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Amoni M, Vermoortele D, Ekhteraei-Tousi S, Doñate Puertas R, Gilbert G, Youness M, Thienpont B, Willems R, Roderick HL, Claus P, Sipido KR. Heterogeneity of Repolarization and Cell-Cell Variability of Cardiomyocyte Remodeling Within the Myocardial Infarction Border Zone Contribute to Arrhythmia Susceptibility. Circ Arrhythm Electrophysiol 2023; 16:e011677. [PMID: 37128895 DOI: 10.1161/circep.122.011677] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND After myocardial infarction, the infarct border zone (BZ) is the dominant source of life-threatening arrhythmias, where fibrosis and abnormal repolarization create a substrate for reentry. We examined whether repolarization abnormalities are heterogeneous within the BZ in vivo and could be related to heterogeneous cardiomyocyte remodeling. METHODS Myocardial infarction was induced in domestic pigs by 120-minute ischemia-reperfusion injury. After 1 month, remodeling was assessed by magnetic resonance imaging, and electroanatomical mapping was performed to determine the spatial distribution of activation-recovery intervals. Cardiomyocytes were isolated and tissue samples collected from the BZ and remote regions. Optical recording allowed assessment of action potential duration (di-8-Anepps, stimulation at 1 Hz, 37 °C) of large cardiomyocyte populations while gene expression in cardiomyocytes was determined by single nuclear RNA sequencing. RESULTS In vivo, activation-recovery intervals in the BZ tended to be longer than in remote with increased spatial heterogeneity evidenced by a greater local SD (3.5±1.3 ms versus remote: 2.0±0.5 ms, P=0.036, npigs=5). Increased activation-recovery interval heterogeneity correlated with enhanced arrhythmia susceptibility. Cellular population studies (ncells=635-862 cells per region) demonstrated greater heterogeneity of action potential duration in the BZ (SD, 105.9±17.0 ms versus remote: 73.9±8.6 ms; P=0.001; npigs=6), which correlated with heterogeneity of activation-recovery interval in vivo. Cell-cell gene expression heterogeneity in the BZ was evidenced by increased Euclidean distances between nuclei of the BZ (12.1 [9.2-15.0] versus 10.6 [7.5-11.6] in remote; P<0.0001). Differentially expressed genes characterizing BZ cardiomyocyte remodeling included hypertrophy-related and ion channel-related genes with high cell-cell variability of expression. These gene expression changes were driven by stress-responsive TFs (transcription factors). In addition, heterogeneity of left ventricular wall thickness was greater in the BZ than in remote. CONCLUSIONS Heterogeneous cardiomyocyte remodeling in the BZ is driven by uniquely altered gene expression, related to heterogeneity in the local microenvironment, and translates to heterogeneous repolarization and arrhythmia vulnerability in vivo.
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Affiliation(s)
- Matthew Amoni
- Experimental Cardiology, KU Leuven, Belgium. (M.A., S.E.-T., R.D.P., G.G., M.Y., R.W., H.L.R., K.R.S.)
- Division of Cardiology, University Hospitals, Leuven, Belgium (M.A., R.W.)
| | - Dylan Vermoortele
- Imaging and Cardiovascular Dynamics, Department of Cardiovascular Sciences, KU Leuven, Belgium. (D.V., P.C.)
| | - Samaneh Ekhteraei-Tousi
- Experimental Cardiology, KU Leuven, Belgium. (M.A., S.E.-T., R.D.P., G.G., M.Y., R.W., H.L.R., K.R.S.)
| | - Rosa Doñate Puertas
- Experimental Cardiology, KU Leuven, Belgium. (M.A., S.E.-T., R.D.P., G.G., M.Y., R.W., H.L.R., K.R.S.)
| | - Guillaume Gilbert
- Experimental Cardiology, KU Leuven, Belgium. (M.A., S.E.-T., R.D.P., G.G., M.Y., R.W., H.L.R., K.R.S.)
| | - Mohamad Youness
- Experimental Cardiology, KU Leuven, Belgium. (M.A., S.E.-T., R.D.P., G.G., M.Y., R.W., H.L.R., K.R.S.)
| | - Bernard Thienpont
- Laboratory for Functional Epigenetics, Department of Human Genetics, KU Leuven, Belgium. (B.T.)
| | - Rik Willems
- Experimental Cardiology, KU Leuven, Belgium. (M.A., S.E.-T., R.D.P., G.G., M.Y., R.W., H.L.R., K.R.S.)
