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Bansmann PM, Mohsen Y, Horlitz M, Stöckigt F. Optimizing fibrosis detection: a comparison of electroanatomical mapping and late enhancement gadolinium magnetic resonance imaging. J Interv Card Electrophysiol 2024; 67:571-577. [PMID: 37612562 DOI: 10.1007/s10840-023-01627-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Fibrotic atrial cardiomyopathy plays an important role in determining the outcome of ablation in patients with atrial fibrillation (AF). Two main methods are being used for the evaluation of fibrosis: voltage-based high-density (HD) electroanatomical mapping (EAM) and late gadolinium enhancement MRI (LGE-MRI). The comparability between both methods in detecting fibrosis has not been systematically investigated. METHODS LGE-MRIs of the left atrium (LA) were performed in 21 patients. LA-fibrosis was evaluated using a custom-designed software generating a 3D-model of the LA. HD-electroanatomical maps were recorded in each patient. After processing the maps and the MRI models by excluding the mitral valve, pulmonary veins, and the left atrial appendage, the LGE areas were measured and compared to the low voltage areas (LVA) in the HD maps using three different cutoff values of 0.5 mV, 0.7 mV, and 1.0 mV. RESULTS The analysis revealed significant differences between EAM and LGE-MRI in assessing LA-fibrosis at 0.5-mV (for anterior and posterior walls) and 1.0-mV cutoffs (for anterior and posterior wall and septum). However, no significant differences were found between EAM and LGE-MRI when using a 0.7-mV cutoff for all the investigated areas. CONCLUSIONS A voltage cutoff of 0.7 mV provided the best correlation between EAM and LGE MRI for detecting left atrial fibrosis. It supports the idea that a 0.5-mV cutoff may underestimate fibrosis, as areas with local signal voltages between 0.6 and 0.8 mV could also show LGE on MRI. Further research is needed to determine the ideal voltage cutoff for detecting left atrial fibrosis.
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Affiliation(s)
- P Martin Bansmann
- Department of Radiology, Krankenhaus Porz am Rhein, Cologne, Germany
| | - Yazan Mohsen
- Department of Cardiology, Electrophysiology and Rhythmology, Krankenhaus Porz am Rhein, Urbacher Weg 19, 51149, Cologne, Germany.
- Clinical Sciences Malmö, Lund University, Lund, Sweden.
| | - Marc Horlitz
- Department of Cardiology, Electrophysiology and Rhythmology, Krankenhaus Porz am Rhein, Urbacher Weg 19, 51149, Cologne, Germany
| | - Florian Stöckigt
- Department of Cardiology, Electrophysiology and Rhythmology, Krankenhaus Porz am Rhein, Urbacher Weg 19, 51149, Cologne, Germany
- Department of Internal Medicine II, University Hospital Bonn, 53125, Bonn, Germany
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2
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Affiliation(s)
| | - Daniel John
- Department of Cardiology, Evangelisches Krankenhaus Kalk, Cologne, Germany
| | - Florian Stöckigt
- Department of Cardiology, Electrophysiology and Rhythmology, Krankenhaus Porz am Rhein, Cologne, Germany.,Department of Cardiology, University Hospital Bonn, Bonn, Germany
| | - Johannes Strunk
- Department of Rheumatology, Krankenhaus Porz am Rhein, Cologne, Germany
| | - Frank Eberhardt
- Department of Cardiology, Evangelisches Krankenhaus Kalk, Cologne, Germany
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3
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Eberhardt F, Bunck AC, Codjambopoulo P, Kalmbach K, Stöckigt F. Benign vena cava superior syndrome in patients with cardiac implantable electronic devices: Presentation and management. HeartRhythm Case Rep 2020; 6:549-553. [PMID: 32983865 PMCID: PMC7498635 DOI: 10.1016/j.hrcr.2020.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Frank Eberhardt
- Department of Cardiology, Evangelisches Krankenhaus Kalk, Cologne, Germany
- Address reprint requests and correspondence: PD Dr med Frank Eberhardt, Department of Cardiology, Evangelisches Krankenhaus Kalk, Buchforststr. 2, 51103 Cologne, Germany.
| | - Alexander C. Bunck
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Kilian Kalmbach
- Department of Anasthesiology, Evangelisches Krankenhaus Kalk, Cologne, Germany
| | - Florian Stöckigt
- Department of Cardiology, Electrophysiology and Rhythmology, Krankenhaus Porz am Rhein, Cologne, Germany
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
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4
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Stöckigt F, Eichhorn L, Beiert T, Knappe V, Radecke T, Steinmetz M, Nickenig G, Peeva V, Kudin AP, Kunz WS, Berwanger C, Kamm L, Schultheis D, Schlötzer-Schrehardt U, Clemen CS, Schröder R, Schrickel JW. Heart failure after pressure overload in autosomal-dominant desminopathies: Lessons from heterozygous DES-p.R349P knock-in mice. PLoS One 2020; 15:e0228913. [PMID: 32126091 PMCID: PMC7053759 DOI: 10.1371/journal.pone.0228913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/27/2020] [Indexed: 11/21/2022] Open
Abstract
Background Mutations in the human desmin gene (DES) cause autosomal-dominant and -recessive cardiomyopathies, leading to heart failure, arrhythmias, and AV blocks. We analyzed the effects of vascular pressure overload in a patient-mimicking p.R349P desmin knock-in mouse model that harbors the orthologue of the frequent human DES missense mutation p.R350P. Methods and results Transverse aortic constriction (TAC) was performed on heterozygous (HET) DES-p.R349P mice and wild-type (WT) littermates. Echocardiography demonstrated reduced left ventricular ejection fraction in HET-TAC (WT-sham: 69.5 ± 2.9%, HET-sham: 64.5 ± 4.7%, WT-TAC: 63.5 ± 4.9%, HET-TAC: 55.7 ± 5.4%; p<0.01). Cardiac output was significantly reduced in HET-TAC (WT sham: 13088 ± 2385 μl/min, HET sham: 10391 ± 1349μl/min, WT-TAC: 8097 ± 1903μl/min, HET-TAC: 5793 ± 2517μl/min; p<0.01). Incidence and duration of AV blocks as well as the probability to induce ventricular tachycardias was highest in HET-TAC. We observed reduced mtDNA copy numbers in HET-TAC (WT-sham: 12546 ± 406, HET-sham: 13526 ± 781, WT-TAC: 11155 ± 3315, HET-TAC: 8649 ± 1582; p = 0.025), but no mtDNA deletions. The activity of respiratory chain complexes I and IV showed the greatest reductions in HET-TAC. Conclusion Pressure overload in HET mice aggravated the clinical phenotype of cardiomyopathy and resulted in mitochondrial dysfunction. Preventive avoidance of pressure overload/arterial hypertension in desminopathy patients might represent a crucial therapeutic measure.
