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Pierre M, Djemai M, Pouliot V, Poulin H, Gollob MH, Chahine M. Exploring SCN5A Variants Associated with Atrial Fibrillation in Atrial Cardiomyocytes Derived from hiPSCs: A Characterization Study. Heart Rhythm 2024:S1547-5271(24)03303-4. [PMID: 39260661 DOI: 10.1016/j.hrthm.2024.09.013] [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: 01/18/2024] [Revised: 08/29/2024] [Accepted: 09/04/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Atrial fibrillation (AF) poses a major risk for heart failure, myocardial infarction, and stroke. Several studies have linked SCN5A variants to AF, but their precise mechanistic contribution remains unclear. Human induced pluripotent stem cells (hiPSCs) provide a promising platform for modeling SCN5A-linked AF variants and their functional alterations. OBJECTIVE The purpose of this study was to assess the electrophysiological impact of three AF-linked SCN5A variants, K1493R, M1875T and N1986K identified in three unrelated individuals. METHODS CRISPR-Cas9 was used to generate a new hiPSC line in which NaV1.5 was knocked-out. Following differentiation into specific atrial cardiomyocyte by using retinoic acid, the adult WT and SCN5A variants were introduced into the NaV1.5 KO line through transfection. Subsequent analysis including molecular biology, optical mapping, and electrophysiology were performed. RESULTS The absence of NaV1.5 channels altered the expression of key cardiac genes. NaV1.5 KO hiPSC-aCMs displayed slower conduction velocities, altered action potential (AP) parameters, and impaired calcium transient propagation. The transfection of the WT channel restored sodium current density and AP characteristics. Among the AF variants, one induced a loss-of-function (N1986K) while the other two induced a gain-of-function in NaV1.5 channel activity. Cellular excitability alterations, and early afterdepolarizations were observed in AF variants. CONCLUSION Our findings suggest that distinct alterations in NaV1.5 channel properties may trigger atrial hyperexcitability and arrhythmogenic activity in AF. Our KO model offers an innovative approach for investigating SCN5A variants in a human cardiac environment.
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Affiliation(s)
- Marion Pierre
- CERVO Brain Research Centre, Quebec City, Quebec, Canada
| | | | | | - Hugo Poulin
- CERVO Brain Research Centre, Quebec City, Quebec, Canada
| | - Michael H Gollob
- Inherited Arrhythmia and Cardiomyopathy Program, Division of Cardiology, University of Toronto, Toronto, Ontario, Canada
| | - Mohamed Chahine
- CERVO Brain Research Centre, Quebec City, Quebec, Canada; Department of Medicine, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada.
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Zhu X, Lv M, Cheng T, Zhou Y, Yuan G, Chu Y, Luan Y, Song Q, Hu Y. Bibliometric analysis of atrial fibrillation and ion channels. Heart Rhythm 2024; 21:1161-1169. [PMID: 38280618 DOI: 10.1016/j.hrthm.2024.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/29/2024]
Abstract
Atrial fibrillation (AF) is a common clinical malignant arrhythmia with an increasing global incidence. Ion channel dysfunction is an important mechanism in the development of AF. In this study, we used bibliometrics to analyze the studies of ion channels and AF, aiming to provide inspiration and reference for researchers. A total of 3179 literature citations were obtained from Web of Science core databases. Analysis software included Excel 2019, VOSviewer 1.6.16, and CiteSpace 5.7.R2. This field of research has been growing since 1985. The most active country is the United States. The University of Montreal is the most important research institution. The journal Cardiovascular Research has published the largest number of articles in this field. Stanley Nattel and Dobromir Dobrev are the most frequently cited authors. The most cited literature was published in Nature and Science. Cardiac electrophysiology, gene expression, pathogenesis of AF, and AF prevention and treatment are the hot topics for this field research. Cardiac fibrillation and catheter ablation may be future research hotspots in this field.
