 enriched pathways, and then 36 candidate pathogenic genes were selected. By combining with PPI analysis, 10 candidate genes were identified, including RYR2, NOS1, SCN1A, CFTR, EPHB4, ROBO1, PRKAG2, MMP2, ASPH, and ABCC8. From the UK Biobank database, 18 genes from candidate genes including SCN1A, PRKAG2, NOS1, and CFTR had rare variants in arrhythmias, and the rare variants in PIK3CB, GAD2, and HIP1R were in patients with PSVT. Moreover, one rare variant of RYR2 (c.4652A > G, p.Asn1551Ser) in our study was also detected in the Danish study. Considering the gene functional roles and external data validation, the most likely candidate genes were SCN1A, PRKAG2, RYR2, CFTR, NOS1, PIK3CB, GAD2, and HIP1R. Conclusion The preliminary results first revealed potential candidate genes such as SCN1A, PRKAG2, RYR2, CFTR, NOS1, PIK3CB, GAD2, and HIP1R, and the pathways mediated by these genes, including neuronal system/neurotransmitter release cycles or ion channels/cardiac conduction, might be involved in AVNRT.
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Affiliation(s)
- Rong Luo
- Institute of Geriatric Cardiovascular Disease, Chengdu Medical College, Chengdu, People's Republic of China
| | - Chenqing Zheng
- State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Hao Yang
- Department of Cardiology, Hospital of the University of Electronic Science and Technology of China and Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Xuepin Chen
- Department of Cardiology, Hospital of the University of Electronic Science and Technology of China and Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Panpan Jiang
- Shenzhen RealOmics (Biotech) Co., Ltd., Shenzhen, China
| | - Xiushan Wu
- The Center of Heart Development, College of Life Sciences, Hunan Norma University, Changsha, China
| | - Zhenglin Yang
- Department of Cardiology, Hospital of the University of Electronic Science and Technology of China and Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Xia Shen
- State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, China.,Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Xiaoping Li
- Department of Cardiology, Hospital of the University of Electronic Science and Technology of China and Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
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Xie D, Geng L, Wang S, Xiong K, Zhao T, Wang G, Feng Z, Lv F, Wang C, Liang D, Shi D, Ma X, Liu Y, Yang J, Zhang C, Chen YH. Cold-inducible RNA-binding protein modulates atrial fibrillation onset by targeting multiple ion channels. Heart Rhythm 2020; 17:998-1008. [PMID: 31918003 DOI: 10.1016/j.hrthm.2019.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/29/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Atrial fibrillation (AF), the most common sustained arrhythmia, significantly increases cardiovascular and cerebrovascular morbidity and mortality. The pathogenesis and treatment of AF remain a major challenge in the field of cardiology. We previously found that cold-inducible RNA-binding protein (CIRP) regulated ventricular repolarization by posttranscriptionally regulating Kv4.2/4.3 ion channels in rats, but the role of CIRP in AF is not clear. OBJECTIVE The purpose of this study was to confirm that CIRP participates in atrial electrophysiological remodeling and AF occurrence by regulating atrial channels posttranscriptionally. METHODS Programmed intra-atrial stimulation was used to induce AF in wild-type or transcription activator-like effector nucleases-based CIRP knockout (KO) rats. Atrial optical mapping, patch clamp, Western blotting, RNA immunoprecipitation, and luciferase reporter assays were performed to evaluate the underlying mechanism of atrial electrical remodeling. RESULTS First, we observed a shortened atrial effective refractory period and increased susceptibility to AF in CIRP KO rats. Second, atria-specific CIRP delivery through an adeno-associated viral vector serotype 9 prolonged the atrial effective refractory period and attenuated AF development in CIRP KO rats. Third, we observed the shortened action potential duration and enhanced expression of Kv1.5 and Kv4.2/4.3 in KO rats. The transient outward current blocker 4-Aminopyridine and ultrarapid component of the delayed rectifier current blocker Diphenyl phosphine oxide-1 restored the shortened action potential duration in KO atria. Finally, we demonstrated that CIRP suppressed Kv1.5 and Kv4.2/4.3 expression by directly targeting their 3'-untranslated regions. CONCLUSION CIRP plays a protective role in preventing AF onset through the posttranscriptional regulation of Kv1.5 and Kv4.2/4.3.
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Affiliation(s)
- Duanyang Xie
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Li Geng
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shuo Wang
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ke Xiong
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tingting Zhao
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guanghua Wang
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhiqiang Feng
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fei Lv
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Cheng Wang
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dandan Liang
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Institute of Medical Genetics, Tongji University, Shanghai, China
| | - Dan Shi
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Institute of Medical Genetics, Tongji University, Shanghai, China
| | - Xiue Ma
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Institute of Medical Genetics, Tongji University, Shanghai, China
| | - Yi Liu
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Institute of Medical Genetics, Tongji University, Shanghai, China
| | - Jian Yang
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chao Zhang
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai, China.
| | - Yi-Han Chen
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Institute of Medical Genetics, Tongji University, Shanghai, China.
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Fousse SL, Tyrrell WD, Dentino ME, Abrams FL, Rosenthal SL, Stern JA. Pedigree analysis of atrial fibrillation in Irish wolfhounds supports a high heritability with a dominant mode of inheritance. Canine Genet Epidemiol 2019; 6:11. [PMID: 31867114 PMCID: PMC6902490 DOI: 10.1186/s40575-019-0079-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/20/2019] [Indexed: 01/08/2023] Open
Abstract
Background Atrial fibrillation (AF) is the most common arrhythmia in dogs. The Irish Wolfhound breed has a high prevalence of AF making them an ideal breed to investigate possible genetic contributions to this disease. The aim of this study was to perform a heritability analysis in North American Irish Wolfhounds using phenotype data from cardiac screenings performed between 2000 and 2019 in order to determine how much of this disease can be attributed to genetics compared to environmental causes. The second aim was to determine the disease mode of inheritance to help inform prevention and breeding practices. Results There were 327 Irish Wolfhounds diagnosed with AF and 136 Irish Wolfhounds over 8 years of age without AF. The estimated mean (95% confidence interval) heritability of AF in Irish Wolfhounds was 0.69 (0.50–0.86). The pedigree was consistent with a dominant mode of inheritance. Conclusion Results of this study indicate a strong genetic contribution to AF in Irish Wolfhounds and suggest that future research to identify causative genetic mutations is warranted.
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Affiliation(s)
- Samantha L Fousse
- 1Department of Medicine and Epidemiology, University of California Davis - School of Veterinary Medicine, Davis, CA USA
| | | | | | | | | | - Joshua A Stern
- 1Department of Medicine and Epidemiology, University of California Davis - School of Veterinary Medicine, Davis, CA USA
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Circular RNA expression profiles of persistent atrial fibrillation in patients with rheumatic heart disease. Anatol J Cardiol 2019; 21:2-10. [PMID: 30587718 PMCID: PMC6382899 DOI: 10.14744/anatoljcardiol.2018.35902] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective: To investigate the expression profile of circular RNAs (circRNAs) and proposed circRNA–microRNA (miRNA) regulatory network in atrial fibrillation (AF). Methods: Atrial tissues from patients with persistent AF with rheumatic heart disease and non-AF myocardium with normal hearts were collected for circRNA differential expression analyses by high-throughput sequencing. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed to predict the potential functions of the differentially expressed genes and AF-related pathways. Co-expression networks of circRNA–miRNA were constructed based on the correlation analyses between the differentially expressed RNAs. Quantitative reverse transcription polymerase chain reaction (PCR) was performed to validate the results. Results: A total of 108 circRNAs were found to be differentially expressed in AF. Among them, 51 were up-regulated, and 57 were down-regulated. Dysregulated circRNAs were validated by quantitative real-time PCR. The GO and KEGG pathway enrichment analyses were executed to determine the principal functions of the significantly deregulated genes. Furthermore, we constructed correlated expression networks between circRNAs and miRNAs. circRNA19591, circRNA19596, and circRNA16175 interacted with 36, 28, and 18 miRNAs, respectively; miR-29b-1-5p and miR-29b-2-5p were related to 12 down-regulated circRNAs, respectively. Conclusion: Our findings provide a novel perspective on circRNAs involved in AF due to rheumatic heart disease and establish the foundation for future research of the potential roles of circRNAs in AF.