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Affiliation(s)
- Florian Stöckigt
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
- Department of Cardiology, Krankenhaus Porz, Urbacher Weg, Cologne, Germany
- * E-mail:
| | - Lars Eichhorn
- Department of Anesthesiology, University Hospital Bonn, Bonn, Germany
| | - Thomas Beiert
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
| | - Vincent Knappe
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
| | - Tobias Radecke
- Department of Cardiology, University Hospital Essen, Hufelandstraße, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology, University Hospital Essen, Hufelandstraße, Essen, Germany
| | - Georg Nickenig
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
| | - Viktoriya Peeva
- Institute of Experimental Epileptology and Cognition Research, Bonn, Germany
- Department of Epileptology, University Hospital of Bonn, Bonn, Germany
| | - Alexei P. Kudin
- Institute of Experimental Epileptology and Cognition Research, Bonn, Germany
- Department of Epileptology, University Hospital of Bonn, Bonn, Germany
| | - Wolfram S. Kunz
- Institute of Experimental Epileptology and Cognition Research, Bonn, Germany
- Department of Epileptology, University Hospital of Bonn, Bonn, Germany
| | - Carolin Berwanger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Linder Höhe, Cologne, Germany
| | - Lisa Kamm
- Institute of Neuropathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany
| | - Dorothea Schultheis
- Institute of Neuropathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany
| | - Ursula Schlötzer-Schrehardt
- Department of Opthalmology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany
| | - Christoph S. Clemen
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Linder Höhe, Cologne, Germany
- Institute of Neuropathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany
- Center for Biochemistry, Institute of Biochemistry I, Medical Faculty, University of Cologne, Cologne, Germany
- Center for Physiology and Pathophysiology, Institute of Vegetative Physiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - Rolf Schröder
- Institute of Neuropathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany
| | - Jan W. Schrickel
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
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5
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Stöckigt F, Eberhardt F, Horlitz M. Complication prevention in ablation procedures: How to perform transseptal puncture safely in case of atrial septum aneurysm. HeartRhythm Case Rep 2019; 5:529-533. [PMID: 31890566 PMCID: PMC6926205 DOI: 10.1016/j.hrcr.2019.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Florian Stöckigt
- Department of Cardiology, Electrophysiology and Rhythmology, Krankenhaus Porz am Rhein, Cologne, Germany.,Department of Cardiology, University Hospital Bonn, Bonn, Germany
| | - Frank Eberhardt
- Department of Cardiology, Evangelisches Krankenhaus Kalk, Cologne, Germany
| | - Marc Horlitz
- Department of Cardiology, Electrophysiology and Rhythmology, Krankenhaus Porz am Rhein, Cologne, Germany
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6
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Beiert T, Straesser S, Malotki R, Stöckigt F, Schrickel JW, Andrié RP. Increased mortality and ICD therapies in ischemic versus non-ischemic dilated cardiomyopathy patients with cardiac resynchronization having survived until first device replacement. Arch Med Sci 2019; 15:845-856. [PMID: 31360179 PMCID: PMC6657262 DOI: 10.5114/aoms.2018.75139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 05/05/2017] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Cardiac resynchronization therapy combined with an implantable cardioverter defibrillator (CRT-D) is widely applied in heart failure patients. Sufficient data on arrhythmia and defibrillator therapies during long-term follow-up of more than 4 years are lacking and data on mortality are conflicting. We aimed to characterize the occurrence of ventricular arrhythmia, respective defibrillator therapies and mortality for several years following CRT-D implantation or upgrade. MATERIAL AND METHODS Eighty-eight patients with ischemic (ICM) or non-ischemic dilated cardiomyopathy (DCM) and at least one CRT-D replacement were included in this study and analyzed for incidence of non-sustained ventricular tachycardia (NSVT), defibrillator shocks, anti-tachycardia pacing (ATP) and mortality. RESULTS ICM was the underlying disease in 59%, DCM in 41% of patients. During a mean follow-up of 76.4 ±24.8 months the incidence of appropriate defibrillator therapies (shock or ATP) was 46.6% and was elevated in ICM compared to DCM patients (57.7% vs. 30.6%, respectively; p = 0.017). Kaplan-Meier analysis revealed significantly higher ICD therapy-free survival rates in DCM patients (p = 0.031). Left ventricular ejection fraction, NSVT per year and ICM (vs. DCM) were independent predictors of device intervention. The ICM patients showed increased mortality compared to DCM patients, with cumulative all-cause mortality at 9 years of follow-up of 45.4% and 10.6%, respectively. Chronic renal failure, peripheral artery disease and chronic obstructive pulmonary disease were independent predictors of mortality. CONCLUSIONS The clinical course of patients with ICM and DCM treated with CRT-D differs significantly during long-term follow-up, with increased mortality and incidence of ICD therapies in ICM patients.
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Affiliation(s)
- Thomas Beiert
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Swanda Straesser
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Robert Malotki
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Florian Stöckigt
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Jan W Schrickel
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - René P Andrié
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
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7
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Andrié RP, Beiert T, Knappe V, Linhart M, Stöckigt F, Klein AM, Ghanem A, Lübkemeier I, Röll W, Nickenig G, Fleischmann BK, Schrickel JW. Treatment with mononuclear cell populations improves post-infarction cardiac function but does not reduce arrhythmia susceptibility. PLoS One 2019; 14:e0208301. [PMID: 30763348 PMCID: PMC6375577 DOI: 10.1371/journal.pone.0208301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 11/15/2018] [Indexed: 12/12/2022] Open
Abstract
Background Clinical and experimental data give evidence that transplantation of stem and progenitor cells in myocardial infarction could be beneficial, although the underlying mechanism has remained elusive. Ventricular tachyarrhythmia is the most frequent and potentially lethal complication of myocardial infarction, but the impact of mono nuclear cells on the incidence of ventricular arrhythmia is still not clear. Objective We aimed to characterize the influence of splenic mononuclear cell populations on ventricular arrhythmia after myocardial infarction. Methods We assessed electrical vulnerability in vivo in mice with left ventricular cryoinfarction 14 days after injury and intramyocardial injection of specific subpopulations of mononuclear cells (MNCs) (CD11b-positive cells, Sca-1-positive cells, early endothelial progenitor cells (eEPCs)). As positive control group we used embryonic cardiomyocytes (eCMs). Epicardial mapping was performed for analysing conduction velocities in the border zone. Left ventricular function was quantified by echocardiography and left heart catheterization. Results In vivo pacing protocols induced ventricular tachycardia (VT) in 30% of non-infarcted mice. In contrast, monomorphic or polymorphic VT could be evoked in 94% of infarcted and vehicle-injected mice (p<0.01). Only transplantation of eCMs prevented post-infarction VT and improved conduction velocities in the border zone in accordance to increased expression of connexin 43. Cryoinfarction resulted in a broad aggravation of left ventricular function. All transplanted cell types augmented left ventricular function to a similar extent. Conclusions Transplantation of different MNC populations after myocardial infarction improves left ventricular function similar to effects of eCMs. Prevention of inducible ventricular arrhythmia is only seen after transplantation of eCMs.