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Affiliation(s)
- Xueping Zhu
- Guang 'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Meng Lv
- Guang 'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tao Cheng
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Yan Zhou
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Guozhen Yuan
- Guang 'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuguang Chu
- Guang 'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yujie Luan
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Qingqiao Song
- Guang 'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Yuanhui Hu
- Guang 'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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Baines O, Sha R, Kalla M, Holmes AP, Efimov IR, Pavlovic D, O’Shea C. Optical mapping and optogenetics in cardiac electrophysiology research and therapy: a state-of-the-art review. Europace 2024; 26:euae017. [PMID: 38227822 PMCID: PMC10847904 DOI: 10.1093/europace/euae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/07/2023] [Accepted: 01/12/2024] [Indexed: 01/18/2024] Open
Abstract
State-of-the-art innovations in optical cardiac electrophysiology are significantly enhancing cardiac research. A potential leap into patient care is now on the horizon. Optical mapping, using fluorescent probes and high-speed cameras, offers detailed insights into cardiac activity and arrhythmias by analysing electrical signals, calcium dynamics, and metabolism. Optogenetics utilizes light-sensitive ion channels and pumps to realize contactless, cell-selective cardiac actuation for modelling arrhythmia, restoring sinus rhythm, and probing complex cell-cell interactions. The merging of optogenetics and optical mapping techniques for 'all-optical' electrophysiology marks a significant step forward. This combination allows for the contactless actuation and sensing of cardiac electrophysiology, offering unprecedented spatial-temporal resolution and control. Recent studies have performed all-optical imaging ex vivo and achieved reliable optogenetic pacing in vivo, narrowing the gap for clinical use. Progress in optical electrophysiology continues at pace. Advances in motion tracking methods are removing the necessity of motion uncoupling, a key limitation of optical mapping. Innovations in optoelectronics, including miniaturized, biocompatible illumination and circuitry, are enabling the creation of implantable cardiac pacemakers and defibrillators with optoelectrical closed-loop systems. Computational modelling and machine learning are emerging as pivotal tools in enhancing optical techniques, offering new avenues for analysing complex data and optimizing therapeutic strategies. However, key challenges remain including opsin delivery, real-time data processing, longevity, and chronic effects of optoelectronic devices. This review provides a comprehensive overview of recent advances in optical mapping and optogenetics and outlines the promising future of optics in reshaping cardiac electrophysiology and therapeutic strategies.
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Affiliation(s)
- Olivia Baines
- Institute of Cardiovascular Sciences, College of Medical and Dental Science, University of Birmingham, Edgbastion, Wolfson Drive, Birmingham B15 2TT, UK
| | - Rina Sha
- Institute of Cardiovascular Sciences, College of Medical and Dental Science, University of Birmingham, Edgbastion, Wolfson Drive, Birmingham B15 2TT, UK
| | - Manish Kalla
- Institute of Cardiovascular Sciences, College of Medical and Dental Science, University of Birmingham, Edgbastion, Wolfson Drive, Birmingham B15 2TT, UK
| | - Andrew P Holmes
- Institute of Cardiovascular Sciences, College of Medical and Dental Science, University of Birmingham, Edgbastion, Wolfson Drive, Birmingham B15 2TT, UK
| | - Igor R Efimov
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
- Department of Medicine, Division of Cardiology, Northwestern University, Evanston, IL, USA
| | - Davor Pavlovic
- Institute of Cardiovascular Sciences, College of Medical and Dental Science, University of Birmingham, Edgbastion, Wolfson Drive, Birmingham B15 2TT, UK
| | - Christopher O’Shea
- Institute of Cardiovascular Sciences, College of Medical and Dental Science, University of Birmingham, Edgbastion, Wolfson Drive, Birmingham B15 2TT, UK
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He C, Wu X, Lin L, Liu C, Li M, Jiang C, Xu Z, Fang B. Causal relationship between atrial fibrillation and stroke risk: a Mendelian randomization. J Stroke Cerebrovasc Dis 2023; 32:107446. [PMID: 38442074 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the causal relationship between Atrial Fibrillation (AF) and the risk of Stroke using a Mendelian randomization (MR) approach. METHODS A two-sample MR analysis was conducted using publicly available genome-wide association study (GWAS) summary statistics data. In this analysis, genetic variants associated with AF were used as instrumental variables to estimate the causal effect. The inverse-variance weighted (IVW) method, weighted median estimator, and MR-Egger regression were employed for estimation. Additionally, sensitivity analysis was performed using the leave-one-out method. RESULTS The analysis included 87 single nucleotide polymorphisms (SNPs) associated with AF. The results from the IVW method indicated a positive association between genetic predisposition to AF and the risk of stroke (OR 1.002, 95 % CI 1.001-1.003, P < 0.001). The weighted median and MR-Egger methods showed consistent results (weighted median: OR 1.001, 95 % CI 1.000-1.002, P = 0.034; MR-Egger: OR 1.001, 95 % CI 1.000-1.003, P = 0.086). Sensitivity analysis demonstrated that no individual SNP significantly influenced the causal inference. CONCLUSIONS This study provides evidence of a causal relationship between AF and an elevated risk of stroke. These findings emphasize the significance of managing AF in order to prevent and treat strokes. Additional research is required to better understand the underlying mechanisms of this causal association.