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Han M, Zhao M, Cheng C, Huang Y, Han S, Li W, Tu X, Luo X, Yu X, Liu Y, Chen Q, Ren X, Wang QK, Ke T. Lamin A mutation impairs interaction with nucleoporin NUP155 and disrupts nucleocytoplasmic transport in atrial fibrillation. Hum Mutat 2018; 40:310-325. [PMID: 30488537 DOI: 10.1002/humu.23691] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/19/2018] [Accepted: 11/26/2018] [Indexed: 12/19/2022]
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia. Here, we show the identification and functional characterization of one AF-associated mutation p.Arg399Cys in lamin A/C. Co-immunoprecipitation and GST pull-down assays demonstrate that lamin A/C interacts with NUP155, which is a nucleoporin and causes AF when mutated. Lamin A/C mutation p.Arg399Cys impairs the interaction between lamin A/C and NUP155, and increases extractability of NUP155 from the nuclear envelope (NE). Mutation p.Arg399Cys leads to aggregation of lamin A/C in the nucleus, although it does not impair the integrity of NE upon cellular stress. Mutation p.Arg399Cys inhibits the export of HSP70 mRNA and the nuclear import of HSP70 protein. Electrophysiological studies show that mutation p.Arg399Cys decreases the peak cardiac sodium current by decreasing the cell surface expression level of cardiac sodium channel Nav 1.5, but does not affect IKr potassium current. In conclusion, our results indicate that lamin A/C mutation p.Arg399Cys weakens the interaction between nuclear lamina (lamin A/C) and the nuclear pore complex (NUP155), leading to the development of AF. The findings provide a novel molecular mechanism for the pathogenesis of AF.
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Affiliation(s)
- Meng Han
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Miao Zhao
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Chen Cheng
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Yuan Huang
- National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, P. R. China
| | - Shengna Han
- Department of Pharmacology, Basic Medical College, Zhengzhou University, Zhengzhou, P. R. China
| | - Wenjuan Li
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Xin Tu
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Xuan Luo
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Xiaoling Yu
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Yinan Liu
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Qiuyun Chen
- Center for Cardiovascular Genetics, Department of Molecular Cardiology, Lerner Research Institute, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
- Department of Molecular Medicine, Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Xiang Ren
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Qing Kenneth Wang
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
- Center for Cardiovascular Genetics, Department of Molecular Cardiology, Lerner Research Institute, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
- Department of Molecular Medicine, Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Tie Ke
- The Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, P. R. China
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Association evidence of CCTTT repeat polymorphism in the iNOS promoter and the risk of atrial fibrillation in Taiwanese. Sci Rep 2017; 7:42388. [PMID: 28205526 PMCID: PMC5304328 DOI: 10.1038/srep42388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 01/09/2017] [Indexed: 11/17/2022] Open
Abstract
Inducible nitric oxide synthase (iNOS) plays an important role in the pathogenesis of atrial fibrillation (AF). The iNOS promoter has a CCTTT-repeat length polymorphism that can determine the level of gene transcription. This study enrolled 200 AF patients and 240 controls. The length of CCTTT-repeat polymorphism in the iNOS promoter region was examined by polymerase chain reactions, with the alleles with ≤11 repeats designated as S and alleles with ≥12 repeats designated as L alleles. AF patients carried significantly higher frequencies of the LL genotype than control subjects (40.0% versus 28.3%, P = 0.010). Multivariate analysis showed that the presence of LL genotype was significantly associated with AF (odds ratio: 1.87, 95% CI = 1.10–3.17, P = 0.021). In vitro, transient transfection assay in HL-1 atrial myocytes showed that the responsiveness of iNOS transcriptional activity to tachypacing was correlated with the length of the CCTTT-repeats. Right atrial tissues from patients with chronic AF were investigated with immunoconfocal microscopy. Patients with LL genotype exhibited greater oxidative stress and substrate remodeling in their atria than those with non-LL genotypes. Our results suggest that the iNOS microsatellite polymorphism may contribute to the genetic background of AF in Chinese-Taiwanese patients.
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Atrial flutter/fibrillation in patients receiving transcatheter closure of atrial septal defect. J Formos Med Assoc 2016; 116:522-528. [PMID: 27816405 DOI: 10.1016/j.jfma.2016.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 09/06/2016] [Accepted: 09/06/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND/PURPOSE Atrial flutter/fibrillation (AFL/Af) is a common late complication in atrial septal defect (ASD) patients even after occluder implantation. We try to delineate the risk factors of persistent AFL/Af. METHODS From 1998 to 2010, all patients older than 18 years of age who received ASD occluder implantation in our hospital were enrolled, and their records were retrospectively reviewed. In addition, renin-angiotensin system gene polymorphisms including angiotensinogen gene, A1166C polymorphism on the angiotensin II type I receptor gene, and insertion/deletion (I/D) patterns on the angiotensin-converting enzyme gene were checked using direct sequencing. RESULTS A total of 517 patients (male/female 127/390) were enrolled. The mean age of patients receiving occluder deployment was 41.5 ± 14.5 years. Prior to occluder deployment, 3.9% of patients had persistent Af, 3.1% of patients had paroxysmal Af, and 0.8% had AFL. After a follow-up of 1894 patient-years, 3.5% had persistent Af and 1.9% of patients had paroxysmal Af. The greatest risk factors of AFL/Af genesis included age, occluder size, presence of multiple ASDs, and underlying thyroid or mitral valve disorder (p < 0.001, p < 0.001, p = 0.033, p = 0.016, and p = 0.012, respectively). Preoperative AFL/Af status is the most important factor in determining AFL/Af resolution and progression after an intervention. The renin-angiotensin system gene polymorphisms had no association with AFL/Af genesis, and progression or resolution after intervention. CONCLUSION AFL/Af is common after ASD occluder implantation, and predisposed by older age, larger and multiple ASDs, and underlying disorders. Preoperative atrial arrhythmia status is the most important predictor of AFL/Af progression or resolution. Renin-angiotensin system gene polymorphisms had no association with AFL/Af.
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Zhao L, Chen XG, Liu Y, Fang Z, Zhang F. Association of rs17042171 with chromosome 4q25 with atrial fibrillation in Chinese Han populations. Anatol J Cardiol 2015; 16:165-9. [PMID: 26467376 PMCID: PMC5336801 DOI: 10.5152/akd.2015.5999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: A recent genome-wide association study (GWAS) identified a susceptibility single nucleotide polymorphism (SNP), rs17042171 on 4q25 for atrial fibrillation (AF). The aim of the present study was to investigate whether this association between rs17042171 and AF also exists in Chinese Han populations. Methods: It was a case-control study. We enrolled a total of 1,593 Chinese Han origin individuals in the study, including 597 AF patients and 996 AF-free controls. Genotyping was performed using the TaqMan allelic discrimination Assay. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in logistic regression models. Results: There was strongly significant difference between AF patients and control subjects regarding rs17042171 assumption of additive model (OR=2.20, 95% CI: 1.88-2.57, p=2.00 × 10-22), dominant model (OR=2.99; 95% CI: 2.19-4.09; p=6.47 × 10-12) and a recessive (OR=2.75; 95% CI: 2.21-3.43; p=1.30 10-19). In the stratification analysis based on age, gender, hypertension, diabetes and coronary artery disease, there was no significant difference of the associations for rs17042171 among the subgroups. Conclusion: Our results indicated that rs17042171 confers an increased risk of AF in Chinese Han Populations and expanded the association to non-European ancestry populations for the first time. (Anatol J Cardiol 2016; 16: 165-9)
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Affiliation(s)
- Liyan Zhao
- Section of Pacing and Electrophysiology, Division of Cardiology, the First Affiliated Hospital of Nanjing Medical University; Nanjing-China.
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Yao JL, Zhou YF, Yang XJ, Qian XD, Jiang WP. KCNN3 SNP rs13376333 on Chromosome 1q21 Confers Increased Risk of Atrial Fibrillation. Int Heart J 2015; 56:511-5. [PMID: 26370375 DOI: 10.1536/ihj.15-133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
To investigate the relationship between KCNN3 SNP (single-nucleotide polymorphism) rs13376333 and risk of atrial fibrillation (AF) and to provide evidence for prevention and treatment for AF.The PubMed, Embase, OVID, Cochrane library, CNKI, and Wan Fang databases were searched to identify studies on the relationship between KCNN3 SNP rs13376333 polymorphism and atrial fibrillation. Two authors performed independent article reviews and study quality assessment using the Newcastle-Ottawa Scale (NOS) checklist.Seven studies involving 24,339 individuals were included in the meta-analysis. The overall combined OR of rs13376333 polymorphism was observed for both lone AF (OR: 1.58 [95%CI: 1.37 to 1.82]; P < 0.001; I(2) = 47.0%) and total AF (OR: 1.33 [95%CI: 1.14 to 1.54]; P < 0.001; I(2) = 0). Further, when stratified by ethnicity, control sources, sample sizes, and genotyping method, similar results were observed in both subgroups. Sensitivity analysis revealed that the source of control was the source of the heterogeneity for lone AF. Omission of any single study had little effect on the combined risk estimate. No evidence of publication bias was found.This meta-analysis suggests that KCNN3 SNP rs13376333 polymorphism significantly increases the risk of lone AF and total AF, which suggests the rs13376333 polymorphism of the KCNN3 gene may play an important role in the pathogenesis of AF.