- Division of Cardiology, University Hospitals, Leuven, Belgium (M.A., R.W.)
| | - H Llewelyn Roderick
- Experimental Cardiology, KU Leuven, Belgium. (M.A., S.E.-T., R.D.P., G.G., M.Y., R.W., H.L.R., K.R.S.)
| | - Piet Claus
- Imaging and Cardiovascular Dynamics, Department of Cardiovascular Sciences, KU Leuven, Belgium. (D.V., P.C.)
| | - Karin R Sipido
- Experimental Cardiology, KU Leuven, Belgium. (M.A., S.E.-T., R.D.P., G.G., M.Y., R.W., H.L.R., K.R.S.)
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Jin X, Meletiou A, Chung J, Tilunaite A, Demydenko K, Dries E, Puertas RD, Amoni M, Tomar A, Claus P, Soeller C, Rajagopal V, Sipido K, Roderick HL. InsP 3R-RyR channel crosstalk augments sarcoplasmic reticulum Ca 2+ release and arrhythmogenic activity in post-MI pig cardiomyocytes. J Mol Cell Cardiol 2023; 179:47-59. [PMID: 37003353 DOI: 10.1016/j.yjmcc.2023.03.015] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/08/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023]
Abstract
Ca2+ transients (CaT) underlying cardiomyocyte (CM) contraction require efficient Ca2+ coupling between sarcolemmal Ca2+ channels and sarcoplasmic reticulum (SR) ryanodine receptor Ca2+ channels (RyR) for their generation; reduced coupling in disease contributes to diminished CaT and arrhythmogenic Ca2+ events. SR Ca2+ release also occurs via inositol 1,4,5-trisphosphate receptors (InsP3R) in CM. While this pathway contributes negligeably to Ca2+ handling in healthy CM, rodent studies support a role in altered Ca2+ dynamics and arrhythmogenic Ca2+ release involving InsP3R crosstalk with RyRs in disease. Whether this mechanism persists in larger mammals with lower T-tubular density and coupling of RyRs is not fully resolved. We have recently shown an arrhythmogenic action of InsP3-induced Ca2+ release (IICR) in end stage human heart failure, often associated with underlying ischemic heart disease (IHD). How IICR contributes to early stages of disease is however not determined but highly relevant. To access this stage, we chose a porcine model of IHD, which shows substantial remodelling of the area adjacent to the infarct. In cells from this region, IICR preferentially augmented Ca2+ release from non-coupled RyR clusters that otherwise showed delayed activation during the CaT. IICR in turn synchronised Ca2+ release during the CaT but also induced arrhythmogenic delayed afterdepolarizations and action potentials. Nanoscale imaging identified co-clustering of InsP3Rs and RyRs, thereby allowing Ca2+-mediated channel crosstalk. Mathematical modelling supported and further delineated this mechanism of enhanced InsP3R-RyRs coupling in MI. Our findings highlight the role of InsP3R-RyR channel crosstalk in Ca2+ release and arrhythmia during post-MI remodelling.
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Affiliation(s)
- Xin Jin
- KU Leuven, Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, B-3000 Leuven, Belgium
| | - Anna Meletiou
- Department of Physiology, University of Bern, Bern, Switzerland
| | - Joshua Chung
- KU Leuven, Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, B-3000 Leuven, Belgium; Cell Structure and Mechanobiology Group, Department of Biomedical Engineering, Melbourne School of Engineering, University of Melbourne, Australia
| | - Agne Tilunaite
- Cell Structure and Mechanobiology Group, Department of Biomedical Engineering, Melbourne School of Engineering, University of Melbourne, Australia; Systems Biology Laboratory, School of Mathematics and Statistics, and Department of Biomedical Engineering, University of Melbourne, Australia
| | - Kateryna Demydenko
- KU Leuven, Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, B-3000 Leuven, Belgium
| | - Eef Dries
- KU Leuven, Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, B-3000 Leuven, Belgium
| | - Rosa Doñate Puertas
- KU Leuven, Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, B-3000 Leuven, Belgium
| | - Matthew Amoni
- KU Leuven, Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, B-3000 Leuven, Belgium
| | - Ashutosh Tomar
- KU Leuven, Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, B-3000 Leuven, Belgium
| | - Piet Claus
- KU Leuven, Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, B-3000 Leuven, Belgium
| | | | - Vijay Rajagopal
- Cell Structure and Mechanobiology Group, Department of Biomedical Engineering, Melbourne School of Engineering, University of Melbourne, Australia
| | - Karin Sipido
- KU Leuven, Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, B-3000 Leuven, Belgium
| | - H Llewelyn Roderick
- KU Leuven, Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, B-3000 Leuven, Belgium.