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Affiliation(s)
- René P. Andrié
- Department of Cardiology, University of Bonn, Bonn, Germany
- * E-mail:
| | - Thomas Beiert
- Department of Cardiology, University of Bonn, Bonn, Germany
| | - Vincent Knappe
- Department of Cardiology, University of Bonn, Bonn, Germany
| | - Markus Linhart
- Department of Cardiology, University of Bonn, Bonn, Germany
| | | | - Alexandra M. Klein
- Institute of Physiology I, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Alexander Ghanem
- Department of Cardiology, Asklepios Hospital Hamburg, Hamburg, Germany
| | - Indra Lübkemeier
- LIMES-Institute, Molecular Genetics, University of Bonn, Bonn, Germany
| | - Wilhelm Röll
- Department of Cardiovascular Surgery, University of Bonn, Bonn, Germany
| | - Georg Nickenig
- Department of Cardiology, University of Bonn, Bonn, Germany
| | - Bernd K. Fleischmann
- Institute of Physiology I, Life & Brain Center, University of Bonn, Bonn, Germany
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Luetkens JA, Wolpers AC, Beiert T, Kuetting D, Dabir D, Homsi R, Meendermann H, Dayé NA, Knappe V, Karsdal M, Nielsen SH, Genovese F, Stöckigt F, Linhart M, Thomas D, Nickenig G, Schild HH, Schrickel JW, Andrié RP. Cardiac magnetic resonance using late gadolinium enhancement and atrial T1 mapping predicts poor outcome in patients with atrial fibrillation after catheter ablation therapy. Sci Rep 2018; 8:13618. [PMID: 30206274 PMCID: PMC6134059 DOI: 10.1038/s41598-018-31916-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/29/2018] [Indexed: 01/26/2023] Open
Abstract
To determine the pre-procedural value of different fibrotic biomarkers and comprehensive cardiac magnetic resonance (CMR) for the prediction of poor response to ablation therapy in patients with atrial fibrillation (AF). Left atrial (LA) late gadolinium enhancement (LGE) and native LA T1 relaxation times were assessed using CMR. Plasma levels of relaxin, myeloperoxidase and serum levels of matrix metalloproteinase (MMP)-mediated cardiac specific titin fragmentation and MMP-mediated type IV collagen degradation were obtained. Poor outcome was defined by the recurrence of AF during 1-year follow-up. 61 patients were included in final analysis. Twenty (32.8%) patients had recurrence of AF. Patients with a recurrence of AF had a higher percentage of LA LGE (26.7 ± 12.5% vs. 17.0 ± 7.7%; P < 0.001), higher LA T1 relaxation times (856.7 ± 112.2 ms vs. 746.8 ± 91.0 ms; P < 0.001) and higher plasma levels of relaxin (0.69 ± 1.34 pg/ml vs. 0.37 ± 0.88 pg/ml; P = 0.035). In the multivariate Cox regression analysis, poor ablation outcome was best predicted by advanced LGE stage (hazard ratio (HR):5.487; P = 0.001) and T1 relaxation times (HR:1.007; P = 0.001). Pre-procedural CMR is a valuable tool for prediction of poor response to catheter ablation therapy in patients with AF. It offers various imaging techniques for outcome prediction and might be valuable for a better patient selection prior to ablation therapy.
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Affiliation(s)
- Julian A Luetkens
- Department of Radiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany.
| | - Anne C Wolpers
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Thomas Beiert
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Daniel Kuetting
- Department of Radiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Darius Dabir
- Department of Radiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Rami Homsi
- Department of Radiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Hendrik Meendermann
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Natalie Abou Dayé
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Vincent Knappe
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Morten Karsdal
- Fibrosis Biology and Biomarkers, Nordic Bioscience, Herlev, Denmark
| | - Signe H Nielsen
- Fibrosis Biology and Biomarkers, Nordic Bioscience, Herlev, Denmark
| | | | - Florian Stöckigt
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Markus Linhart
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Daniel Thomas
- Department of Radiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Georg Nickenig
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Hans H Schild
- Department of Radiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Jan W Schrickel
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - René P Andrié
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
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Eichhorn L, Weisheit CK, Gestrich C, Peukert K, Duerr GD, Ayub MA, Erdfelder F, Stöckigt F. A Closed-chest Model to Induce Transverse Aortic Constriction in Mice. J Vis Exp 2018. [PMID: 29683463 DOI: 10.3791/57397] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Research on cardiac hypertrophy and heart failure is frequently based on pressure overload mouse models induced by TAC. The standard procedure is to perform a partial thoracotomy to visualize the transverse aortic arch. However, the surgical trauma caused by the thoracotomy in open-chest models changes the respiratory physiology as the ribs are dissected and left unattached after chest closure. To prevent this, we established a minimally invasive, closed chest approach via lateral thoracotomy. Herein we approach the aortic arch via the 2nd intercostal space without entering the chest cavities, leaving the mouse with a less traumatic injury to recover from. We perform this operation using standard laboratory settings for open chest TAC procedures with equal survival rates. Apart from maintaining physiological breathing patterns due to the closed chest approach, the mice seem to benefit by showing rapid recovery, as the less invasive technique appears to facilitate a fast healing process and to reduce immune response after trauma.