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Affiliation(s)
- Jia-Lu Yao
- Department of Cardiology, the First Affiliated Hospital of Soochow University
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Abstract
Atrial fibrillation is the most common heart rhythm disorder in the world, with major public health impact especially due to increased risk of stroke and hospitalizations. The recently published results on epidemiology of atrial fibrillation from the Global Burden of Diseases, Injuries, and Risk Factors Study confirm the existence of a significant and progressive worldwide increase in the burden of atrial fibrillation. However, there appears to be regional variation in both the burden of atrial fibrillation and availability of epidemiological data regarding this condition. In this review, the authors identify issues that are unique to the developed versus developing regions and outline a road map for possible approaches to surveillance, management, and prevention of atrial fibrillation at the global level.
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Zhai C, Cong H, Liu Y, Zhang Y, Liu X, Zhang H, Ren Z. Rs7193343 polymorphism in zinc finger homeobox 3 (ZFHX3) gene and atrial fibrillation: an updated meta-analysis of 10 case-control comparisons. BMC Cardiovasc Disord 2015; 15:58. [PMID: 26112950 PMCID: PMC4480884 DOI: 10.1186/s12872-015-0044-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 06/01/2015] [Indexed: 01/08/2023] Open
Abstract
Background The previous genome-wide studies have shown that rs7193343 single-nucleotide polymorphism (SNP) in zinc finger homeobox 3 (ZFHX3) gene correlate with risk of atrial fibrillation (AF). However, the distribution of this SNP differs significantly among various populations. The present study was to investigate whether combined evidence shows the association between ZFHX3 rs7193343 SNP and the risk of AF in various populations. Methods A systematic search of all studies published through Dec 2014 was conducted using the Medline, Embase, WanFang, ScienceDirect, CNKI, and OVID databases. The case-control studies that evaluated an association between rs7193343 SNP and risk of AF were identified. The association between the ZFHX3 rs7193343 SNP and AF susceptibility was assessed using genetic models. Results We collected 10 comparisons from six studies for rs7193343 SNP, including 1037 cases and 4310 controls in Asian, 5583 cases and 38215 controls in Caucasian, and then performed an updated meta-analysis and subgroup analysis based on ethnicity. In overall population, the occurrence of AF was found to be associated with T-allelic of rs7193343 SNP in ZFHX3 (OR =1.17, 95% CI 1.10-1.26). In subgroup analysis, we observed there was significant association between T-allele of rs7193343 and risk of AF in Caucasian subgroups (OR =1.20, 95% CI 1.12-1.30), but no statistically significance (OR = 1.07, 95% CI 0.92-1.24) in Asian population. Conclusion In Caucasian population, genetic variant rs7193343 SNP is associated with risk of AF in Caucasian population. However, no association is found in Asian population based on the current evidence. Further studies with larger sample size involving case-control populations with multiple ethnics are still required in the future.
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Affiliation(s)
- ChuanNan Zhai
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350, China. .,Graduate School, Tianjin Medical University, Tianjin, 300051, China. .,Department of Cardiology, Tianjin Gongan Hospital, Xinhua Road No. 162, Heping District, Tianjin, 300042, China.
| | - HongLiang Cong
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350, China.
| | - YuJie Liu
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350, China.
| | - Ying Zhang
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350, China.
| | - XianFeng Liu
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350, China. .,Graduate School, Tianjin Medical University, Tianjin, 300051, China.
| | - Hao Zhang
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350, China. .,Graduate School, Tianjin Medical University, Tianjin, 300051, China.
| | - ZhiJing Ren
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350, China. .,Graduate School, Tianjin Medical University, Tianjin, 300051, China.
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18
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Curran J, Musa H, Kline CF, Makara MA, Little SC, Higgins JD, Hund TJ, Band H, Mohler PJ. Eps15 Homology Domain-containing Protein 3 Regulates Cardiac T-type Ca2+ Channel Targeting and Function in the Atria. J Biol Chem 2015; 290:12210-21. [PMID: 25825486 DOI: 10.1074/jbc.m115.646893] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Indexed: 11/06/2022] Open
Abstract
Proper trafficking of membrane-bound ion channels and transporters is requisite for normal cardiac function. Endosome-based protein trafficking of membrane-bound ion channels and transporters in the heart is poorly understood, particularly in vivo. In fact, for select cardiac cell types such as atrial myocytes, virtually nothing is known regarding endosomal transport. We previously linked the C-terminal Eps15 homology domain-containing protein 3 (EHD3) with endosome-based protein trafficking in ventricular cardiomyocytes. Here we sought to define the roles and membrane protein targets for EHD3 in atria. We identify the voltage-gated T-type Ca(2+) channels (CaV3.1, CaV3.2) as substrates for EHD3-dependent trafficking in atria. Mice selectively lacking EHD3 in heart display reduced expression and targeting of both Cav3.1 and CaV3.2 in the atria. Furthermore, functional experiments identify a significant loss of T-type-mediated Ca(2+) current in EHD3-deficient atrial myocytes. Moreover, EHD3 associates with both CaV3.1 and CaV3.2 in co-immunoprecipitation experiments. T-type Ca(2+) channel function is critical for proper electrical conduction through the atria. Consistent with these roles, EHD3-deficient mice demonstrate heart rate variability, sinus pause, and atrioventricular conduction block. In summary, our findings identify CaV3.1 and CaV3.2 as substrates for EHD3-dependent protein trafficking in heart, provide in vivo data on endosome-based trafficking pathways in atria, and implicate EHD3 as a key player in the regulation of atrial myocyte excitability and cardiac conduction.
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Affiliation(s)
- Jerry Curran
- From the Dorothy M. Davis Heart and Lung Research Institute, the Departments of Physiology and Cell Biology,
| | - Hassan Musa
- From the Dorothy M. Davis Heart and Lung Research Institute, the Departments of Physiology and Cell Biology
| | - Crystal F Kline
- From the Dorothy M. Davis Heart and Lung Research Institute, the Departments of Physiology and Cell Biology
| | - Michael A Makara
- From the Dorothy M. Davis Heart and Lung Research Institute, the Departments of Physiology and Cell Biology
| | - Sean C Little
- From the Dorothy M. Davis Heart and Lung Research Institute, the Departments of Physiology and Cell Biology
| | - John D Higgins
- From the Dorothy M. Davis Heart and Lung Research Institute, the Departments of Physiology and Cell Biology
| | - Thomas J Hund
- From the Dorothy M. Davis Heart and Lung Research Institute, Biomedical Engineering,The Ohio State University Wexner Medical Center, Columbus, Ohio 43210 and
| | - Hamid Band
- The Eppley Institute and UNMC-Eppley Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska 68198
| | - Peter J Mohler
- From the Dorothy M. Davis Heart and Lung Research Institute, the Departments of Physiology and Cell Biology, Medicine, and
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19
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Zhou M, Liao Y, Tu X. The role of transcription factors in atrial fibrillation. J Thorac Dis 2015; 7:152-8. [PMID: 25713730 DOI: 10.3978/j.issn.2072-1439.2015.01.21] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 12/09/2014] [Indexed: 12/21/2022]
Abstract
Atrial fibrillation (AF) is a complex disease that results from genetic and environmental factors and their interactions. In recent years, genome-wide association studies (GWAS) and family-based linkage analysis have found amounts of genetic variants associated with AF. Some of them lie in coding sequences and thus mediate the encoded proteins, some in non-coding regions and influence the expression of adjacent genes. These variants exert influence on the development of cardiovascular system and normal cardiac electrical activity in different levels, and eventually contribute to the occurrence of AF. Among these affected genes, as a crucial means of transcriptional regulation, several transcription factors play important roles in the pathogenesis of AF. In this review, we will focus on the potential role of PITX2, PRRX1, ZHFX3, TBX5, and NKX2.5 in AF.
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Affiliation(s)
- Mengchen Zhou
- 1 Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan 430074, China ; 2 Laboratory of Cardiovascular Immunology, Institute of Cardiology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430000, China
| | - Yuhua Liao
- 1 Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan 430074, China ; 2 Laboratory of Cardiovascular Immunology, Institute of Cardiology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430000, China
| | - Xin Tu
- 1 Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan 430074, China ; 2 Laboratory of Cardiovascular Immunology, Institute of Cardiology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430000, China
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20
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Yue JK, Pronger AM, Ferguson AR, Temkin NR, Sharma S, Rosand J, Sorani MD, McAllister TW, Barber J, Winkler EA, Burchard EG, Hu D, Lingsma HF, Cooper SR, Puccio AM, Okonkwo DO, Diaz-Arrastia R, Manley GT. Association of a common genetic variant within ANKK1 with six-month cognitive performance after traumatic brain injury. Neurogenetics 2015; 16:169-80. [PMID: 25633559 DOI: 10.1007/s10048-015-0437-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 01/02/2015] [Indexed: 01/18/2023]
Abstract
Genetic association analyses suggest that certain common single nucleotide polymorphisms (SNPs) may adversely impact recovery from traumatic brain injury (TBI). Delineating their causal relationship may aid in development of novel interventions and in identifying patients likely to respond to targeted therapies. We examined the influence of the (C/T) SNP rs1800497 of ANKK1 on post-TBI outcome using data from two prospective multicenter studies: the Citicoline Brain Injury Treatment (COBRIT) trial and Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot). We included patients with ANKK1 genotyping results and cognitive outcomes at six months post-TBI (n = 492: COBRIT n = 272, TRACK-TBI Pilot n = 220). Using the California Verbal Learning Test Second Edition (CVLT-II) Trial 1-5 Standard Score, we found a dose-dependent effect for the T allele, with T/T homozygotes scoring lowest on the CVLT-II Trial 1-5 Standard Score (T/T 45.1, C/T 51.1, C/C 52.1, ANOVA, p = 0.008). Post hoc testing with multiple comparison-correction indicated that T/T patients performed significantly worse than C/T and C/C patients. Similar effects were observed in a test of non-verbal processing (Wechsler Adult Intelligence Scale, Processing Speed Index). Our findings extend those of previous studies reporting a negative relationship of the ANKK1 T allele with cognitive performance after TBI. In this study, we demonstrate the value of pooling shared clinical, biomarker, and outcome variables from two large datasets applying the NIH TBI Common Data Elements. The results have implications for future multicenter investigations to further elucidate the role of ANKK1 in post-TBI outcome.