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Chevalier P, Moreau A, Bessière F, Richard S, Chahine M, Millat G, Morel E, Paganelli F, Lesavre N, Placide L, Montestruc F, Ankou B, Puertas RD, Asatryan B, Delinière A. Identification of Cx43 variants predisposing to ventricular fibrillation in the acute phase of ST-elevation myocardial infarction. Europace 2023; 25:101-111. [PMID: 35942675 PMCID: PMC10103570 DOI: 10.1093/europace/euac128] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS Ventricular fibrillation (VF) occurring in the acute phase of ST-elevation myocardial infarction (STEMI) is the leading cause of sudden cardiac death worldwide. Several studies showed that reduced connexin 43 (Cx43) expression and reduced conduction velocity increase the risk of VF in acute myocardial infarction (MI). Furthermore, genetic background might predispose individuals to primary VF (PVF). The primary objective was to evaluate the presence of GJA1 variants in STEMI patients. The secondary objective was to evaluate the arrhythmogenic impact of GJA1 variants in STEMI patients with VF. METHODS AND RESULTS The MAP-IDM prospective cohort study included 966 STEMI patients and was designed to identify genetic predisposition to VF. A total of 483 (50.0%) STEMI patients with PVF were included. The presence of GJA1 variants increased the risk of VF in STEMI patients [from 49.1 to 70.8%, P = 0.0423; odds ratio (OR): 0.40; 95% confidence interval: 0.16-0.97; P = 0.04]. The risk of PVF decreased with beta-blocker intake (from 53.5 to 44.8%, P = 0.0085), atrial fibrillation (from 50.7 to 26.4%, P = 0.0022), and with left ventricular ejection fraction >50% (from 60.2 to 41.4%, P < 0.0001). Among 16 GJA1 variants, three novel heterozygous missense variants were identified in three patients: V236I, H248R, and I327M. In vitro studies of these variants showed altered Cx43 localization and decreased cellular communication, mainly during acidosis. CONCLUSION Connexin 43 variants are associated with increased VF susceptibility in STEMI patients. Restoring Cx43 function may be a potential therapeutic target to prevent PVF in patients with acute MI. CLINICAL TRIAL REGISTRATION Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT00859300.
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Affiliation(s)
- Philippe Chevalier
- Université de Lyon, université Lyon 1, Inserm, CNRS, INMG, Lyon F-69008, France.,Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Rythmologie, Hôpital Cardiologique Louis Pradel, 59 Boulevard Pinel, 69677 Bron Cedex, France
| | - Adrien Moreau
- PhyMedExp, INSERM U1046, CNRS UMR9214, Université de Montpellier, CHU Arnaud de Villeneuve, 34295 Montpellier, France
| | - Francis Bessière
- Université de Lyon, université Lyon 1, Inserm, CNRS, INMG, Lyon F-69008, France.,Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Rythmologie, Hôpital Cardiologique Louis Pradel, 59 Boulevard Pinel, 69677 Bron Cedex, France
| | - Sylvain Richard
- PhyMedExp, INSERM U1046, CNRS UMR9214, Université de Montpellier, CHU Arnaud de Villeneuve, 34295 Montpellier, France
| | | | - Gilles Millat
- Laboratoire de Cardiogénétique moléculaire, Centre de biologie et pathologie Est, Bron, France
| | - Elodie Morel
- Université de Lyon, université Lyon 1, Inserm, CNRS, INMG, Lyon F-69008, France.,Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Rythmologie, Hôpital Cardiologique Louis Pradel, 59 Boulevard Pinel, 69677 Bron Cedex, France
| | | | | | - Leslie Placide
- Université de Lyon, université Lyon 1, Inserm, CNRS, INMG, Lyon F-69008, France.,Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Rythmologie, Hôpital Cardiologique Louis Pradel, 59 Boulevard Pinel, 69677 Bron Cedex, France
| | | | - Bénédicte Ankou
- Université de Lyon, université Lyon 1, Inserm, CNRS, INMG, Lyon F-69008, France.,Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Rythmologie, Hôpital Cardiologique Louis Pradel, 59 Boulevard Pinel, 69677 Bron Cedex, France
| | - Rosa Doñate Puertas
- Signaling and Cardiovascular Pathophysiology-UMR-S 1180, Inserm, Université Paris-Saclay, Paris, France