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Affiliation(s)
- Lars Eichhorn
- Department of Anaesthesiology, University Hospital Bonn;
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10
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Linhart M, Werner JT, Stöckigt F, Kohlmann AT, Lodde PC, Linneborn LPT, Beiert T, Hammerstingl C, Borràs R, Nickenig G, Andrié RP, Schrickel JW. High rate of persistent iatrogenic atrial septal defect after single transseptal puncture for cryoballoon pulmonary vein isolation. J Interv Card Electrophysiol 2018; 52:141-148. [DOI: 10.1007/s10840-018-0352-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/04/2018] [Indexed: 10/17/2022]
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11
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Beiert T, Knappe V, Tiyerili V, Stöckigt F, Effelsberg V, Linhart M, Steinmetz M, Klein S, Schierwagen R, Trebicka J, Roell W, Nickenig G, Schrickel JW, Andrié RP. Chronic lower-dose relaxin administration protects from arrhythmia in experimental myocardial infarction due to anti-inflammatory and anti-fibrotic properties. Int J Cardiol 2018; 250:21-28. [DOI: 10.1016/j.ijcard.2017.09.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/30/2017] [Accepted: 09/06/2017] [Indexed: 12/11/2022]
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12
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Beiert T, Lodde PC, Linneborn LP, Werner J, Prinz L, Stöckigt F, Linhart M, Lickfett L, Nickenig G, Schrickel JW, Andrié RP. Outcome in patients with left common pulmonary vein after cryoablation with second-generation cryoballoon. Pacing Clin Electrophysiol 2017; 41:22-27. [DOI: 10.1111/pace.13247] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/18/2017] [Accepted: 11/26/2017] [Indexed: 01/15/2023]
Affiliation(s)
- Thomas Beiert
- Department of Internal Medicine II; University Hospital Bonn; Rheinische Friedrich-Wilhelms University; Bonn Germany
| | - Pia C. Lodde
- Department of Internal Medicine II; University Hospital Bonn; Rheinische Friedrich-Wilhelms University; Bonn Germany
| | - Lutz P.T. Linneborn
- Department of Internal Medicine II; University Hospital Bonn; Rheinische Friedrich-Wilhelms University; Bonn Germany
| | - Jessica Werner
- Department of Internal Medicine II; University Hospital Bonn; Rheinische Friedrich-Wilhelms University; Bonn Germany
| | - Lisa Prinz
- Department of Internal Medicine II; University Hospital Bonn; Rheinische Friedrich-Wilhelms University; Bonn Germany
| | - Florian Stöckigt
- Department of Internal Medicine II; University Hospital Bonn; Rheinische Friedrich-Wilhelms University; Bonn Germany
| | - Markus Linhart
- Department of Internal Medicine II; University Hospital Bonn; Rheinische Friedrich-Wilhelms University; Bonn Germany
| | - Lars Lickfett
- Clinic for Cardiology and Pneumology; Mönchengladbach Germany
| | - Georg Nickenig
- Department of Internal Medicine II; University Hospital Bonn; Rheinische Friedrich-Wilhelms University; Bonn Germany
| | - Jan W. Schrickel
- Department of Internal Medicine II; University Hospital Bonn; Rheinische Friedrich-Wilhelms University; Bonn Germany
| | - René P. Andrié
- Department of Internal Medicine II; University Hospital Bonn; Rheinische Friedrich-Wilhelms University; Bonn Germany
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Stöckigt F, Beiert T, Knappe V, Baris OR, Wiesner RJ, Clemen CS, Nickenig G, Andrié RP, Schrickel JW. Aging-related mitochondrial dysfunction facilitates the occurrence of serious arrhythmia after myocardial infarction. Biochem Biophys Res Commun 2017; 493:604-610. [PMID: 28867191 DOI: 10.1016/j.bbrc.2017.08.145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 08/25/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND During aging a mosaic of normal cells and cells with mitochondrial deficiency develops in various tissues including the heart. Whether this contributes to higher susceptibility for arrhythmia following myocardial infarction (MI) is unknown. METHODS AND RESULTS Myocardial cryoinfarction was performed in 12-month-old transgenic mice with accelerated accumulation of deletions in mitochondrial DNA. Occurrence and pathogenesis of arrhythmia was investigated after two weeks. Holter-ECG recordings revealed higher rates of premature ventricular complexes (incidence > 10/24 h: 100% vs. 20%; p = 0.048) and more severe spontaneous arrhythmia during stress test in mutant mice with MI as compared to control mice with MI. Mice with mitochondrial dysfunction exhibited longer spontaneous AV-blocks (467 ± 26 ms vs. 377 ± 24 ms; p = 0.013), an increased probability for induction of ventricular tachycardia during in vivo electrophysiological investigation (22% vs. 9%; p = 0.044), and a reduced conduction velocity in the infarct borderzone (38.5 ± 0.5 cm/s vs. 55.3 ± 0.9 cm/s; p = 0.001). Furthermore, mutant mice exhibited a significant reduction of the phospho-Cx43/Cx43 ratio in right (0.59 ± 0.04 vs. 0.85 ± 0.01; p = 0.027) and left ventricular myocardium (0.72 ± 0.01 vs. 0.86 ± 0.02; p = 0.023). CONCLUSIONS Aging-related cardiac mosaic respiratory chain dysfunction facilitates the occurrence of spontaneous and inducible cardiac arrhythmia after myocardial infarction and is associated with slowing of electrical impulse propagation in the infarct borderzone.
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Affiliation(s)
- Florian Stöckigt
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany.
| | - Thomas Beiert
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Vincent Knappe
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Olivier R Baris
- Center for Physiology and Pathophysiology, Institute of Vegetative Physiology, University of Cologne, Cologne, Germany
| | - Rudolf J Wiesner
- Center for Physiology and Pathophysiology, Institute of Vegetative Physiology, University of Cologne, Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Christoph S Clemen
- Center for Biochemistry, Institute of Biochemistry I, Medical Faculty, University of Cologne, Cologne, Germany; Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Georg Nickenig
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - René P Andrié
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Jan W Schrickel
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
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14
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Peche VS, Holak TA, Burgute BD, Kosmas K, Kale SP, Wunderlich FT, Elhamine F, Stehle R, Pfitzer G, Nohroudi K, Addicks K, Stöckigt F, Schrickel JW, Gallinger J, Schleicher M, Noegel AA. Erratum to: Ablation of cyclase-associated protein 2 (CAP2) leads to cardiomyopathy. Cell Mol Life Sci 2017; 74:4045. [PMID: 28852764 DOI: 10.1007/s00018-017-2630-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Vivek S Peche
- Institute of Biochemistry I, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 52, 50931, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Tad A Holak
- Max-Planck-Institute of Biochemistry, 82152, Martinsried, Germany.,Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060, Krakow, Poland
| | - Bhagyashri D Burgute
- Institute of Biochemistry I, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 52, 50931, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Kosmas Kosmas
- Institute of Biochemistry I, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 52, 50931, Cologne, Germany
| | - Sushant P Kale
- Department of Neurology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - F Thomas Wunderlich
- Center for Molecular Medicine Cologne (CMMC), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,Max-Planck-Institute of Neurological Research, Cologne, Germany
| | - Fatiha Elhamine
- Institute of Vegetative Physiology, University of Cologne, Cologne, Germany
| | - Robert Stehle
- Institute of Vegetative Physiology, University of Cologne, Cologne, Germany
| | - Gabriele Pfitzer
- Institute of Vegetative Physiology, University of Cologne, Cologne, Germany
| | - Klaus Nohroudi
- Institute of Anatomy I, University of Cologne, Cologne, Germany
| | - Klaus Addicks
- Institute of Anatomy I, University of Cologne, Cologne, Germany
| | - Florian Stöckigt
- Department of Medicine-Cardiology, University of Bonn, Bonn, Germany
| | - Jan W Schrickel
- Department of Medicine-Cardiology, University of Bonn, Bonn, Germany
| | - Julia Gallinger
- Institute for Anatomy and Cell Biology, Ludwig-Maximilians University, 80336, Munich, Germany
| | - Michael Schleicher
- Institute for Anatomy and Cell Biology, Ludwig-Maximilians University, 80336, Munich, Germany
| | - Angelika A Noegel
- Institute of Biochemistry I, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 52, 50931, Cologne, Germany. .,Center for Molecular Medicine Cologne (CMMC), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
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15
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Beiert T, Tiyerili V, Knappe V, Effelsberg V, Linhart M, Stöckigt F, Klein S, Schierwagen R, Trebicka J, Nickenig G, Schrickel JW, Andrié RP. Relaxin reduces susceptibility to post-infarct atrial fibrillation in mice due to anti-fibrotic and anti-inflammatory properties. Biochem Biophys Res Commun 2017. [DOI: 10.1016/j.bbrc.2017.06.091] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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16
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Beiert T, Malotki R, Kraemer N, Stöckigt F, Linhart M, Nickenig G, Schrickel JW, Andrié RP. A real world wearable cardioverter defibrillator experience - Very high appropriate shock rate in ischemic cardiomyopathy patients at a European single-center. J Electrocardiol 2017; 50:603-609. [PMID: 28499628 DOI: 10.1016/j.jelectrocard.2017.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The wearable cardioverter defibrillator (WCD) has emerged as a valuable tool to protect patients with increased risk of sudden cardiac death (SCD). We sought to characterize WCD patients and to analyze predictors of ventricular arrhythmia (VA) occurrence and WCD shock delivery. METHODS AND RESULTS One hundred fourteen patients with WCD use were included in the study. Indications were mainly ischemic cardiomyopathy (ICM; 31.6%), non-ICM (45.6%) and explantation of implantable cardioverter defibrillator due to device infection (11.4%). We observed sustained VA in 9.6% of the study population and 6.1% received an appropriate shock. VA occurred in 16.7% of ICM, 3.8% of non-ICM and 15.4% of patients with device infection. CONCLUSIONS Our data demonstrate a very high rate of sustained VA in patients at risk for SCD during WCD use. ICM patients, including those with recent MI, bore the highest risk.