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Affiliation(s)
- John K Yue
- Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
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21
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Catheter Ablation of Atrial Fibrillation. J Am Coll Cardiol 2015; 65:196-206. [DOI: 10.1016/j.jacc.2014.10.034] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 10/12/2014] [Accepted: 10/21/2014] [Indexed: 11/24/2022]
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22
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Nishii K, Shibata Y, Kobayashi Y. Connexin mutant embryonic stem cells and human diseases. World J Stem Cells 2014; 6:571-578. [PMID: 25426253 PMCID: PMC4178256 DOI: 10.4252/wjsc.v6.i5.571] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 09/11/2014] [Accepted: 09/17/2014] [Indexed: 02/06/2023] Open
Abstract
Intercellular communication via gap junctions allows cells within multicellular organisms to share small molecules. The effect of such interactions has been elucidated using mouse gene knockout strategies. Although several mutations in human gap junction-encoding connexin (Cx) have been described, Cx mutants in mice do not always recapitulate the human disease. Among the 20 mouse Cxs, Cx26, Cx43, and Cx45 play roles in early cardiac or placental development, and disruption of the genes results in lethality that hampers further analyses. Embryonic stem cells (ESCs) that lack Cx43 or Cx45 have made analysis feasible in both in vitro differentiated cell cultures and in vivo chimeric tissues. The success of mouse ESCs studies is leading to the use of induced pluripotent stem cells to learn more about the pathogenesis of human Cx diseases. This review summarizes the current status of mouse Cx disruption models and ESC differentiation studies, and discusses their implication for understanding human Cx diseases.
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23
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Hsu LA, Yeh YH, Kuo CT, Chen YH, Chang GJ, Tsai FC, Chen WJ. Microsatellite polymorphism in the heme oxygenase-1 gene promoter and the risk of atrial fibrillation in Taiwanese. PLoS One 2014; 9:e108773. [PMID: 25268359 PMCID: PMC4182563 DOI: 10.1371/journal.pone.0108773] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 08/25/2014] [Indexed: 11/18/2022] Open
Abstract
Background Atrial fibrillation (AF) is associated with increased oxidative stress. Emerging evidence suggests that heme oxygenase-1 (HO-1) is a potent antioxidant system against various oxidative stress-related diseases. The human HO-1 promoter has a GT-repeat length polymorphism that can determine the level of gene transcription. Objective The aim of this study is to assess the role of the GT-repeat polymorphism in the promoter region of the HO-1 gene in Chinese-Taiwanese patients with AF. Methods and Results This study enrolled 200 AF patients and 240 controls, comparable for age and gender. In each subject, the length of GT-repeat polymorphism in the HO-1 promoter region was examined by polymerase chain reactions. The frequencies of long GT-repeat alleles (≧32) were significantly higher in AF patients than in controls. Multivariate analysis showed that the presence of long allele was significantly and independently associated with AF (odds ratio: 1.91, 95% CI 1.07–3.72; P = 0.028). Right atrial tissues from patients with chronic AF were investigated with immunoconfocal microscopy. Patients homozygous for shorter GT-repeat alleles exhibited greater HO-1 expression in their atria than those homozygous for longer alleles, which was reflected by less oxidative stress, myofibril degradation, and fibrosis in the atria of patients with shorter GT-repeat. In vitro, transient transfection assay in HL-1 atrial myocytes showed that the responsiveness of HO-1 transcriptional activity to tachypacing was inversely correlated with the length of the GT-repeats. Conclusion Our results suggest that the HO-1 microsatellite polymorphism may contribute to the genetic background of AF in Chinese-Taiwanese patients.
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Affiliation(s)
- Lung-An Hsu
- Cardiovascular Division, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Yung-Hsin Yeh
- Cardiovascular Division, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Chi-Tai Kuo
- Cardiovascular Division, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Ying-Hwa Chen
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, National Yang-Ming University College of Medicine, Taipei, Taiwan
- * E-mail: (YHC); (WJC)
| | - Gwo-Jyh Chang
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan, Taiwan
| | - Feng-Chun Tsai
- Division of Cardiac Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Wei-Jan Chen
- Cardiovascular Division, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
- * E-mail: (YHC); (WJC)
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24
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Liu Y, Ni B, Lin Y, Chen XG, Chen M, Hu Z, Zhang F. The rs3807989 G/A polymorphism in CAV1 is associated with the risk of atrial fibrillation in Chinese Han populations. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2014; 38:164-70. [PMID: 25196315 DOI: 10.1111/pace.12494] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 05/18/2014] [Accepted: 06/29/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND A recent meta-analysis of several genome-wide association studies identified six new susceptibility single nucleotide polymorphisms (SNPs) for atrial fibrillation (AF) in individuals of the European ancestry. We aimed to replicate the associations between these SNPs and the risk of AF in a Chinese Han population. METHODS We genotyped six SNPs (rs3903239 in PRRX1, rs3807989 in CAV1, rs10821415 in C9orf3, rs10824026 in SYNPO2L, rs1152591 in SYNE2, and rs7164883 in HCN4) using the middle-throughput iPLEX Sequenom MassARRAY platform. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in logistic regression models. RESULTS We enrolled a total of 1,593 Chinese Han origin individuals in the study, including 597 AF patients and 996 non-AF controls. Among the six SNPs analyzed in the study, the SNP rs3807989 in CAV1 on chromosome 7q31 was found to be significantly associated with a decreased risk of AF (crude OR = 0.76, 95% CI: 0.64-0.89, P = 0.001; adjusted OR = 0.75, 95% CI: 0.63-0.89, P = 0.001). There were no significant associations between the other five loci and AF risk. CONCLUSION Our results confirmed that CAV1 rs3807989 may contribute to a decreased AF risk in Chinese Han populations. However, further validation studies with different ethnic backgrounds and biological function analyses are warranted to confirm our finding.
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Affiliation(s)
- Yaowu Liu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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25
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Mutational Consequences of Aberrant Ion Channels in Neurological Disorders. J Membr Biol 2014; 247:1083-127. [DOI: 10.1007/s00232-014-9716-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 07/25/2014] [Indexed: 12/25/2022]
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26
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Yao M, Cao Y, Zhu H, Chen Y, Zhu T, Xiao J. Paired-like homeodomain 2: a novel therapeutic target for atrial fibrillation? Front Genet 2014; 5:74. [PMID: 24782888 PMCID: PMC3997000 DOI: 10.3389/fgene.2014.00074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 03/24/2014] [Indexed: 01/19/2023] Open
Affiliation(s)
- Mengchao Yao
- Regeneration Lab and Experimental Center of Life Sciences, School of Life Science, Shanghai University Shanghai, China ; Shanghai Key Laboratory of Bio-Energy Crops, School of Life Science, Shanghai University Shanghai, China
| | - Yujie Cao
- Regeneration Lab and Experimental Center of Life Sciences, School of Life Science, Shanghai University Shanghai, China ; Shanghai Key Laboratory of Bio-Energy Crops, School of Life Science, Shanghai University Shanghai, China
| | - Hui Zhu
- Regeneration Lab and Experimental Center of Life Sciences, School of Life Science, Shanghai University Shanghai, China ; Shanghai Key Laboratory of Bio-Energy Crops, School of Life Science, Shanghai University Shanghai, China
| | - Yao Chen
- Regeneration Lab and Experimental Center of Life Sciences, School of Life Science, Shanghai University Shanghai, China ; Shanghai Key Laboratory of Bio-Energy Crops, School of Life Science, Shanghai University Shanghai, China
| | - Tianhao Zhu
- Regeneration Lab and Experimental Center of Life Sciences, School of Life Science, Shanghai University Shanghai, China ; Shanghai Key Laboratory of Bio-Energy Crops, School of Life Science, Shanghai University Shanghai, China
| | - Junjie Xiao
- Regeneration Lab and Experimental Center of Life Sciences, School of Life Science, Shanghai University Shanghai, China ; Shanghai Key Laboratory of Bio-Energy Crops, School of Life Science, Shanghai University Shanghai, China ; Innovative Drug Research Center of Shanghai University Shanghai, China
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27
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Sun Y, Tong X, Chen H, Huang T, Shao Q, Huang W, Laird DW, Bai D. An atrial-fibrillation-linked connexin40 mutant is retained in the endoplasmic reticulum and impairs the function of atrial gap-junction channels. Dis Model Mech 2014; 7:561-9. [PMID: 24626989 PMCID: PMC4007407 DOI: 10.1242/dmm.013813] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 03/11/2014] [Indexed: 12/18/2022] Open
Abstract
Connexin40 (Cx40)-containing gap-junction channels are expressed in the atrial myocardium and provide a low-resistance passage for rapid impulse propagation. A germline mutation in the GJA5 gene, which encodes Cx40, resulting in a truncated Cx40 (Q49X) was identified in a large Chinese family with lone (idiopathic) atrial fibrillation (AF). This mutation co-segregated with seven AF probands in an autosomal-dominant way over generations. To test the hypothesis that this Cx40 mutant affects the distribution and function of atrial gap junctions, we studied the Q49X mutant in gap-junction-deficient HeLa and N2A cells. The Q49X mutant, unlike wild-type Cx40, was typically localized in the cytoplasm and failed to form gap-junction plaques at cell-cell interfaces. When the Q49X mutant was co-expressed with Cx40 or Cx43, the mutant substantially reduced the gap-junction plaque formation of Cx40 and Cx43. Electrophysiological studies revealed no electrical coupling of cell pairs expressing the mutant alone and a significant decrease in the coupling conductance when the mutant was co-expressed with Cx40 or Cx43. Further colocalization experiments with the organelle residential proteins indicate that Q49X was retained in the endoplasmic reticulum. These findings provide evidence that the Q49X mutant is capable of impairing gap-junction distribution and function of key atrial connexins, which might play a role in the predisposition to and onset of AF.