| | - Babken Asatryan
- Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Antoine Delinière
- Université de Lyon, université Lyon 1, Inserm, CNRS, INMG, Lyon F-69008, France.,Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Rythmologie, Hôpital Cardiologique Louis Pradel, 59 Boulevard Pinel, 69677 Bron Cedex, France
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Jin X, Amoni M, Gilbert G, Dries E, Doñate Puertas R, Tomar A, Nagaraju CK, Pradhan A, Yule DI, Martens T, Menten R, Vanden Berghe P, Rega F, Sipido K, Roderick HL. InsP 3R-RyR Ca 2+ channel crosstalk facilitates arrhythmias in the failing human ventricle. Basic Res Cardiol 2022; 117:60. [PMID: 36378362 DOI: 10.1007/s00395-022-00967-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 06/27/2022] [Revised: 10/13/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
Dysregulated intracellular Ca2+ handling involving altered Ca2+ release from intracellular stores via RyR channels underlies both arrhythmias and reduced function in heart failure (HF). Mechanisms linking RyR dysregulation and disease are not fully established. Studies in animals support a role for InsP3 receptor Ca2+ channels (InsP3R) in pathological alterations in cardiomyocyte Ca2+ handling but whether these findings translate to the divergent physiology of human cardiomyocytes during heart failure is not determined. Using electrophysiological and Ca2+ recordings in human ventricular cardiomyocytes, we uncovered that Ca2+ release via InsP3Rs facilitated Ca2+ release from RyR and induced arrhythmogenic delayed after depolarisations and action potentials. InsP3R-RyR crosstalk was particularly increased in HF at RyR clusters isolated from the T-tubular network. Reduced SERCA activity in HF further facilitated the action of InsP3. Nanoscale imaging revealed co-localisation of InsP3Rs with RyRs in the dyad, which was increased in HF, providing a mechanism for augmented Ca2+ channel crosstalk. Notably, arrhythmogenic activity dependent on InsP3Rs was increased in tissue wedges from failing hearts perfused with AngII to promote InsP3 generation. These data indicate a central role for InsP3R-RyR Ca2+ signalling crosstalk in the pro-arrhythmic action of GPCR agonists elevated in HF and the potential for their therapeutic targeting.
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Affiliation(s)
- Xin Jin
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium.,Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Matthew Amoni
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium
| | - Guillaume Gilbert
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium
| | - Eef Dries
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium
| | - Rosa Doñate Puertas
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium
| | - Ashutosh Tomar
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium
| | - Chandan K Nagaraju
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium
| | - Ankit Pradhan
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium
| | - David I Yule
- Department of Pharmacology and Physiology, Medical Center School of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Box 711, Rochester, NY, 14642, USA
| | - Tobie Martens
- Laboratory for Enteric NeuroScience (LENS), Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, 3000, Leuven, Belgium.,Cell and Tissue Imaging Cluster (CIC), KU Leuven, 3000, Leuven, Belgium
| | - Roxane Menten
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium
| | - Pieter Vanden Berghe
- Laboratory for Enteric NeuroScience (LENS), Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, 3000, Leuven, Belgium.,Cell and Tissue Imaging Cluster (CIC), KU Leuven, 3000, Leuven, Belgium
| | - Filip Rega
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium.,Department of Cardiology and Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Karin Sipido
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium
| | - H Llewelyn Roderick
- Department of Cardiovascular Sciences, Laboratory of Experimental Cardiology, KU Leuven, 3000, Leuven, Belgium.