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Affiliation(s)
- Thomas Beiert
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany.
| | - Robert Malotki
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Natalie Kraemer
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Florian Stöckigt
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Markus Linhart
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Georg Nickenig
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Jan W Schrickel
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - René P Andrié
- Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
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17
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Voelkl J, Alesutan I, Primessnig U, Feger M, Mia S, Jungmann A, Castor T, Viereck R, Stöckigt F, Borst O, Gawaz M, Schrickel JW, Metzler B, Katus HA, Müller OJ, Pieske B, Heinzel FR, Lang F. AMP-activated protein kinase α1-sensitive activation of AP-1 in cardiomyocytes. J Mol Cell Cardiol 2016; 97:36-43. [PMID: 27106803 DOI: 10.1016/j.yjmcc.2016.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 04/13/2016] [Accepted: 04/18/2016] [Indexed: 01/12/2023]
Abstract
AMP-activated protein kinase (Ampk) regulates myocardial energy metabolism and plays a crucial role in the response to cell stress. In the failing heart, an isoform shift of the predominant Ampkα2 to the Ampkα1 was observed. The present study explored possible isoform specific effects of Ampkα1 in cardiomyocytes. To this end, experiments were performed in HL-1 cardiomyocytes, as well as in Ampkα1-deficient and corresponding wild-type mice and mice following AAV9-mediated cardiac overexpression of constitutively active Ampkα1. As a result, in HL-1 cardiomyocytes, overexpression of constitutively active Ampkα1 increased the phosphorylation of Pkcζ. Constitutively active Ampkα1 further increased AP-1-dependent transcriptional activity and mRNA expression of the AP-1 target genes c-Fos, Il6 and Ncx1, effects blunted by Pkcζ silencing. In HL-1 cardiomyocytes, angiotensin-II activated AP-1, an effect blunted by silencing of Ampkα1 and Pkcζ, but not of Ampkα2. In wild-type mice, angiotensin-II infusion increased cardiac Ampkα1 and cardiac Pkcζ protein levels, as well as c-Fos, Il6 and Ncx1 mRNA expression, effects blunted in Ampkα1-deficient mice. Pressure overload by transverse aortic constriction (TAC) similarly increased cardiac Ampkα1 and Pkcζ abundance as well as c-Fos, Il6 and Ncx1 mRNA expression, effects again blunted in Ampkα1-deficient mice. AAV9-mediated cardiac overexpression of constitutively active Ampkα1 increased Pkcζ protein abundance and the mRNA expression of c-Fos, Il6 and Ncx1 in cardiac tissue. In conclusion, Ampkα1 promotes myocardial AP-1 activation in a Pkcζ-dependent manner and thus contributes to cardiac stress signaling.
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Affiliation(s)
- Jakob Voelkl
- Department of Physiology & Cardiology and Cardiovascular Medicine, University of Tübingen, Gmelinstr.5/Otfried-Mueller-Str. 10, 72076, Tübingen, Germany
| | - Ioana Alesutan
- Department of Physiology & Cardiology and Cardiovascular Medicine, University of Tübingen, Gmelinstr.5/Otfried-Mueller-Str. 10, 72076, Tübingen, Germany
| | - Uwe Primessnig
- Department of Cardiology, Charité, Campus Virchow & German Centre for Cardiovascular Research (DZHK), Charite & Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Martina Feger
- Department of Physiology & Cardiology and Cardiovascular Medicine, University of Tübingen, Gmelinstr.5/Otfried-Mueller-Str. 10, 72076, Tübingen, Germany
| | - Sobuj Mia
- Department of Physiology & Cardiology and Cardiovascular Medicine, University of Tübingen, Gmelinstr.5/Otfried-Mueller-Str. 10, 72076, Tübingen, Germany
| | - Andreas Jungmann
- Department of Internal Medicine III, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany, and DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany
| | - Tatsiana Castor
- Department of Physiology & Cardiology and Cardiovascular Medicine, University of Tübingen, Gmelinstr.5/Otfried-Mueller-Str. 10, 72076, Tübingen, Germany
| | - Robert Viereck
- Department of Physiology & Cardiology and Cardiovascular Medicine, University of Tübingen, Gmelinstr.5/Otfried-Mueller-Str. 10, 72076, Tübingen, Germany
| | - Florian Stöckigt
- Department of Medicine - Cardiology, University Hospital Bonn, Sigmund-Freud-Str.25, 53127 Bonn, Germany
| | - Oliver Borst
- Department of Physiology & Cardiology and Cardiovascular Medicine, University of Tübingen, Gmelinstr.5/Otfried-Mueller-Str. 10, 72076, Tübingen, Germany
| | - Meinrad Gawaz
- Department of Physiology & Cardiology and Cardiovascular Medicine, University of Tübingen, Gmelinstr.5/Otfried-Mueller-Str. 10, 72076, Tübingen, Germany
| | - Jan Wilko Schrickel
- Department of Medicine - Cardiology, University Hospital Bonn, Sigmund-Freud-Str.25, 53127 Bonn, Germany
| | - Bernhard Metzler
- Department of Medicine - Cardiology, Medical University Innsbruck, Anichstr.35, 6020 Innsbruck, Austria
| | - Hugo A Katus
- Department of Internal Medicine III, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany, and DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany
| | - Oliver J Müller
- Department of Internal Medicine III, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany, and DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany
| | - Burkert Pieske
- Department of Cardiology, Charité, Campus Virchow & German Centre for Cardiovascular Research (DZHK), Charite & Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany; Department of Cardiology, University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Frank R Heinzel
- Department of Cardiology, Charité, Campus Virchow & German Centre for Cardiovascular Research (DZHK), Charite & Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Florian Lang
- Department of Physiology & Cardiology and Cardiovascular Medicine, University of Tübingen, Gmelinstr.5/Otfried-Mueller-Str. 10, 72076, Tübingen, Germany.