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Affiliation(s)
- Yiguo Sun
- Department of Physiology and Pharmacology, The University of Western Ontario, London, ON N6A 5C1, Canada
| | - Xiaoling Tong
- Department of Physiology and Pharmacology, The University of Western Ontario, London, ON N6A 5C1, Canada
| | - Honghong Chen
- Department of Physiology and Pharmacology, The University of Western Ontario, London, ON N6A 5C1, Canada
| | - Tao Huang
- Anatomy and Cell Biology, The University of Western Ontario, London, ON N6A 5C1, Canada
| | - Qing Shao
- Anatomy and Cell Biology, The University of Western Ontario, London, ON N6A 5C1, Canada
| | - Weixiong Huang
- Department of Physiology and Pharmacology, The University of Western Ontario, London, ON N6A 5C1, Canada
| | - Dale W. Laird
- Department of Physiology and Pharmacology, The University of Western Ontario, London, ON N6A 5C1, Canada
- Anatomy and Cell Biology, The University of Western Ontario, London, ON N6A 5C1, Canada
| | - Donglin Bai
- Department of Physiology and Pharmacology, The University of Western Ontario, London, ON N6A 5C1, Canada
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Nair GM, Nery PB, Redpath CJ, Birnie DH. The Role Of Renin Angiotensin System In Atrial Fibrillation. J Atr Fibrillation 2014; 6:972. [PMID: 27957054 DOI: 10.4022/jafib.972] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 02/26/2014] [Accepted: 02/28/2014] [Indexed: 01/23/2023]
Abstract
Atrial fibrillation (AF) is the most prevalent arrhythmia and its incidence is on the rise. AF causes significant morbidity and mortality leading to rising AF-related health care costs. There is experimental and clinical evidence from animal and human studies that suggests a role for the renin angiotensin system (RAS) in the etiopathogenesis of AF. This review appraises the current understanding of RAS antagonism, using angiotensin converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB) and aldosterone antagonists (AA), for prevention of AF. RAS antagonism has proven to be effective for primary and secondary prevention of AF in subjects with heart failure and left ventricular (LV) dysfunction.However, most of the evidence for the protective effect of RAS antagonism is from clinical trials that had AF as a secondary outcome or from unspecified post-hoc analyses. The evidence for prevention in subjects without heart failure and with normal LV function is not as clear. RAS antagonism, in the absence of concomitant antiarrhythmic therapy, was not shown to reduce post cardioversion AF recurrences. RAS antagonism in subjects undergoing catheter ablation has also been ineffective in preventing AF recurrences.
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Affiliation(s)
- Girish M Nair
- Arrhythmia Service, Division of Cardiology University of Ottawa Heart Institute 40 Ruskin Ave, Ottawa Canada - K1Y 4W7
| | - Pablo B Nery
- Arrhythmia Service, Division of Cardiology University of Ottawa Heart Institute 40 Ruskin Ave, Ottawa Canada - K1Y 4W7
| | - Calum J Redpath
- Arrhythmia Service, Division of Cardiology University of Ottawa Heart Institute 40 Ruskin Ave, Ottawa Canada - K1Y 4W7
| | - David H Birnie
- Arrhythmia Service, Division of Cardiology University of Ottawa Heart Institute 40 Ruskin Ave, Ottawa Canada - K1Y 4W7
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29
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Francia P, Ricotta A, Frattari A, Stanzione R, Modestino A, Mercanti F, Adduci C, Sensini I, Cotugno M, Balla C, Rubattu S, Volpe M. Atrial natriuretic Peptide single nucleotide polymorphisms in patients with nonfamilial structural atrial fibrillation. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2013; 7:153-9. [PMID: 24093000 PMCID: PMC3782394 DOI: 10.4137/cmc.s12239] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Atrial natriuretic peptide (ANP) has antihypertrophic and antifibrotic properties that are relevant to AF substrates. The –G664C and rs5065 ANP single nucleotide polymorphisms (SNP) have been described in association with clinical phenotypes, including hypertension and left ventricular hypertrophy. A recent study assessed the association of early AF and rs5065 SNPs in low-risk subjects. In a Caucasian population with moderate-to-high cardiovascular risk profile and structural AF, we conducted a case-control study to assess whether the ANP –G664C and rs5065 SNP associate with nonfamilial structural AF. Methods 168 patients with nonfamilial structural AF and 168 age- and sex-matched controls were recruited. The rs5065 and –G664C ANP SNPs were genotyped. Results The study population had a moderate-to-high cardiovascular risk profile with 86% having hypertension, 23% diabetes, 26% previous myocardial infarction, and 23% left ventricular systolic dysfunction. Patients with AF had greater left atrial diameter (44 ± 7 vs. 39 ± 5 mm; P < 0.001) and higher plasma NTproANP levels (6240 ± 5317 vs. 3649 ± 2946 pmol/mL; P < 0.01). Odds ratios (ORs) for rs5065 and –G664C gene variants were 1.1 (95% confidence interval [CI], 0.7–1.8; P = 0.71) and 1.2 (95% CI, 0.3–3.2; P = 0.79), respectively, indicating no association with AF. There were no differences in baseline clinical characteristics among carriers and noncarriers of the –664C and rs5065 minor allele variants. Conclusions We report lack of association between the rs5065 and –G664C ANP gene SNPs and AF in a Caucasian population of patients with structural AF. Further studies will clarify whether these or other ANP gene variants affect the risk of different subphenotypes of AF driven by distinct pathophysiological mechanisms.
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Affiliation(s)
- Pietro Francia
- Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy
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30
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Dewhurst MJ, Di Marco LY, Dewhurst F, Adams PC, Murray A, Orega GP, Mwita JC, Walker RW, Langley P. Electrocardiographic reference values for a population of older adults in sub-Saharan Africa. Ann Noninvasive Electrocardiol 2013; 19:34-42. [PMID: 24460804 DOI: 10.1111/anec.12078] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVES Older adults in sub-Saharan Africa (SSA) are at greatest risk of an impending noncommunicable diseases epidemic, of which cardiac disease is the most prevalent contributor. Thus, it is essential to establish electrocardiographic reference values for a population that is likely to differ genetically and environmentally from others where reference values are established. METHODS Two thousand two hundred thirty-two apparently healthy community-based participants without known cardiac disease aged 70+ in rural Tanzania underwent 12-lead electrocardiography. Electrocardiograms were digitally analyzed and gender-specific reference values for P duration (PD), P amplitude (PAMP), P area (PAREA), P terminal negative force (V1) (PTNF), PR interval, QRS duration (QRSD), QT/QTc, R amplitude (II, V5) (RAMP) LVH index (LVHI), R axis and R/S ratio (V1) reported, following univariate analysis of covariance using a multiple linear regression model, adjusting for age, systolic blood pressure (SBP), body mass index (BMI), and RR interval. RESULTS Data from 1824 subjects were suitable for analysis. Adjusted mean values for men/women were: PD 115/110 ms, PAMP (avg) 123/114 μV, PAMP (II) 203/190 μV, PAREA (avg) 5.3/4.6 mV*s, PAREA (II) 9.3/8.1 mV*s, PTNF 1.7/1.4 mV*s, PR 158/152 ms, QRSD 89/84 ms, QT 370/375 ms, QTc 421/427 ms, RAMP (II) 805/854 μV, (V5) 2022/1742 μV, LVHI 3.0/2.8 mV (Sokolow-Lyon), 1.293/1.146 mV (Cornell), R axis 51/49°, R/S 0.2/0.2. Excluding PTNF , R axis and R/S ratio, all gender differences were significant (P < 0.001 apart from LVHI [Sokolow-Lyon; P < 0.005)] and RAMP (II) [P < 0.05]) following adjustment for age, SBP, BMI, and RR interval. CONCLUSIONS Our description of comprehensive electrocardiographic parameters establishes reference values in this genetically and environmentally diverse SSA population thereby allowing identification of "outliers" with potential cardiac disease.