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Doñate Puertas R, Deflers C, Puech F, Fischmeister R, Hillaireau H, Pidoux G. Novel specific cardiac homing peptides to target failing cardiomyocytes. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.04.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gilbert G, Demydenko K, Dries E, Puertas RD, Jin X, Sipido K, Roderick HL. Calcium Signaling in Cardiomyocyte Function. Cold Spring Harb Perspect Biol 2020; 12:cshperspect.a035428. [PMID: 31308143 DOI: 10.1101/cshperspect.a035428] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Rhythmic increases in intracellular Ca2+ concentration underlie the contractile function of the heart. These heart muscle-wide changes in intracellular Ca2+ are induced and coordinated by electrical depolarization of the cardiomyocyte sarcolemma by the action potential. Originating at the sinoatrial node, conduction of this electrical signal throughout the heart ensures synchronization of individual myocytes into an effective cardiac pump. Ca2+ signaling pathways also regulate gene expression and cardiomyocyte growth during development and in pathology. These fundamental roles of Ca2+ in the heart are illustrated by the prevalence of altered Ca2+ homeostasis in cardiovascular diseases. Indeed, heart failure (an inability of the heart to support hemodynamic needs), rhythmic disturbances, and inappropriate cardiac growth all share an involvement of altered Ca2+ handling. The prevalence of these pathologies, contributing to a third of all deaths in the developed world as well as to substantial morbidity makes understanding the mechanisms of Ca2+ handling and dysregulation in cardiomyocytes of great importance.
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Affiliation(s)
- Guillaume Gilbert
- Laboratory of Experimental Cardiology, Department of Cardiovascular Sciences, KU Leuven, BE3000 Leuven, Belgium
| | - Kateryna Demydenko
- Laboratory of Experimental Cardiology, Department of Cardiovascular Sciences, KU Leuven, BE3000 Leuven, Belgium
| | - Eef Dries
- Laboratory of Experimental Cardiology, Department of Cardiovascular Sciences, KU Leuven, BE3000 Leuven, Belgium
| | - Rosa Doñate Puertas
- Laboratory of Experimental Cardiology, Department of Cardiovascular Sciences, KU Leuven, BE3000 Leuven, Belgium
| | - Xin Jin
- Laboratory of Experimental Cardiology, Department of Cardiovascular Sciences, KU Leuven, BE3000 Leuven, Belgium
| | - Karin Sipido
- Laboratory of Experimental Cardiology, Department of Cardiovascular Sciences, KU Leuven, BE3000 Leuven, Belgium
| | - H Llewelyn Roderick
- Laboratory of Experimental Cardiology, Department of Cardiovascular Sciences, KU Leuven, BE3000 Leuven, Belgium
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7
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Dries E, Amoni M, Vandenberk B, Johnson DM, Gilbert G, Nagaraju CK, Puertas RD, Abdesselem M, Santiago DJ, Roderick HL, Claus P, Willems R, Sipido KR. Altered adrenergic response in myocytes bordering a chronic myocardial infarction underlies in vivo triggered activity and repolarization instability. J Physiol 2020; 598:2875-2895. [PMID: 31900932 PMCID: PMC7496440 DOI: 10.1113/jp278839] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/01/2020] [Indexed: 01/24/2023] Open
Abstract
Key points Ventricular arrhythmias are a major complication after myocardial infarction (MI), associated with sympathetic activation. The structurally heterogeneous peri‐infarct zone is a known substrate, but the functional role of the myocytes is less well known. Recordings of monophasic action potentials in vivo reveal that the peri‐infarct zone is a source of delayed afterdepolarizations (DADs) and has a high beat‐to‐beat variability of repolarization (BVR) during adrenergic stimulation (isoproterenol, ISO). Myocytes isolated from the peri‐infarct region have more DADs and spontaneous action potentials, with spontaneous Ca2+ release, under ISO. These myocytes also have reduced repolarization reserve and increased BVR. Other properties of post‐MI remodelling are present in both peri‐infarct and remote myocytes. These data highlight the importance of altered myocyte adrenergic responses in the peri‐infarct region as source and substrate of post‐MI arrhythmias.