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18
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Stöckigt F, Peche VS, Linhart M, Nickenig G, Noegel AA, Schrickel JW. Deficiency of cyclase-associated protein 2 promotes arrhythmias associated with connexin43 maldistribution and fibrosis. Arch Med Sci 2016; 12:188-98. [PMID: 26925136 PMCID: PMC4754362 DOI: 10.5114/aoms.2015.54146] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 11/09/2014] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Cyclase-associated protein 2 (CAP2) plays a major role in regulating the actin cytoskeleton. Since inactivation of CAP2 in a mouse model by a gene trap approach (Cap2 (gt/gt) ) results in cardiomyopathy and increased mortality, we hypothesized that CAP2 has a major impact on arrhythmias and electrophysiological parameters. MATERIAL AND METHODS We performed long-term-ECG recordings in transgenic CAP2 deficient mice (C57BL/6) to detect spontaneous arrhythmias. In vivo electrophysiological studies by right heart catheterization and ex vivo epicardial mapping were used to analyze electrophysiological parameters, the inducibility of arrhythmias, and conduction velocities. Expression and distribution of cardiac connexins and the amount of cardiac fibrosis were evaluated. RESULTS Spontaneous ventricular arrhythmias could be detected in Cap2 (gt/gt) during the long-term-ECG recording. Cap2 (gt/gt) showed marked conduction delays at atrial and ventricular levels, including a reduced heart rate (421.0 ±40.6 bpm vs. 450.8 ±27.9 bpm; p < 0.01), and prolongations of PQ (46.3 ±4.1 ms vs. 38.6 ±6.5 ms; p < 0.01), QRS (16.2 ±2.6 ms vs. 12.6 ±1.4 ms; p < 0.01), and QTc interval (55.8 ±6.0 ms vs. 45.2 ±3.3 ms; p = 0.02) in comparison to wild type mice. The PQ prolongation was due to an infra-Hisian conduction delay (HV: 9.7 ±2.1 ms vs. 6.5 ±3.1 ms; p = 0.02). The inducibility of ventricular tachycardias during the electrophysiological studies was significantly elevated in the mutant mice (inducible animals: 88% vs. 33%; p = 0.04). Cap2 (gt/gt) showed more abnormal distribution of connexin43 compared to WT (23.0 ±4.7% vs. 2.9 ±0.8%; p < 0.01). Myocardial fibrosis was elevated in Cap2 (gt/gt) hearts (9.1 ±6.7% vs. 5.5 ±3.3%; p < 0.01). CONCLUSIONS Loss of CAP2 results in marked electrophysiological disturbances including impaired sinus node function, conduction delays, and susceptibility to malignant arrhythmias. Structural changes in Cap2 (gt/gt) are associated with alterations in myocardial connexins and fibrosis.
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Affiliation(s)
- Florian Stöckigt
- Department of Medicine – Cardiology, University Hospital Bonn, Bonn, Germany
| | - Vivek Shahaji Peche
- Institute of Biochemistry I, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Markus Linhart
- Department of Medicine – Cardiology, University Hospital Bonn, Bonn, Germany
| | - Georg Nickenig
- Department of Medicine – Cardiology, University Hospital Bonn, Bonn, Germany
| | - Angelika Anna Noegel
- Institute of Biochemistry I, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Jan Wilko Schrickel
- Department of Medicine – Cardiology, University Hospital Bonn, Bonn, Germany
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19
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Stöckigt F, Jüngst P, Linhart M, Nickenig G, Andrié R, Beiert T, Schrickel JW. Association of Heart Rate Turbulence With Arrhythmia Susceptibility and Heart Disease in Mice. J Cardiovasc Electrophysiol 2015. [PMID: 26222888 DOI: 10.1111/jce.12766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Recent studies have demonstrated the feasibility of measuring heart rate turbulence (HRT) as a marker of baroreflex function in healthy mice. The aim of this investigation was to measure HRT in a mouse model with induced structural heart defects and to determine if there were threshold values of HRT for inducible ventricular tachycardias (VTs). METHODS AND RESULTS HRT was measured during electrophysiological investigations 2 weeks after transverse aortic constriction (TAC, n = 13) or myocardial cryoinfarction (MCI, n = 14). Sham-operated mice served as controls (n = 8 for TAC controls and n = 9 for MCI controls). Mice with heart disease lacked an early acceleration (turbulence onset [TO]) in heart rate after extrastimulus pacing (heart disease: 0.39% [0.19%-0.59%] vs. all controls: -0.04% [-0.25-0.19%]; P < 0.01). At a cutoff value of >0.25%, TO could be used to classify mice with induced heart disease with a sensitivity of 64.0% and specificity of 88.2% (P < 0.01) but did not identify mice at higher risk of induced VTs. Animals that were susceptible to VTs (n = 8) had lower values for turbulence slope (TS) compared with noninducible mice (6.2 milliseconds/beat [3.1-9.5 milliseconds/beat] vs. 10.1 milliseconds/beat [7.2-14.2 milliseconds/beat]; P = 0.03). TS <7.8 milliseconds/beat identified mice with inducible VTs with a sensitivity of 75.0% and specificity of 75.8% (P = 0.02). CONCLUSION Measurement of HRT is feasible in mouse models with induced structural heart disease. More abnormal values for TO were found in the presence of structural heart disease but did not predict susceptibility to VTs. Decreased TS was associated with VTs induced by programmed stimulation.