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Affiliation(s)
- Matthew J Dewhurst
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
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Ki CS, Jung CL, Kim HJ, Baek KH, Park SJ, On YK, Kim KS, Noh SJ, Youm JB, Kim JS, Cho H. A KCNQ1 mutation causes age-dependant bradycardia and persistent atrial fibrillation. Pflugers Arch 2013; 466:529-40. [PMID: 23989646 DOI: 10.1007/s00424-013-1337-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/13/2013] [Accepted: 08/13/2013] [Indexed: 01/06/2023]
Abstract
Atrial fibrillation (AF) is the most common arrhythmia. Gain-of-function mutations in KCNQ1, the pore-forming α-subunit of the slow delayed rectifier K current (IKs) channel, have been associated with AF. The purpose of this study was functional assessment of a mutation in KCNQ1 identified in a family with persistent AF and sinus bradycardia. We investigated whether this KCNQ1 missense mutation could form the genetic basis for AF and bradycardia simultaneously in this family. Sanger sequencing in a family with hereditary persistent AF identified a novel KCNQ1 variant (V241F) in a highly conserved region of S4 domain. The proband and her son developed bradycardia and persistent AF in an age-dependent fashion. The other son was a mutation carrier but he showed sinus bradycardia and not AF. Whole-cell patch clamp electrophysiology showed that V241F mutation in KCNQ1 shifted the activation curve to the left and dramatically slowed deactivation, leading to a constitutively open-like phenotype. Computer modeling showed that V241F would slow pacemaker activity. Also, simulations of atrial excitation predicted that V241F results in extreme shortening of action potential duration, possibly resulting in AF. Our study indicates that V241F might cause sinus bradycardia by increasing IKs. Additionally, V241F likely shortens atrial refractoriness to promote a substrate for reentry. KCNQ1 mutations have previously been described in AF, yet this is the first time a mutation in KCNQ1 is associated with age-dependent bradycardia and persistent AF. This finding further supports the hypothesis that sinus node dysfunction contributes to the development of AF.
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Affiliation(s)
- Chang-Seok Ki
- Departments of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Mihaescu R, Pencina MJ, Alonso A, Lunetta KL, Heckbert SR, Benjamin EJ, Janssens ACJW. Incremental value of rare genetic variants for the prediction of multifactorial diseases. Genome Med 2013; 5:76. [PMID: 23961719 PMCID: PMC3971349 DOI: 10.1186/gm480] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 08/03/2013] [Accepted: 08/20/2013] [Indexed: 12/26/2022] Open
Abstract
Background It is often assumed that rare genetic variants will improve available risk prediction scores. We aimed to estimate the added predictive ability of rare variants for risk prediction of common diseases in hypothetical scenarios. Methods In simulated data, we constructed risk models with an area under the ROC curve (AUC) ranging between 0.50 and 0.95, to which we added a single variant representing the cumulative frequency and effect (odds ratio, OR) of multiple rare variants. The frequency of the rare variant ranged between 0.0001 and 0.01 and the OR between 2 and 10. We assessed the resulting AUC, increment in AUC, integrated discrimination improvement (IDI), net reclassification improvement (NRI(>0.01)) and categorical NRI. The analyses were illustrated by a simulation of atrial fibrillation risk prediction based on a published clinical risk model. Results We observed minimal improvement in AUC with the addition of rare variants. All measures increased with the frequency and OR of the variant, but maximum increment in AUC remained below 0.05. Increment in AUC and NRI(>0.01) decreased with higher AUC of the baseline model, whereas IDI remained constant. In the atrial fibrillation example, the maximum increment in AUC was 0.02 for a variant with frequency = 0.01 and OR = 10. IDI and NRI showed at most minimal increase for variants with frequency greater than or equal to 0.005 and OR greater than or equal to 5. Conclusions Since rare variants are present in only a minority of affected individuals, their predictive ability is generally low at the population level. To improve the predictive ability of clinical risk models for complex diseases, genetic variants must be common and have substantial effect on disease risk.
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Affiliation(s)
- Raluca Mihaescu
- Department of Epidemiology, Erasmus University Medical Center, Dr. Molewaterplein 50, Rotterdam, 3000 CA, The Netherlands
| | - Michael J Pencina
- Department of Biostatistics, Boston University, 801 Massachusetts Avenue, Boston, MA 02118, USA ; Harvard Clinical Research Institute, 930-W Commonwealth Avenue, Boston, MA 02215-1212, USA
| | - Alvaro Alonso
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. Second Street, Minneapolis, MN 55454-1015, USA
| | - Kathryn L Lunetta
- Department of Biostatistics, Boston University, 801 Massachusetts Avenue, Boston, MA 02118, USA ; The National Heart, Lung, and Blood Institute's Framingham Heart Study, 73 Mt. Wayte Avenue, Framingham, MA 01702-5827, USA
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, 1959 NE Pacific Street, Seattle, WA 98195-7236, USA
| | - Emelia J Benjamin
- The National Heart, Lung, and Blood Institute's Framingham Heart Study, 73 Mt. Wayte Avenue, Framingham, MA 01702-5827, USA ; Cardiology and Preventive Medicine Section, Boston University School of Medicine, Boston, 715 Albany Street, MA 02118, USA ; Department of Epidemiology, Boston University School of Public Health, Boston, 715 Albany Street, MA 02118, USA
| | - A Cecile J W Janssens
- Department of Epidemiology, Erasmus University Medical Center, Dr. Molewaterplein 50, Rotterdam, 3000 CA, The Netherlands ; Emory University, Rollins School of Public Health, 1518 Clifton Road, Atlanta, GA 30322 USA
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Chang SH, Chang SN, Hwang JJ, Chiang FT, Tseng CD, Lee JK, Lai LP, Lin JL, Wu CK, Tsai CT. Significant Association of rs13376333 in KCNN3 on Chromosome 1q21 With Atrial Fibrillation in a Taiwanese Population. Circ J 2012; 76:184-8. [DOI: 10.1253/circj.cj-11-0525] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shu-Hsuan Chang
- Division of Cardiology, Department of Internal Medicine, Lotung Poh-Ai Hospital
| | - Sheng-Nan Chang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital
| | - Juey-Jen Hwang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital
| | - Fu-Tien Chiang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital
- Department of Laboratory Medicine, National Taiwan University Hospital
| | - Chuen-Den Tseng
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital
| | - Jen-Kuang Lee
- Department of Laboratory Medicine, National Taiwan University Hospital
| | - Ling-Ping Lai
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital
- Institute of Pharmacology, National Taiwan University
| | - Jiunn-Lee Lin
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital
| | - Cho-Kai Wu
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital
| | - Chia-Ti Tsai
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital
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Xiao J, Liang D, Chen YH. The genetics of atrial fibrillation: from the bench to the bedside. Annu Rev Genomics Hum Genet 2011; 12:73-96. [PMID: 21682648 DOI: 10.1146/annurev-genom-082410-101515] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Atrial fibrillation (AF) has become a growing global epidemic and a financial burden for society. The past 10 years have seen significant advances in our understanding of the genetic aspects of AF: At least 2 chromosomal loci and 17 causal genes have been identified in familial AF, and an additional 7 common variants and single-nucleotide polymorphisms in 11 different genes have been indicated in nonfamilial AF. However, the current management strategies for AF are suboptimal. The integration of genetic information into clinical practice may aid the early identification of AF patients who are at risk as well as the characterization of molecular pathways that culminate in AF, with the eventual result of better treatment. Never before has such an opportunity arisen to advance our understanding of the biology of AF through the translation of genetics findings from the bench to the bedside.