Abstract Ventricular arrhythmias are a major early complication after myocardial infarction (MI). The heterogeneous peri‐infarct zone forms a substrate for re‐entry while arrhythmia initiation is often associated with sympathetic activation. We studied the mechanisms triggering these post‐MI arrhythmias in vivo and their relation to regional myocyte remodelling. In pigs with chronic MI (6 weeks), in vivo monophasic action potentials were simultaneously recorded in the peri‐infarct and remote regions during adrenergic stimulation with isoproterenol (isoprenaline; ISO). Sham animals served as controls. During infusion of ISO in vivo, the incidence of delayed afterdepolarizations (DADs) and beat‐to‐beat variability of repolarization (BVR) was higher in the peri‐infarct than in the remote region. Myocytes isolated from the peri‐infarct region, in comparison to myocytes from the remote region, had more DADs, associated with spontaneous Ca2+ release, and a higher incidence of spontaneous action potentials (APs) when exposed to ISO (9.99 ± 4.2 vs. 0.16 ± 0.05 APs/min, p = 0.004); these were suppressed by CaMKII inhibition. Peri‐infarct myocytes also had reduced repolarization reserve and increased BVR (26 ± 10 ms vs. 9 ± 7 ms, P < 0.001), correlating with DAD activity. In contrast to these regional distinctions under ISO, alterations in Ca2+ handling at baseline and myocyte hypertrophy were present throughout the left ventricle (LV). Expression of some of the related genes was, however, different between the regions. In conclusion, altered myocyte adrenergic responses in the peri‐infarct but not the remote region provide a source of triggered activity in vivo and of repolarization instability amplifying the substrate for re‐entry. These findings stimulate further exploration of region‐specific therapies targeting myocytes and autonomic modulation. Ventricular arrhythmias are a major complication after myocardial infarction (MI), associated with sympathetic activation. The structurally heterogeneous peri‐infarct zone is a known substrate, but the functional role of the myocytes is less well known. Recordings of monophasic action potentials in vivo reveal that the peri‐infarct zone is a source of delayed afterdepolarizations (DADs) and has a high beat‐to‐beat variability of repolarization (BVR) during adrenergic stimulation (isoproterenol, ISO). Myocytes isolated from the peri‐infarct region have more DADs and spontaneous action potentials, with spontaneous Ca2+ release, under ISO. These myocytes also have reduced repolarization reserve and increased BVR. Other properties of post‐MI remodelling are present in both peri‐infarct and remote myocytes. These data highlight the importance of altered myocyte adrenergic responses in the peri‐infarct region as source and substrate of post‐MI arrhythmias.
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Affiliation(s)
- Eef Dries
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
| | - Matthew Amoni
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
| | - Bert Vandenberk
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
| | - Daniel M Johnson
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium.,Institute of Cardiovascular Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Guillaume Gilbert
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
| | - Chandan K Nagaraju
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
| | - Rosa Doñate Puertas
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
| | - Mouna Abdesselem
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
| | - Demetrio J Santiago
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium.,Laboratory of Molecular Cardiology, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), C. Melchor Fernández Almagro 3, 28029, Madrid, Spain
| | - H Llewelyn Roderick
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
| | - Piet Claus
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
| | - Rik Willems
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
| | - Karin R Sipido
- Experimental Cardiology, University of Leuven, Herestraat 49 box 911, Leuven, Belgium
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Doñate Puertas R, Jalabert A, Meugnier E, Euthine V, Chevalier P, Rome S. Analysis of the microRNA signature in left atrium from patients with valvular heart disease reveals their implications in atrial fibrillation. PLoS One 2018; 13:e0196666. [PMID: 29723239 PMCID: PMC5933750 DOI: 10.1371/journal.pone.0196666] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 04/17/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Among the potential factors which may contribute to the development and perpetuation of atrial fibrillation, dysregulation of miRNAs has been suggested. Thus in this study, we have quantified the basal expressions of 662 mature human miRNAs in left atrium (LA) from patients undergoing cardiac surgery for valve repair, suffering or not from atrial fibrillation (AF) by using TaqMan® Low Density arrays (v2.0). RESULTS Among the 299 miRNAs expressed in all patients, 42 miRNAs had altered basal expressions in patients with AF. Binding-site predictions with Targetscan (conserved sites among species) indicated that the up- and down-regulated miRNAs controlled respectively 3,310 and 5,868 genes. To identify the most relevant cellular functions under the control of the altered miRNAs, we focused on the 100 most targeted genes of each list and identified 5 functional protein-protein networks among these genes. Up-regulated networks were involved in synchronisation of circadian rythmicity and in the control of the AKT/PKC signaling pathway (i.e., proliferation/adhesion). Down-regulated networks were the IGF-1 pathway and TGF-beta signaling pathway and a network involved in RNA-mediated gene silencing, suggesting for the first time that alteration of miRNAs in AF would also perturbate the whole miRNA machinery. Then we crossed the list of miRNA predicted genes, and the list of mRNAs altered in similar patients suffering from AF and we found that respectively 44.5% and 55% of the up- and down-regulated mRNA are predicted to be conserved targets of the altered miRNAs (at least one binding site in 3'-UTR). As they were involved in the same biological processes mentioned above, these data demonstrated that a great part of the transcriptional defects previously published in LA from AF patients are likely due to defects at the post-transcriptional level and involved the miRNAs. CONCLUSIONS Our stringent analysis permitted us to identify highly targeted protein-protein networks under the control of miRNAs in LA and, among them, to highlight those specifically affected in AF patients with altered miRNA signature. Further studies are now required to determine whether alterations of miRNA levels in AF pathology are causal or represent an adaptation to prevent cardiac electrical and structural remodeling.