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Affiliation(s)
- Florian Stöckigt
- University Hospital Bonn, Department of Medicine-Cardiology, Sigmund Freud, Bonn, Germany
| | - Philipp Jüngst
- University Hospital Bonn, Department of Medicine-Cardiology, Sigmund Freud, Bonn, Germany
| | - Markus Linhart
- University Hospital Bonn, Department of Medicine-Cardiology, Sigmund Freud, Bonn, Germany
| | - Georg Nickenig
- University Hospital Bonn, Department of Medicine-Cardiology, Sigmund Freud, Bonn, Germany
| | - René Andrié
- University Hospital Bonn, Department of Medicine-Cardiology, Sigmund Freud, Bonn, Germany
| | - Thomas Beiert
- University Hospital Bonn, Department of Medicine-Cardiology, Sigmund Freud, Bonn, Germany
| | - Jan Wilko Schrickel
- University Hospital Bonn, Department of Medicine-Cardiology, Sigmund Freud, Bonn, Germany
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20
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Clemen CS, Stöckigt F, Strucksberg KH, Chevessier F, Winter L, Schütz J, Bauer R, Thorweihe JM, Wenzel D, Schlötzer-Schrehardt U, Rasche V, Krsmanovic P, Katus HA, Rottbauer W, Just S, Müller OJ, Friedrich O, Meyer R, Herrmann H, Schrickel JW, Schröder R. The toxic effect of R350P mutant desmin in striated muscle of man and mouse. Acta Neuropathol 2015; 129:297-315. [PMID: 25394388 PMCID: PMC4309020 DOI: 10.1007/s00401-014-1363-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/14/2014] [Accepted: 10/30/2014] [Indexed: 01/09/2023]
Abstract
Mutations of the human desmin gene on chromosome 2q35 cause autosomal dominant, autosomal recessive and sporadic forms of protein aggregation myopathies and cardiomyopathies. We generated R349P desmin knock-in mice, which harbor the ortholog of the most frequently occurring human desmin missense mutation R350P. These mice develop age-dependent desmin-positive protein aggregation pathology, skeletal muscle weakness, dilated cardiomyopathy, as well as cardiac arrhythmias and conduction defects. For the first time, we report the expression level and subcellular distribution of mutant versus wild-type desmin in our mouse model as well as in skeletal muscle specimens derived from human R350P desminopathies. Furthermore, we demonstrate that the missense-mutant desmin inflicts changes of the subcellular localization and turnover of desmin itself and of direct desmin-binding partners. Our findings unveil a novel principle of pathogenesis, in which not the presence of protein aggregates, but disruption of the extrasarcomeric intermediate filament network leads to increased mechanical vulnerability of muscle fibers. These structural defects elicited at the myofiber level finally impact the entire organ and subsequently cause myopathy and cardiomyopathy.
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MESH Headings
- Animals
- Arrhythmias, Cardiac/pathology
- Arrhythmias, Cardiac/physiopathology
- Cardiomyopathies/pathology
- Cardiomyopathies/physiopathology
- Cardiomyopathy, Dilated/pathology
- Cardiomyopathy, Dilated/physiopathology
- Cytoskeleton/metabolism
- Cytoskeleton/pathology
- Desmin/genetics
- Desmin/metabolism
- Disease Models, Animal
- Escherichia coli
- Gene Knock-In Techniques
- Heart Ventricles/pathology
- Heart Ventricles/physiopathology
- Humans
- Mice, Transgenic
- Muscle Weakness/pathology
- Muscle Weakness/physiopathology
- Muscle, Skeletal/pathology
- Muscle, Skeletal/physiopathology
- Muscular Dystrophies/pathology
- Muscular Dystrophies/physiopathology
- Mutation, Missense
- Myocardium/pathology
- RNA, Messenger/metabolism
- Recombinant Proteins/genetics
- Recombinant Proteins/metabolism
- Sf9 Cells
- Spodoptera
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Affiliation(s)
- Christoph S. Clemen
- Center for Biochemistry, Institute of Biochemistry I, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 52, 50931 Cologne, Germany
| | - Florian Stöckigt
- Department of Internal Medicine II, University Hospital Bonn, 53105 Bonn, Germany
| | - Karl-Heinz Strucksberg
- Center for Biochemistry, Institute of Biochemistry I, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 52, 50931 Cologne, Germany
- Institute of Neuropathology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Frederic Chevessier
- Institute of Neuropathology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Lilli Winter
- Institute of Neuropathology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Johanna Schütz
- Institute of Neuropathology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Ralf Bauer
- Department of Internal Medicine III, University Hospital Heidelberg, 69120 Heidelberg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | | | - Daniela Wenzel
- Institute of Physiology I, Life and Brain Center, University of Bonn, 53127 Bonn, Germany
| | | | - Volker Rasche
- Department of Internal Medicine II, University Hospital Ulm, 89081 Ulm, Germany
- Core Facility Small Animal Imaging, University of Ulm, 89081 Ulm, Germany
| | - Pavle Krsmanovic
- Functional Architecture of the Cell, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Hugo A. Katus
- Department of Internal Medicine III, University Hospital Heidelberg, 69120 Heidelberg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Wolfgang Rottbauer
- Department of Internal Medicine II, University Hospital Ulm, 89081 Ulm, Germany
| | - Steffen Just
- Department of Internal Medicine II, University Hospital Ulm, 89081 Ulm, Germany
| | - Oliver J. Müller
- Department of Internal Medicine III, University Hospital Heidelberg, 69120 Heidelberg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Oliver Friedrich
- Institute of Medical Biotechnology, University of Erlangen, 91052 Erlangen, Germany
| | - Rainer Meyer
- Institute of Physiology II, Medical Faculty, University of Bonn, 53115 Bonn, Germany
| | - Harald Herrmann
- Functional Architecture of the Cell, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Jan Wilko Schrickel
- Department of Internal Medicine II, University Hospital Bonn, 53105 Bonn, Germany
| | - Rolf Schröder
- Institute of Neuropathology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
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21
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Alesutan I, Voelkl J, Stöckigt F, Mia S, Feger M, Primessnig U, Sopjani M, Munoz C, Borst O, Gawaz M, Pieske B, Metzler B, Heinzel F, Schrickel JW, Lang F. AMP-Activated Protein Kinase α1 Regulates Cardiac Gap Junction Protein Connexin 43 and Electrical Remodeling Following Pressure Overload. Cell Physiol Biochem 2015; 35:406-18. [DOI: 10.1159/000369706] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2014] [Indexed: 11/19/2022] Open
Abstract
Background/Aims: Adenosine 5'-monophosphate (AMP)-activated protein kinase (Ampk) modulates a wide array of cellular functions and regulates various ion channels and transporters. In failing human hearts an increased Ampkα1 activity was observed. The present study aimed to uncover the impact of Ampkα1 on cardiac electrical remodeling. Methods: Gene-targeted mice lacking functional Ampkα1 (Ampkα1-/-) and corresponding wild-type mice were exposed to pressure overload by “transverse aortic constriction” (TAC). In vivo electrophysiology was performed with a single catheter technique, myocardial conduction velocities and conduction characteristics investigated in isolated hearts, transcript levels quantified by RT-PCR and protein abundance determined by Western blotting. Moreover, connexin 43 (Cx43) was expressed in Xenopus oocytes with or without coexpression of wild-type or mutant AMPK and Cx43 protein abundance quantified utilizing confocal microscopy. Results: TAC treatment increased Ampkα1 protein expression in cardiac tissue from wild-type mice. TAC further increased left ventricular conduction inhomogeneity and triggered conduction blocks, effects blunted in the Ampkα1-/- mice. TAC treatment decreased Cx43 protein abundance in cardiac tissue, an effect significantly blunted in the Ampkα1-/- mice. TAC treatment did not modify Cx43 mRNA levels but increased ubiquitination of Cx43 protein, an effect mitigated by Ampkα1 deficiency. As shown in Xenopus oocytes, Cx43 cell membrane protein abundance was significantly downregulated by wild-type AMPKWT and constitutively active AMPKγR70Q, but not by catalytically inactive AMPKαK45R. Conclusion: Ampkα1 stimulates ubiquitination of the gap junction protein Cx43, thereby contributing to gap junction remodeling following pressure overload.