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Affiliation(s)
- Junjie Xiao
- Key Laboratory of Arrhythmias, Ministry of Education, and Department of Cardiology, East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
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Wang K, Terrenoire C, Sampson KJ, Iyer V, Osteen JD, Lu J, Keller G, Kotton DN, Kass RS. Biophysical properties of slow potassium channels in human embryonic stem cell derived cardiomyocytes implicate subunit stoichiometry. J Physiol 2011; 589:6093-104. [PMID: 22025662 DOI: 10.1113/jphysiol.2011.220863] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Human embryonic stem cells (hESCs) are an important cellular model for studying ion channel function in the context of a human cardiac cell and will provide a wealth of information about both heritable arrhythmias and acquired electrophysiological disorders. However, detailed electrophysiological characterization of the important cardiac ion channels has been so far overlooked. Because mutations in the gene for the I(Ks) α subunit, KCNQ1, constitute the majority of long QT syndrome (LQT-1) cases, we have carried out a detailed biophysical analysis of this channel expressed in hESCs to establish baseline I(Ks) channel biophysical properties in cardiac myocytes derived from hESCs (hESC-CMs). I(Ks) channels are heteromultimeric proteins consisting of four identical α-subunits (KCNQ1) assembled with auxiliary β-subunits (KCNE1). We found that the half-maximal I(Ks) activation voltage in hESC-CMs and in myocytes derived from human induced pluripotent stems cells (hiPSC-CMs) falls between that of KCNQ1 channels expressed alone and with full complement of KCNE1, the major KCNE subunit expressed in hESC-CMs as shown by qPCR analysis. Overexpression of KCNE1 by transfection of hESC-CMs markedly shifted and slowed native I(Ks) activation implying assembly of additional KCNE1 subunits with endogenous channels. Our results in hESC-CMs, which indicate an I(Ks) subunit stoichiometry that can be altered by variable KCNE1 expression, suggest the possibility for variable I(Ks) function in the developing heart, in different tissues in the heart, and in disease. This establishes a new baseline for I(Ks) channel properties in myocytes derived from pluripotent stem cells and will guide future studies in patient-specific hiPSCs.
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Affiliation(s)
- Kai Wang
- Department of Pharmacology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY 10032, USA
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Palmer BR, Frampton CM, Skelton L, Yandle TG, Doughty RN, Whalley GA, Ellis CJ, Troughton RW, Richards AM, Cameron VA. KCNE5 polymorphism rs697829 is associated with QT interval and survival in acute coronary syndromes patients. J Cardiovasc Electrophysiol 2011; 23:319-24. [PMID: 21985337 DOI: 10.1111/j.1540-8167.2011.02192.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The KCNE family is a group of small transmembrane channel proteins involved in potassium ion (K(+)) conductance. The X-linked KCNE5 gene encodes a regulator of the K(+) current mediated by the potassium channel KCNQ1. Polymorphisms in KCNE5 have been associated with altered cardiac electrophysiological properties in human studies. We investigated associations of the common rs697829 polymorphism from KCNE5 with baseline characteristics, baseline electrocardiographic (ECG) measurements, and patient survival in a cohort of post-acute coronary syndromes (ACS) patients (the Coronary Disease Cohort Study cohort). METHODS AND RESULTS DNA samples (n = 1,740) were genotyped for rs697829 using a TaqMan assay. Baseline ECG data revealed corrected QT (QTc) interval was associated with rs697829 in male, but not female, patients, being extended in the G genotype group (A 416 ± 1.71; G 431 ± 4.25 ms, P = 0.002). Covariate-adjusted survival was poorest in G genotype patients in Cox proportional hazard modeling of mortality data of males (P(overall) = 0.020). Male patients with G genotype had a hazard ratio of 1.44 (1.11-2.33) for death when compared to the A genotype male patients (P = 0.048) after adjustment for age, baseline log-transformed N-terminal pro-B-type natriuretic peptide (NTproBNP), β-blocker and insulin treatment, QTc interval, history of myocardial infarction, and physical activity score. CONCLUSION This study suggests an association between rs697829, a common single nucleotide polymorphism (SNP) from KCNE5, and ECG measurements and survival in postacute ACS patients. Prolonged subclinical QT interval may be a marker of adverse outcome in this group of patients.
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Affiliation(s)
- Barry R Palmer
- Christchurch Cardioendocrine Research Group, Department of Medicine, University of Otago, Christchurch, New Zealand.
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Sivapalaratnam S, Motazacker MM, Maiwald S, Hovingh GK, Kastelein JJP, Levi M, Trip MD, Dallinga-Thie GM. Genome-wide association studies in atherosclerosis. Curr Atheroscler Rep 2011; 13:225-32. [PMID: 21369780 PMCID: PMC3085784 DOI: 10.1007/s11883-011-0173-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardiovascular disease remains the major cause of worldwide morbidity and mortality. Its pathophysiology is complex and multifactorial. Because the phenotype of cardiovascular disease often shows a marked heritable pattern, it is likely that genetic factors play an important role. In recent years, large genome-wide association studies have been conducted to decipher the molecular mechanisms underlying this heritable and prevalent phenotype. The emphasis of this review is on the recently identified 17 susceptibility loci for coronary artery disease. Implications of their discovery for biology and clinical medicine are discussed. A description of the landscape of human genetics in the near future in the context of next-generation sequence technologies is provided at the conclusion of this review.
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Affiliation(s)
- S Sivapalaratnam
- Department of Vascular Medicine, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
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Atrial fibrillation and heart failure parallels: lessons for atrial fibrillation prevention. Crit Pathw Cardiol 2011; 10:46-51. [PMID: 21562376 DOI: 10.1097/hpc.0b013e31820e1a4b] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Heart failure (HF) and atrial fibrillation (AF) are 2 of the most common cardiovascular diseases encountered in clinical practice, and the prevalence of these diseases continues to grow worldwide with the aging of the global population. While recognizing that AF is a heterogeneous disorder, we submit that the parallels between AF and HF may arise because many cases of AF and HF result from the cumulative exposure of the atria and ventricles to a common set of systemic cardiovascular risk factors. Over time, exposure to risk factors promotes development of atrial and ventricular structural and functional abnormalities through activation of several biologic pathways in concert: upregulation of neurohormonal signaling cascades, release of inflammatory mediators, programmed cell death, and fibrosis. Cardiac structural remodeling occurs in concert with electrophysiologic remodeling, both of which contribute to atrial and ventricular rhythm disturbances, including AF. AF and HF, instead of representing distinct disease processes, often represent different endpoints along a disease continuum. By reviewing some of the mechanistic parallels between AF and HF, we hope to emphasize the connection between established cardiovascular risk factors, cardiac remodeling and AF, with a view to promote strategies for AF prevention.
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Sun X, Yang J, Hou X, Li J, Shi Y, Jing Y. Relationship between -344T/C polymorphism in the aldosterone synthase gene and atrial fibrillation in patients with essential hypertension. J Renin Angiotensin Aldosterone Syst 2011; 12:557-63. [PMID: 21846681 DOI: 10.1177/1470320311417654] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Aldosterone plays an important role in the pathogenesis of non-familial atrial fibrillation (AF). We tested the hypothesis that the -344T/C polymorphism in the aldosterone synthase gene may be associated with non-familial AF in Chinese patients with hypertension. MATERIALS AND METHODS We performed a 1:1 paired case-control study in 310 cases of hypertension with AF and same number matched controls. The -344T/C polymorphism was determined with polymerase chain reaction-restriction fragment length polymorphism. RESULTS The distribution of the CYP11B2 genotypes (TT, TC and CC) was 41.9%, 50.6%, and 7.4% in AF patients, which was not different from controls (48.4%, 44.5%, and 7.1%, χ(2) = 2.675, p = 0.263). The difference between the C allele (32.3% vs. 29.4%) was also not significant between two groups (χ(2) = 1.661, p = 0.197). Logistic regression analysis showed that LAD and LVEDD (both p < 0.001), rather than the C allele of the CYP11B2 gene (p= 0.107) were significant predictors for AF. The LAD of C allele carriers is significantly larger than that of non-C allele carriers (p = 0.009). CONCLUSIONS Our results indicate that the -344T/C polymorphism in the aldostrone synthase gene is not associated with AF but it might be associated with atrial remodelling in hypertensives.
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Affiliation(s)
- Xiaojian Sun
- Department of Cardiology, Yuhuangding Hospital, Yantai, China
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Miyagawa S, Sakaguchi T, Nishi H, Yoshikawa Y, Fukushima S, Saito S, Sawa Y. Recent clinical and experimental advances in atrial fibrillation. ISRN CARDIOLOGY 2011; 2011:958189. [PMID: 22347664 PMCID: PMC3262506 DOI: 10.5402/2011/958189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 05/13/2011] [Indexed: 12/03/2022]
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in clinical settings (Fuster et al., 2001), and it is often associated with congestive heart diseases (Issac et al., 2007). Many studies in both laboratory and clinical settings have sought to analyze the mechanisms of AF, develop treatments based on these mechanisms, and examine atrial remodeling in chronic AF. The aim of this paper is to analyze recent findings regarding the atrial remodeling that occurs in AF. In particular, we will describe the electrical and structural changes that involve atrial myocytes and the extracellular matrix. We will also describe the general classification and basic pathophysiology of AF and its surgical treatments.
