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Ye T, Zhou Y, Yang J, Yu F, Song Z, Shi J, Wang L, Huang Z, Yang B, Wang X. P2X7 receptor inhibition prevents atrial fibrillation in rodent models of depression. Europace 2024; 26:euae022. [PMID: 38261756 PMCID: PMC10873709 DOI: 10.1093/europace/euae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/07/2023] [Indexed: 01/25/2024] Open
Abstract
AIMS Depression, the most prevalent psychiatric disorder, is associated with the occurrence and development of atrial fibrillation (AF). P2X7 receptor (P2X7R) activation participates in the development of depression, but little attention has been given to its role in AF. This study was to investigate the effects of P2X7R on AF in depression models. METHODS AND RESULTS Lipopolysaccharide (LPS) and chronic unpredictable stress (CUS) were carried out to induce depression in rodents. Behavioural assessments, atrial electrophysiological parameters, electrocardiogram (ECG) parameters, western blot, and histology were performed. Atrial fibrillation inducibility was increased in both LPS- and CUS-induced depression, along with the up-regulation of P2X7R in atria. CUS facilitated atrial fibrosis. CUS reduced heart rate variability (HRV) and increased the expression of TH and GAP43, representing autonomic dysfunction. Down-regulation of Nav1.5, Cav1.2, Kv1.5, Kv4.3, Cx40, and Cx43 in CUS indicated the abnormalities in ion channels. In addition, the expression levels of TLR4, P65, P-P65, NLRP3, ASC, caspase-1, and IL-1β were elevated in depression models. Pharmacological inhibitor (Brilliant Blue G, BBG) or genetic deficiency of P2X7R significantly mitigated depressive-like behaviours; ameliorated electrophysiological deterioration and autonomic dysfunction; improved ion channel expression and atrial fibrosis; and prevented atrial NLRP3 inflammasome activation in the pathophysiological process of AF in depression models. CONCLUSION LPS or CUS induces AF and promotes P2X7R-dependent activation of NLRP3 inflammasome, whereas pharmacological P2X7R inhibition or P2X7R genetic deficiency prevents atrial remodelling without interrupting normal atrial physiological functions. Our results point to P2X7R as an important factor in the pathology of AF in depression.
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Affiliation(s)
- Tianxin Ye
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003, PR China
| | - Yunping Zhou
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003, PR China
| | - Jinxiu Yang
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003, PR China
| | - Fangcong Yu
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003, PR China
| | - Zhuonan Song
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003, PR China
| | - Jiaran Shi
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003, PR China
| | - Longbo Wang
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003, PR China
| | - Zhouqing Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Road, Wenzhou, Zhejiang Province 325000, PR China
| | - Bo Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan 430060, PR China
- Cardiovascular Research Institute, Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan 430060, PR China
- Hubei Key Laboratory of Cardiology, Wuhan 430060, PR China
| | - Xingxiang Wang
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003, PR China
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Carmona Puerta R, Lorenzo Martínez E, Donoiu I, Chávez González E. P‐wave dispersion is a vectorial phenomenon: Is it time to change minds? J Arrhythm 2022; 38:1106-1107. [DOI: 10.1002/joa3.12779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/23/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Raimundo Carmona Puerta
- Department of Electrophysiology and Arrhythmology Cardiovascular Hospital "Ernesto Guevara" Santa Clara Cuba
| | | | - Ionut Donoiu
- Department of Cardiology University of Medicine and Pharmacy of Craiova Craiova Romania
| | - Elibet Chávez González
- Department of Electrophysiology and Arrhythmology Cardiovascular Hospital "Ernesto Guevara" Santa Clara Cuba
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Carmona-Puerta R, Chávez-González E, Padrón-Peña G, Cruz-Elizundia JM, Rodríguez-González F, Lorenzo-Martínez E. Uneven vectorial projection is the best explanation for QRS dispersion, not the asynchronic ventricular activation. J Electrocardiol 2022; 74:116-121. [PMID: 36183521 DOI: 10.1016/j.jelectrocard.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/07/2022] [Accepted: 09/14/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND It is believed that QRS dispersion (QRSd) is caused by asynchrony of ventricular activation, but there are no studies that prove it. OBJECTIVES To determine the mechanism that best explains QRSd in surface electrocardiogram (ECG). METHODS Cross-sectional study in 95 consecutive patients (median age: 31.0 years [25-52], female sex: 66.3%) with atrioventricular nodal reentrant tachycardia. All 12 ECG leads were recorded at once, simultaneously with the intracardiac recordings. QRSd was quantified as the difference between maximum (QRSmax) and minimum QRS duration (QRSmin). QRS was measured firstly at a calibration of 20 mm/mV and a sweep speed of 50 mm/s, enhancement 10× (basic measurement [BM]), and after at sweep speed of 150 mm/s, enhancement 80 - 160×. The interventricular dyssynchrony (IVD) was also quantified. RESULTS QRSmax increased from BM (98 ms [91-103]) to 80× (102 ms [99-108]; p = 0.029) and 160× (104 ms [101.5-110]; p = 0.027). QRSmin, almost equaled the duration of QRSmax at 160× (103 ms [100-108]). With BM, QRSd was 26 ms [22-35] and was reduced 26-fold (p < 0.001) by magnifying the QRS at 160× (1 ms [0-3]). IVD was weakly correlated with QRSd (r = 0.234, p = 0.023), but strongly with the total QRS at 160× (r = 0.676, p < 0.001). CONCLUSION When QRS complex is narrow, the best explanation for the origin of QRSd on the surface ECG is the unequal projection of the ventricular depolarization vector in the different axis of the leads.