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22
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Friedrichs K, Adam M, Remane L, Mollenhauer M, Rudolph V, Rudolph TK, Andrié RP, Stöckigt F, Schrickel JW, Ravekes T, Deuschl F, Nickenig G, Willems S, Baldus S, Klinke A. Induction of atrial fibrillation by neutrophils critically depends on CD11b/CD18 integrins. PLoS One 2014; 9:e89307. [PMID: 24558493 PMCID: PMC3928425 DOI: 10.1371/journal.pone.0089307] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 01/21/2014] [Indexed: 01/09/2023] Open
Abstract
Background Recent observational clinical and ex-vivo studies suggest that inflammation and in particular leukocyte activation predisposes to atrial fibrillation (AF). However, whether local binding and extravasation of leukocytes into atrial myocardium is an essential prerequisite for the initiation and propagation of AF remains elusive. Here we investigated the role of atrial CD11b/CD18 mediated infiltration of polymorphonuclear neutrophils (PMN) for the susceptibility to AF. Methods and Results C57bl/6J wildtype (WT) and CD11b/CD18 knock-out (CD11b−/−) mice were treated for 14 days with subcutaneous infusion of angiotensin II (Ang II), a known stimulus for PMN activation. Atria of Ang II-treated WT mice were characterized by increased PMN infiltration assessed in immunohistochemically stained sections. In contrast, atrial sections of CD11b−/− mice lacked a significant increase in PMN infiltration upon Ang II infusion. PMN infiltration was accompanied by profoundly enhanced atrial fibrosis in Ang II treated WT as compared to CD11b−/− mice. Upon in-vivo electrophysiological investigation, Ang II treatment significantly elevated the susceptibility for AF in WT mice if compared to vehicle treated animals given an increased number and increased duration of AF episodes. In contrast, animals deficient of CD11b/CD18 were entirely protected from AF induction. Likewise, epicardial activation mapping revealed decreased electrical conduction velocity in atria of Ang II treated WT mice, which was preserved in CD11b−/− mice. In addition, atrial PMN infiltration was enhanced in atrial appendage sections of patients with persistent AF as compared to patients without AF. Conclusions The current data critically link CD11b-integrin mediated atrial PMN infiltration to the formation of fibrosis, which promotes the initiation and propagation of AF. These findings not only reveal a mechanistic role of leukocytes in AF but also point towards a potential novel avenue of treatment in AF.
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Affiliation(s)
- Kai Friedrichs
- Heart Center, University of Cologne, Cologne, Germany
- Cologne Cardiovascular Research Center, University of Cologne, Cologne, Germany
| | - Matti Adam
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
| | - Lisa Remane
- Heart Center, University of Cologne, Cologne, Germany
- Cologne Cardiovascular Research Center, University of Cologne, Cologne, Germany
| | - Martin Mollenhauer
- Heart Center, University of Cologne, Cologne, Germany
- Cologne Cardiovascular Research Center, University of Cologne, Cologne, Germany
| | - Volker Rudolph
- Heart Center, University of Cologne, Cologne, Germany
- Cologne Cardiovascular Research Center, University of Cologne, Cologne, Germany
| | - Tanja K. Rudolph
- Heart Center, University of Cologne, Cologne, Germany
- Cologne Cardiovascular Research Center, University of Cologne, Cologne, Germany
| | - René P. Andrié
- Department of Medicine-Cardiology, University Hospital of Bonn, Bonn, Germany
| | - Florian Stöckigt
- Department of Medicine-Cardiology, University Hospital of Bonn, Bonn, Germany
| | - Jan W. Schrickel
- Department of Medicine-Cardiology, University Hospital of Bonn, Bonn, Germany
| | - Thorben Ravekes
- Heart Center, University of Cologne, Cologne, Germany
- Cologne Cardiovascular Research Center, University of Cologne, Cologne, Germany
| | - Florian Deuschl
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
| | - Georg Nickenig
- Department of Medicine-Cardiology, University Hospital of Bonn, Bonn, Germany
| | - Stephan Willems
- Department of Electrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - Stephan Baldus
- Heart Center, University of Cologne, Cologne, Germany
- Cologne Cardiovascular Research Center, University of Cologne, Cologne, Germany
| | - Anna Klinke
- Heart Center, University of Cologne, Cologne, Germany
- Cologne Cardiovascular Research Center, University of Cologne, Cologne, Germany
- * E-mail:
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23
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Lübkemeier I, Andrié R, Lickfett L, Bosen F, Stöckigt F, Dobrowolski R, Draffehn AM, Fregeac J, Schultze JL, Bukauskas FF, Schrickel JW, Willecke K. The Connexin40A96S mutation from a patient with atrial fibrillation causes decreased atrial conduction velocities and sustained episodes of induced atrial fibrillation in mice. J Mol Cell Cardiol 2013; 65:19-32. [PMID: 24060583 DOI: 10.1016/j.yjmcc.2013.09.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 09/11/2013] [Accepted: 09/13/2013] [Indexed: 12/22/2022]
Abstract
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and a major cause of stroke. In the mammalian heart the gap junction proteins connexin40 (Cx40) and connexin43 (Cx43) are strongly expressed in the atrial myocardium mediating effective propagation of electrical impulses. Different heterozygous mutations in the coding region for Cx40 were identified in patients with AF. We have generated transgenic Cx40A96S mice harboring one of these mutations, the loss-of-function Cx40A96S mutation, as a model for atrial fibrillation. Cx40A96S mice were characterized by immunochemical and electrophysiological analyses. Significantly reduced atrial conduction velocities and strongly prolonged episodes of atrial fibrillation were found after induction in Cx40A96S mice. Analyses of the gating properties of Cx40A96S channels in cultured HeLa cells also revealed significantly lower junctional conductance and enhanced sensitivity voltage gating of Cx40A96S in comparison to Cx40 wild-type gap junctions. This is caused by reduced open probabilities of Cx40A96S gap junction channels, while single channel conductance remained the same. Similar to the corresponding patient, heterozygous Cx40A96S mice revealed normal expression levels and localization of the Cx40 protein. We conclude that heterozygous Cx40A96S mice exhibit prolonged episodes of induced atrial fibrillation and severely reduced atrial conduction velocities similar to the corresponding human patient.
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Affiliation(s)
- Indra Lübkemeier
- Life and Medical Sciences (LIMES) Institute, Molecular Genetics, University of Bonn, Bonn, Germany
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