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Affiliation(s)
- Chenming He
- Shaanxi University of Chinese Medicine, Xianyang, China
| | - Xinxin Wu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ling Lin
- Huizhou Hospital of Guangzhou University of Chinese Medicine, Huizhou, China
| | - Changya Liu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Li
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chao Jiang
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - Zhongju Xu
- Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Bangjiang Fang
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Remme CA, Heijman J, Gomez AM, Zaza A, Odening KE. 25 years of basic and translational science in EP Europace: novel insights into arrhythmia mechanisms and therapeutic strategies. Europace 2023; 25:euad210. [PMID: 37622575 PMCID: PMC10450791 DOI: 10.1093/europace/euad210] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 08/26/2023] Open
Abstract
In the last 25 years, EP Europace has published more than 300 basic and translational science articles covering different arrhythmia types (ranging from atrial fibrillation to ventricular tachyarrhythmias), different diseases predisposing to arrhythmia formation (such as genetic arrhythmia disorders and heart failure), and different interventional and pharmacological anti-arrhythmic treatment strategies (ranging from pacing and defibrillation to different ablation approaches and novel drug-therapies). These studies have been conducted in cellular models, small and large animal models, and in the last couple of years increasingly in silico using computational approaches. In sum, these articles have contributed substantially to our pathophysiological understanding of arrhythmia mechanisms and treatment options; many of which have made their way into clinical applications. This review discusses a representative selection of EP Europace manuscripts covering the topics of pacing and ablation, atrial fibrillation, heart failure and pro-arrhythmic ventricular remodelling, ion channel (dys)function and pharmacology, inherited arrhythmia syndromes, and arrhythmogenic cardiomyopathies, highlighting some of the advances of the past 25 years. Given the increasingly recognized complexity and multidisciplinary nature of arrhythmogenesis and continued technological developments, basic and translational electrophysiological research is key advancing the field. EP Europace aims to further increase its contribution to the discovery of arrhythmia mechanisms and the implementation of mechanism-based precision therapy approaches in arrhythmia management.
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Affiliation(s)
- Carol Ann Remme
- Department of Experimental Cardiology, Amsterdam UMC location University of Amsterdam, Heart Centre, Academic Medical Center, Room K2-104.2, Meibergdreef 11, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| | - Jordi Heijman
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Ana M Gomez
- Signaling and Cardiovascular Pathophysiology, UMR-S 1180, Inserm, Université Paris-Saclay, 91400 Orsay, France
| | - Antonio Zaza
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, 20126 Milan, Italy
| | - Katja E Odening
- Translational Cardiology, Department of Cardiology and Department of Physiology, Inselspital University Hospital Bern, University of Bern, 3012 Bern, Switzerland
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Heijman J, Christ T. Mind the gap: leak currents and induced pluripotent stem cell-derived cardiomyocytes in translational cardiac electrophysiology. Europace 2023; 25:euad236. [PMID: 37522360 PMCID: PMC10445299 DOI: 10.1093/europace/euad236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/01/2023] Open
Affiliation(s)
- Jordi Heijman
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands
| | - Torsten Christ
- Institute of Experimental Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20251 Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Martinistraße 52, 20251 Hamburg, Germany
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Jia L, Veldkamp MW, Verkerk AO, Tan HL. The opioid tramadol blocks the cardiac sodium channel Nav1.5 in HEK293 cells. Europace 2023; 25:euad209. [PMID: 37433113 PMCID: PMC10396326 DOI: 10.1093/europace/euad209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/03/2023] [Indexed: 07/13/2023] Open
Abstract