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Affiliation(s)
- Raimundo Carmona-Puerta
- Department of Electrophysiology and Arrhythmology. Cardiovascular Hospital "Ernesto Guevara", Santa Clara City, Villa Clara Province, Cuba; Department of Physiology. Medical University of Villa Clara, Santa Clara City, Villa Clara Province, Cuba.
| | - Elibet Chávez-González
- Department of Electrophysiology and Arrhythmology. Cardiovascular Hospital "Ernesto Guevara", Santa Clara City, Villa Clara Province, Cuba; Department of Physiology. Medical University of Villa Clara, Santa Clara City, Villa Clara Province, Cuba
| | - Gustavo Padrón-Peña
- Department of Electrophysiology and Arrhythmology. Cardiovascular Hospital "Ernesto Guevara", Santa Clara City, Villa Clara Province, Cuba
| | - Juan Miguel Cruz-Elizundia
- Department of Electrophysiology and Arrhythmology. Cardiovascular Hospital "Ernesto Guevara", Santa Clara City, Villa Clara Province, Cuba; Department of Physiology. Medical University of Villa Clara, Santa Clara City, Villa Clara Province, Cuba
| | - Fernando Rodríguez-González
- Department of Electrophysiology and Arrhythmology. Cardiovascular Hospital "Ernesto Guevara", Santa Clara City, Villa Clara Province, Cuba; Department of Physiology. Medical University of Villa Clara, Santa Clara City, Villa Clara Province, Cuba
| | - Elizabeth Lorenzo-Martínez
- Department of Physiology. Medical University of Villa Clara, Santa Clara City, Villa Clara Province, Cuba
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Carmona Puerta R, Lorenzo Martínez E, Rabassa López-Calleja M, Padrón Peña G, Cruz Elizundia JM, Rodríguez González F, Chávez González E. Vectorial theory surpasses the local theory in explaining the origin of P-wave dispersion. J Electrocardiol 2021; 66:152-160. [PMID: 33962125 DOI: 10.1016/j.jelectrocard.2021.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Local theory and the vectorial theory are used to explain the origin of P-wave dispersion (PWD). There are no previous studies that analyze both at the same time. OBJECTIVES We set out to determine the implication of local and vectorial theories in the origin of PWD. METHODS Cross-sectional study in 153 randomly selected patients aged 18-70 years, undergoing electrophysiological study. Inhomogeneous atrial conduction was evaluated by atrial electrogram dispersion in terms of duration (EGMdurdis) and morphology (EGMmorph dis). P-distal coronary sinus interval (P-DCS) was also measured. P-wave was measured twice, firstly at a calibration of 20 mm/mV and a sweep speed of 50 mm/s, enhancement 10× (basic measurement [BM]), and second time at sweep speed of 150 mm/s, enhancement 80-160× (high precision measurement [HPM]). RESULTS PWD with BM was 48 ms [36-54 ms] while with HPM it was 4 ms [0-10 ms], p < 0.001. With BM, maximum and minimum P- wave duration presented a moderate correlation (r = 0.342; p < 0.001), using HPM it becomes strong (r = 0.750; p < 0.001). In cases with P-DCS < 80 ms (r = 0.965; p < 0.001), but not with P-DCS ≥ 80 ms (r = 0.649; p < 0.001), the previous correlation became almost perfect with HPM. EGMdurdis and EGMmorphdis were weak but significantly correlated with PWD. This correlation became moderate in patients with P-DCS ≥ 80 ms and disappeared in those with P-DCS, using BM and HPM. CONCLUSION Vectorial theory explains almost entirely the PWD phenomenon. Inhomogeneous conduction could be an additional mechanism to explain PWD, but its contribution is small.