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Affiliation(s)
- Shigeru Miyagawa
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan
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Assessment of association of rs2200733 on chromosome 4q25 with atrial fibrillation and ischemic stroke in a Chinese Han population. Hum Genet 2011; 126:843-9. [PMID: 19707791 DOI: 10.1007/s00439-009-0737-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 08/16/2009] [Indexed: 01/19/2023]
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in the clinical setting and an independent risk factor for stroke. Approximately 10 million Chinese people are affected by AF, but the genetic basis is largely unknown. A recent genome-wide association study in Iceland identified association between SNP rs2200733 on 4q25 and AF; however, many independent replication studies are essential to unequivocally validate this association. To assess the association between rs2200733 and AF as well as that between rs2200733 and ischemic stroke in a mainland Chinese Han population, we carried out case-control association studies with 383 AF patients versus 851 non-AF controls and 811 ischemic stroke patients versus 688 non-stroke controls. Highly significant association was detected between rs2200733 and AF in a Chinese Han population (allelic P = 3.7 × 10(-11) with OR = 1.81; genotypic P = 4.1 × 10(-12) with a dominant model). When the AF cases were divided into lone AF (32.6%) and other types of AF (67.4%), significantly stronger association was found with lone AF (OR = 2.40, P = 1.3 × 10(-9) compared to OR = 1.59, P = 6.2 × 10(-7) for other types of AF; P = 0.02 for two ORs). No significant association was found between rs2200733 and ischemic stroke. Our results suggest that SNP rs2200733 confers a highly significant risk of AF, but not ischemic stroke, in a more representative Chinese Han population in the mainland China.
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Kirchhof P, Kahr PC, Kaese S, Piccini I, Vokshi I, Scheld HH, Rotering H, Fortmueller L, Laakmann S, Verheule S, Schotten U, Fabritz L, Brown NA. PITX2c is expressed in the adult left atrium, and reducing Pitx2c expression promotes atrial fibrillation inducibility and complex changes in gene expression. CIRCULATION. CARDIOVASCULAR GENETICS 2011; 4:123-33. [PMID: 21282332 DOI: 10.1161/circgenetics.110.958058] [Citation(s) in RCA: 212] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Intergenic variations on chromosome 4q25, close to the PITX2 transcription factor gene, are associated with atrial fibrillation (AF). We therefore tested whether adult hearts express PITX2 and whether variation in expression affects cardiac function. METHODS AND RESULTS mRNA for PITX2 isoform c was expressed in left atria of human and mouse, with levels in right atrium and left and right ventricles being 100-fold lower. In mice heterozygous for Pitx2c (Pitx2c(+/-)), left atrial Pitx2c expression was 60% of wild-type and cardiac morphology and function were not altered, except for slightly elevated pulmonary flow velocity. Isolated Pitx2c(+/-) hearts were susceptible to AF during programmed stimulation. At short paced cycle lengths, atrial action potential durations were shorter in Pitx2c(+/-) than in wild-type. Perfusion with the β-receptor agonist orciprenaline abolished inducibility of AF and reduced the effect on action potential duration. Spontaneous heart rates, atrial conduction velocities, and activation patterns were not affected in Pitx2c(+/-) hearts, suggesting that action potential duration shortening caused wave length reduction and inducibility of AF. Expression array analyses comparing Pitx2c(+/-) with wild-type, for left atrial and right atrial tissue separately, identified genes related to calcium ion binding, gap and tight junctions, ion channels, and melanogenesis as being affected by the reduced expression of Pitx2c. CONCLUSIONS These findings demonstrate a physiological role for PITX2 in the adult heart and support the hypothesis that dysregulation of PITX2 expression can be responsible for susceptibility to AF.
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Affiliation(s)
- Paulus Kirchhof
- Department of Cardiology and Angiology, University Hospital Muenster, Germany
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Zografos T, Katritsis DG. Inhibition of the renin-angiotensin system for prevention of atrial fibrillation. Pacing Clin Electrophysiol 2011; 33:1270-85. [PMID: 20636314 DOI: 10.1111/j.1540-8159.2010.02832.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Atrial fibrillation (AF) is a source of considerable morbidity and mortality. There has been compelling evidence supporting the role of renin-angiotensin system (RAS) in the genesis and perpetuation of AF through atrial remodeling, and experimental studies have validated the utilization of RAS inhibition for AF prevention. This article reviews clinical trials on the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) for the prevention of AF. Results have been variable, depending on the clinical background of treated patients. ACEIs and ARBs appear beneficial for primary prevention of AF in patients with heart failure, whereas they are not equally effective in hypertensive patients with normal left ventricular function. Furthermore, the use of ACEIs or ARBs for secondary prevention of AF has been found beneficial only after electrical cardioversion. Additional data are needed to establish the potential clinical role of renin-angiotensin inhibition for prevention of AF.
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Affiliation(s)
- Theodoros Zografos
- Department of Cardiology, Athens Euroclinic, 9 Athanassiadou Street, Athens, Greece
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Ferrero-Miliani L, Holst AG, Pehrson S, Morling N, Bundgaard H. Strategy for clinical evaluation and screening of sudden cardiac death relatives. Fundam Clin Pharmacol 2011; 24:619-35. [PMID: 20698891 DOI: 10.1111/j.1472-8206.2010.00864.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Sudden cardiac death (SCD) may be the first and final manifestation of several heart diseases. In the young, SCD is often caused by a hereditary cardiac disease. As the most frequently seen inherited cardiac diseases have an autosomal-dominant pattern of inheritance, half of the first-degree relatives are at risk of having or developing the same disease. Therefore, screening of these high-risk relatives is a rational approach to reduce the incidence of SCD. To offer family screening and counseling, the cause of death should be carefully established. Autopsy is only performed in a limited number of cases. We advocate for systematic autopsies in SCD, because positive findings are crucial for choosing the optimal screening program for the relatives. A negative autopsy makes identification of at-risk population difficult. However, this finding also provides clues to the cardiologist, because a limited number of inherited cardiac diseases associated with SCD are without any structural changes. In other cases, the autopsy may reveal noncardiac causes of death, which is also important for reassuring the relatives. However, in cases with no autopsy or negative findings, thorough clinical examinations and selective genetic screening of relatives may identify a likely diagnosis in more than 50% of affected families. There is a need for consensus regarding routine evaluation of SCD cases and the ethical and legal framework related to postmortem testing. We propose an algorithm that narrows the diagnostic possibilities in apparently healthy relatives of young SCD victims. Molecular autopsy may play an important role.
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Affiliation(s)
- Laura Ferrero-Miliani
- Section of Forensic Genetics, Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen, Frederik V's Vej 11, DK-2100 Copenhagen, Denmark.
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Lack of replication in polymorphisms reported to be associated with atrial fibrillation. Heart Rhythm 2010; 8:403-9. [PMID: 21056700 DOI: 10.1016/j.hrthm.2010.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 11/01/2010] [Indexed: 01/08/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common sustained arrhythmia and has a substantial heritable component. Numerous associations between single nucleotide polymorphisms (SNPs) and AF have been described, but few have been replicated. OBJECTIVE We sought to systematically replicate SNPs that are reported to be associated with AF in two large study samples of European descent. METHODS We searched PubMed for studies reporting associations between SNPs and AF published before July 1, 2007. SNPs were genotyped in two independent case-control samples from Germany and the United States. Associations between SNPs and AF were assessed using logistic regression models adjusting for age, sex, and hypertension. A meta-analysis of the results from the two studies was performed. RESULTS We identified 21 SNPs and the angiotensin-converting enzyme insertion/deletion polymorphism that were reported to be associated with AF in the literature. Nine of these genetic variants were not represented on common genome-wide SNP arrays. We successfully genotyped 21 of these 22 variants in 2,145 cases with AF from the German Competence Network for Atrial Fibrillation and 4,073 controls from the KORA S4 study and 16 variants in 790 cases and 1,330 controls from the Massachusetts General Hospital. None of the SNPs replicated in independent populations with AF. CONCLUSION Our results suggest that previously reported associations to AF were likely false positives and highlight the need for systematic replication of genetic associations in large, independent cohorts to accurately detect variants associated with disease.
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Lubitz SA, Ozcan C, Magnani JW, Kääb S, Benjamin EJ, Ellinor PT. Genetics of atrial fibrillation: implications for future research directions and personalized medicine. Circ Arrhythm Electrophysiol 2010; 3:291-9. [PMID: 20551423 DOI: 10.1161/circep.110.942441] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Steven A Lubitz
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
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Liao JK. Rac1 and connective tissue growth factor. The missing link between atrial remodeling and the pathogenesis of atrial fibrillation? J Am Coll Cardiol 2010; 55:481-2. [PMID: 20117463 DOI: 10.1016/j.jacc.2009.07.071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 07/27/2009] [Indexed: 12/20/2022]
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Wehrens XHT, Ather S, Dobrev D. Role of abnormal sarcoplasmic reticulum function in atrial fibrillation. ACTA ACUST UNITED AC 2010. [DOI: 10.2217/thy.10.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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