AIMS Opioids are associated with increased risk of sudden cardiac death. This may be due to their effects on the cardiac sodium channel (Nav1.5) current. In the present study, we aim to establish whether tramadol, fentanyl, or codeine affects Nav1.5 current. METHODS AND RESULTS Using whole-cell patch-clamp methodology, we studied the effects of tramadol, fentanyl, and codeine on currents of human Nav1.5 channels stably expressed in HEK293 cells and on action potential (AP) properties of freshly isolated rabbit ventricular cardiomyocytes. In fully available Nav1.5 channels (holding potential -120 mV), tramadol exhibited inhibitory effects on Nav1.5 current in a concentration-dependent manner with an IC50 of 378.5 ± 33.2 µm. In addition, tramadol caused a hyperpolarizing shift of voltage-gated (in)activation and a delay in recovery from inactivation. These blocking effects occurred at lower concentrations in partially inactivated Nav1.5 channels: during partial fast inactivation (close-to-physiological holding potential -90 mV), IC50 of Nav1.5 block was 4.5 ± 1.1 μm, while it was 16 ± 4.8 μm during partial slow inactivation. The tramadol-induced changes on Nav1.5 properties were reflected by a reduction in AP upstroke velocity in a frequency-dependent manner. Fentanyl and codeine had no effect on Nav1.5 current, even when tested at lethal concentrations. CONCLUSION Tramadol reduces Nav1.5 currents, in particular, at close-to-physiological membrane potentials. Fentanyl and codeine have no effects on Nav1.5 current.
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Affiliation(s)
- Lixia Jia
- Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Marieke W Veldkamp
- Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Arie O Verkerk
- Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Hanno L Tan
- Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
- Netherlands Heart Institute, Moreelsepark 1, Utrecht 3511 EP, The Netherlands
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Nasilli G, Yiangou L, Palandri C, Cerbai E, Davis RP, Verkerk AO, Casini S, Remme CA. Beneficial effects of chronic mexiletine treatment in a human model of SCN5A overlap syndrome. Europace 2023; 25:euad154. [PMID: 37369559 PMCID: PMC10299896 DOI: 10.1093/europace/euad154] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
AIMS SCN5A mutations are associated with various cardiac phenotypes, including long QT syndrome type 3 (LQT3), Brugada syndrome (BrS), and cardiac conduction disease (CCD). Certain mutations, such as SCN5A-1795insD, lead to an overlap syndrome, with patients exhibiting both features of BrS/CCD [decreased sodium current (INa)] and LQT3 (increased late INa). The sodium channel blocker mexiletine may acutely decrease LQT3-associated late INa and chronically increase peak INa associated with SCN5A loss-of-function mutations. However, most studies have so far employed heterologous expression systems and high mexiletine concentrations. We here investigated the effects of a therapeutic dose of mexiletine on the mixed phenotype associated with the SCN5A-1795insD mutation in HEK293A cells and human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). METHODS AND RESULTS To assess only the chronic effects on trafficking, HEK293A cells transfected with wild-type (WT) SCN5A or SCN5A-1795insD were incubated for 48 h with 10 µm mexiletine followed by wash-out, which resulted in an increased peak INa for both SCN5A-WT and SCN5A-1795insD and an increased late INa for SCN5A-1795insD. Acute re-exposure of HEK293A cells to 10 µm mexiletine did not impact on peak INa but significantly decreased SCN5A-1795insD late INa. Chronic incubation of SCN5A-1795insD hiPSC-CMs with mexiletine followed by wash-out increased peak INa, action potential (AP) upstroke velocity, and AP duration. Acute re-exposure did not impact on peak INa or AP upstroke velocity, but significantly decreased AP duration. CONCLUSION These findings demonstrate for the first time the therapeutic benefit of mexiletine in a human cardiomyocyte model of SCN5A overlap syndrome.
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Affiliation(s)
- Giovanna Nasilli
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| | - Loukia Yiangou
- Department of Anatomy and Embryology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Chiara Palandri
- Department NeuroFarBa, University of Florence, Viale Gaetano Pieraccini 6, 50139, Florence, Italy
| | - Elisabetta Cerbai
- Department NeuroFarBa, University of Florence, Viale Gaetano Pieraccini 6, 50139, Florence, Italy
| | - Richard P Davis
- Department of Anatomy and Embryology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
- The Novo Nordisk Foundation Center for Stem Cell Medicine (reNEW), Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Arie O Verkerk
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
- Department of Medical Biology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Simona Casini
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| | - Carol Ann Remme
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
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