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Affiliation(s)
- Rosa Doñate Puertas
- Institut NeuroMyoGene (INMG), UMR CNRS 5310-INSERM U1217 / University of Lyon, Lyon, France
| | - Audrey Jalabert
- CarMeN Laboratory (UMR INSERM 1060-INRA 1397, INSA), Lyon-Sud Faculty of Medicine, University of Lyon, Pierre-Bénite, France
| | - Emmanuelle Meugnier
- CarMeN Laboratory (UMR INSERM 1060-INRA 1397, INSA), Lyon-Sud Faculty of Medicine, University of Lyon, Pierre-Bénite, France
| | - Vanessa Euthine
- CarMeN Laboratory (UMR INSERM 1060-INRA 1397, INSA), Lyon-Sud Faculty of Medicine, University of Lyon, Pierre-Bénite, France
| | - Philippe Chevalier
- Institut NeuroMyoGene (INMG), UMR CNRS 5310-INSERM U1217 / University of Lyon, Lyon, France
- Rhythmology Unit, Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Bron, France
- * E-mail: (SR); (PC)
| | - Sophie Rome
- CarMeN Laboratory (UMR INSERM 1060-INRA 1397, INSA), Lyon-Sud Faculty of Medicine, University of Lyon, Pierre-Bénite, France
- * E-mail: (SR); (PC)
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Manati W, Pineau J, Doñate Puertas R, Morel E, Quadiri T, Bui-Xuan B, Chevalier P. Vagal stimulation after acute coronary occlusion: The heart rate matters. Cardiol J 2018; 25:709-713. [PMID: 29297176 DOI: 10.5603/cj.a2017.0156] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is a well documented causal link between autonomic imbalance and cardiac elec-trical instability. However, the mechanisms underlying the antiarrhythmic effect of vagal stimulation are poorly understood. The vagal antiarrhythmic effect might be modulated by a decrease in heart rate. METHODS The proximal anterior interventricular artery was occluded in 16 pigs by clamping under general anaesthesia. Group 1: heart rates remained spontaneous (n = 6; 12 occlusions); Group 2: heart rates were fixed at 190 bpm with atrial electrical stimulation (n = 10; 20 occlusions). Each pig received two occlusions, 30 min apart, one without and one with vagal stimulation (10 Hz, 2 ms, 5-20 mA). The antiarrhythmic effect of vagal activation was defined as the time to the appearance of ventricular fibrillation (VF) after occlusion. RESULTS In Group 1, vagal stimulation triggered a significant decrease in basal heart rate (132 ± 4 vs. 110 ± 17 bpm, p < 0.05), and delayed the time to VF after coronary occlusion (1102 ± 85 vs. 925 ± ± 41 s, p < 0.05). In Group 2, vagal stimulation did not modify the time to VF (103 ± 39 vs. 91 ± 20 s). Analyses revealed that heart rate and the time to VF were positively linearly related. CONCLUSIONS Maintaining a constant heart rate with atrial electrical stimulation in pigs prevented vagal stimulation from modifying the time to VF after acute coronary occlusion.
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Affiliation(s)
| | | | | | | | | | | | - Philippe Chevalier
- Hopital cardiologique Louis Pradel, 28 avenue Doyen Lepine, 69677 Bron, France; Institut NeuroMyogene, UMR CNRS5310-INSERM U1217, Lyon, France.
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Scridon A, Puertas RD, Manati W, Fouilloux-Meugnier E, Loizon E, Oréa V, Chapuis B, Julien C, Barrès C, Tabib A, Chevalier P. Age-dependent ventricular arrhythmias risk, structural and molecular remodeling in systemic arterial hypertension. Mech Ageing Dev 2017; 166:48-54. [DOI: 10.1016/j.mad.2017.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/01/2017] [Accepted: 07/08/2017] [Indexed: 12/01/2022]
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