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Yu L, Zhou L, Cao G, Po SS, Huang B, Zhou X, Wang M, Yuan S, Wang Z, Wang S, Jiang H. Optogenetic Modulation of Cardiac Sympathetic Nerve Activity to Prevent Ventricular Arrhythmias. J Am Coll Cardiol 2017; 70:2778-2790. [PMID: 29191327 DOI: 10.1016/j.jacc.2017.09.1107] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 09/05/2017] [Accepted: 09/26/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Studies have shown that left stellate ganglion (LSG) suppression protects against ventricular arrhythmias (VAs). Optogenetics is a novel technique to reversibly regulate the activity of the targeted neurons. OBJECTIVES This study aimed to investigate whether an optogenetically silenced LSG could protect against VAs induced by myocardial ischemia. METHODS Adeno-associated virus (AAV) was used as the vector to deliver ArchT, an inhibitory light-sensitive opsin, to the LSG neurons. Twenty male beagles were randomized into the optogenetics group (n = 10, AAV2/9-CAG-ArchT-GFP microinjected into LSG) and control group (n = 10, AAV2/9-CAG-GFP microinjected into LSG). After 4 weeks, the LSG function and neural activity, heart rate variability, ventricular action potential duration, and effective refractory period were measured in the absence or presence of a light-emitting diode illumination (565 nm). Myocardial ischemia was induced by left anterior coronary artery ligation and 1 h of electrocardiography was recorded for VAs analysis. RESULTS ArchT was successfully expressed in all dogs. Transient light-emitting diode illumination significantly suppressed the LSG function, LSG neural activity, and sympathetic nerve indices of heart rate variability as well as prolonged left ventricular effective refractory period and APD90 only in the optogenetics group. Thirty-minute illumination further enhanced these changes in the optogenetics group. Importantly, all of these changes returned to baseline within 2 h after illumination was turned off. Moreover, the ischemia-induced VAs were significantly suppressed by illumination only in the optogenetics group. CONCLUSIONS Optogenetic modulation could reversibly inhibit the neural activity of LSG, thereby increasing electrophysiological stability and protecting against myocardial ischemia-induced VAs.
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Affiliation(s)
- Lilei Yu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Liping Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Gang Cao
- Biomedical Center of Huazhong Agricultural University, Wuhan, China; College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Sunny S Po
- Heart Rhythm Institute and Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Bing 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
| | - Xiaoya Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Menglong 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
| | - Shenxu Yuan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Zhuo 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
| | - Songyun 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
| | - Hong Jiang
- 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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Child N, Hanson B, Bishop M, Rinaldi CA, Bostock J, Western D, Cooklin M, O'Neil M, Wright M, Razavi R, Gill J, Taggart P. Effect of mental challenge induced by movie clips on action potential duration in normal human subjects independent of heart rate. Circ Arrhythm Electrophysiol 2014; 7:518-23. [PMID: 24833641 DOI: 10.1161/circep.113.000909] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mental stress and emotion have long been associated with ventricular arrhythmias and sudden death in animal models and humans. The effect of mental challenge on ventricular action potential duration (APD) in conscious healthy humans has not been reported. METHODS AND RESULTS Activation recovery intervals measured from unipolar electrograms as a surrogate for APD (n=19) were recorded from right and left ventricular endocardium during steady-state pacing, whilst subjects watched an emotionally charged film clip. To assess the possible modulating role of altered respiration on APD, the subjects then repeated the same breathing pattern they had during the stress, but without the movie clip. Hemodynamic parameters (mean, systolic, and diastolic blood pressure, and rate of pressure increase) and respiration rate increased during the stressful part of the film clip (P=0.001). APD decreased during the stressful parts of the film clip, for example, for global right ventricular activation recovery interval at end of film clip 193.8 ms (SD, 14) versus 198.0 ms (SD, 13) during the matched breathing control (end film left ventricle 199.8 ms [SD, 16] versus control 201.6 ms [SD, 15]; P=0.004). Respiration rate increased during the stressful part of the film clip (by 2 breaths per minute) and was well matched in the respective control period without any hemodynamic or activation recovery interval changes. CONCLUSIONS Our results document for the first time direct recordings of the effect of a mental challenge protocol on ventricular APD in conscious humans. The effect of mental challenge on APD was not secondary to emotionally induced altered respiration or heart rate.
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Affiliation(s)
- Nicholas Child
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - Ben Hanson
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - Martin Bishop
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - Christopher A Rinaldi
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - Julian Bostock
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - David Western
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - Michael Cooklin
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - Mark O'Neil
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - Matthew Wright
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - Reza Razavi
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - Jaswinder Gill
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.)
| | - Peter Taggart
- From the Department of Cardiology, Guy's and St. Thomas's Hospital, London, United Kingdom (N.C., C.A.R., J.B., M.C., M.O., M.W., R.R., J.G.); Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College, London, United Kingdom (N.C., M.B., R.R.); Department of Mechanical Engineering, University College London, London, United Kingdom (B.H., D.W.); and Neurocardiology Unit, University College London Hospitals, London, United Kingdom (P.T.).
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