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Affiliation(s)
- Raimundo Carmona Puerta
- Department of Electrophysiology and Arrhythmology. Cardiovascular Hospital "Ernesto Guevara", Santa Clara City, Villa Clara Province, Cuba.
| | - Elizabeth Lorenzo Martínez
- Department of Physiology, Medical University of Villa Clara, Santa Clara City, Villa Clara Province, Cuba
| | | | - Gustavo Padrón Peña
- Department of Electrophysiology and Arrhythmology. Cardiovascular Hospital "Ernesto Guevara", Santa Clara City, Villa Clara Province, Cuba
| | - Juan Miguel Cruz Elizundia
- Department of Electrophysiology and Arrhythmology. Cardiovascular Hospital "Ernesto Guevara", Santa Clara City, Villa Clara Province, Cuba
| | - Fernando Rodríguez González
- Department of Electrophysiology and Arrhythmology. Cardiovascular Hospital "Ernesto Guevara", Santa Clara City, Villa Clara Province, Cuba
| | - Elibet Chávez González
- Department of Electrophysiology and Arrhythmology. Cardiovascular Hospital "Ernesto Guevara", Santa Clara City, Villa Clara Province, Cuba
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Carmona Puerta R, Lorenzo Martínez E, Rabassa López-Calleja MA, Padrón Peña G, Castro Torres Y, Cruz Elizundia JM, Rodríguez González F, García Vázquez LÁ, Chávez González E. New Parameter of the Second Half of the P-Wave, P-Wave Duration, and Atrial Conduction Times Predict Atrial Fibrillation during Electrophysiological Studies. Med Princ Pract 2021; 30:462-469. [PMID: 34348309 PMCID: PMC8562052 DOI: 10.1159/000518262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 07/04/2021] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Several P-wave parameters reflect atrial conduction characteristics and have been used to predict atrial fibrillation (AF). The aim of this study was to determine the relationship between maximum P-wave duration (PMax) and new P-wave parameters, with atrial conduction times (CT), and to assess their predictive value of AF during electrophysiological studies (AF-EPS). SUBJECTS AND METHODS This was a cross-sectional study in 153 randomly selected patients aged 18-70 years, undergoing EPS. The patients were divided into 2 groups designated as no AF-EPS and AF-EPS, depending on whether AF occurred during EPS or not. Different P-wave parameters and atrial CT were compared for both study groups. Subsequently, the predictive value of the P-wave parameters and the atrial CT for AF-EPS was evaluated. RESULTS The values of CT, PMax, and maximum Ppeak-Pend interval (Pp-eMax) were significantly higher in patients with AF-EPS. Almost all P-wave parameters were correlated with the left CT. PMax, Pp-eMax, and CT were univariate and multivariate predictors of AF-EPS. The largest ROC area was presented by interatrial CT (0.852; p < 0.001; cutoff value: ≥82.5 ms; sensitivity: 91.1%; specificity: 81.1%). Pp-eMax showed greater sensitivity (79.5%) to discriminate AF-EPS than PMax (72.7%), but the latter had better specificity (60.4% vs. 41.5%). CONCLUSIONS Left atrial CT were directly and significantly correlated with PMax and almost all the parameters of the second half of the P-wave. CT, PMax, and Pp-eMax (new parameter) were good predictors of AF-EPS, although CT did more robustly.
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Affiliation(s)
- Raimundo Carmona Puerta
- Department of Electrophysiology and Arrhythmology, Cardiovascular Hospital “Ernesto Guevara”, Santa Clara, Cuba
- *Raimundo Carmona Puerta,
| | | | | | - Gustavo Padrón Peña
- Department of Electrophysiology and Arrhythmology, Cardiovascular Hospital “Ernesto Guevara”, Santa Clara, Cuba
| | - Yaniel Castro Torres
- Coronary Care Unit, San Juan de Dios Hospital, Santiago de Chile, Santiago, Chile
| | - Juan Miguel Cruz Elizundia
- Department of Electrophysiology and Arrhythmology, Cardiovascular Hospital “Ernesto Guevara”, Santa Clara, Cuba
| | - Fernando Rodríguez González
- Department of Electrophysiology and Arrhythmology, Cardiovascular Hospital “Ernesto Guevara”, Santa Clara, Cuba
| | | | - Elibet Chávez González
- Department of Electrophysiology and Arrhythmology, Cardiovascular Hospital “Ernesto Guevara”, Santa Clara, Cuba
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