1
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Hennis K, Piantoni C, Biel M, Fenske S, Wahl-Schott C. Pacemaker Channels and the Chronotropic Response in Health and Disease. Circ Res 2024; 134:1348-1378. [PMID: 38723033 PMCID: PMC11081487 DOI: 10.1161/circresaha.123.323250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Abstract
Loss or dysregulation of the normally precise control of heart rate via the autonomic nervous system plays a critical role during the development and progression of cardiovascular disease-including ischemic heart disease, heart failure, and arrhythmias. While the clinical significance of regulating changes in heart rate, known as the chronotropic effect, is undeniable, the mechanisms controlling these changes remain not fully understood. Heart rate acceleration and deceleration are mediated by increasing or decreasing the spontaneous firing rate of pacemaker cells in the sinoatrial node. During the transition from rest to activity, sympathetic neurons stimulate these cells by activating β-adrenergic receptors and increasing intracellular cyclic adenosine monophosphate. The same signal transduction pathway is targeted by positive chronotropic drugs such as norepinephrine and dobutamine, which are used in the treatment of cardiogenic shock and severe heart failure. The cyclic adenosine monophosphate-sensitive hyperpolarization-activated current (If) in pacemaker cells is passed by hyperpolarization-activated cyclic nucleotide-gated cation channels and is critical for generating the autonomous heartbeat. In addition, this current has been suggested to play a central role in the chronotropic effect. Recent studies demonstrate that cyclic adenosine monophosphate-dependent regulation of HCN4 (hyperpolarization-activated cyclic nucleotide-gated cation channel isoform 4) acts to stabilize the heart rate, particularly during rapid rate transitions induced by the autonomic nervous system. The mechanism is based on creating a balance between firing and recently discovered nonfiring pacemaker cells in the sinoatrial node. In this way, hyperpolarization-activated cyclic nucleotide-gated cation channels may protect the heart from sinoatrial node dysfunction, secondary arrhythmia of the atria, and potentially fatal tachyarrhythmia of the ventricles. Here, we review the latest findings on sinoatrial node automaticity and discuss the physiological and pathophysiological role of HCN pacemaker channels in the chronotropic response and beyond.
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Affiliation(s)
- Konstantin Hennis
- Institute of Cardiovascular Physiology and Pathophysiology, Biomedical Center Munich, Walter Brendel Centre of Experimental Medicine, Faculty of Medicine (K.H., C.P., C.W.-S.), Ludwig-Maximilians-Universität München, Germany
| | - Chiara Piantoni
- Institute of Cardiovascular Physiology and Pathophysiology, Biomedical Center Munich, Walter Brendel Centre of Experimental Medicine, Faculty of Medicine (K.H., C.P., C.W.-S.), Ludwig-Maximilians-Universität München, Germany
| | - Martin Biel
- Department of Pharmacy, Center for Drug Research (M.B., S.F.), Ludwig-Maximilians-Universität München, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Germany (M.B., S.F.)
| | - Stefanie Fenske
- Department of Pharmacy, Center for Drug Research (M.B., S.F.), Ludwig-Maximilians-Universität München, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Germany (M.B., S.F.)
| | - Christian Wahl-Schott
- Institute of Cardiovascular Physiology and Pathophysiology, Biomedical Center Munich, Walter Brendel Centre of Experimental Medicine, Faculty of Medicine (K.H., C.P., C.W.-S.), Ludwig-Maximilians-Universität München, Germany
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2
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Porro A, Saponaro A, Castelli R, Introini B, Hafez Alkotob A, Ranjbari G, Enke U, Kusch J, Benndorf K, Santoro B, DiFrancesco D, Thiel G, Moroni A. A high affinity switch for cAMP in the HCN pacemaker channels. Nat Commun 2024; 15:843. [PMID: 38287019 PMCID: PMC10825183 DOI: 10.1038/s41467-024-45136-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/16/2024] [Indexed: 01/31/2024] Open
Abstract
Binding of cAMP to Hyperpolarization activated cyclic nucleotide gated (HCN) channels facilitates pore opening. It is unclear why the isolated cyclic nucleotide binding domain (CNBD) displays in vitro lower affinity for cAMP than the full-length channel in patch experiments. Here we show that HCN are endowed with an affinity switch for cAMP. Alpha helices D and E, downstream of the cyclic nucleotide binding domain (CNBD), bind to and stabilize the holo CNBD in a high affinity state. These helices increase by 30-fold cAMP efficacy and affinity measured in patch clamp and ITC, respectively. We further show that helices D and E regulate affinity by interacting with helix C of the CNBD, similarly to the regulatory protein TRIP8b. Our results uncover an intramolecular mechanism whereby changes in binding affinity, rather than changes in cAMP concentration, can modulate HCN channels, adding another layer to the complex regulation of their activity.
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Affiliation(s)
| | - Andrea Saponaro
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milano, Italy
| | | | - Bianca Introini
- Department of Biosciences, University of Milan, Milano, Italy
| | | | - Golnaz Ranjbari
- Department of Biosciences, University of Milan, Milano, Italy
| | - Uta Enke
- Institut für Physiologie II, Universitätsklinikum Jena, Jena, Germany
| | - Jana Kusch
- Institut für Physiologie II, Universitätsklinikum Jena, Jena, Germany
| | - Klaus Benndorf
- Institut für Physiologie II, Universitätsklinikum Jena, Jena, Germany
| | - Bina Santoro
- Department of Neuroscience, Zuckerman Institute, Columbia University, New York, NY, USA
| | | | - Gerhard Thiel
- Department of Biology, TU-Darmstadt, Darmstadt, Germany
| | - Anna Moroni
- Department of Biosciences, University of Milan, Milano, Italy.
- Institute of Biophysics Milan, Consiglio Nazionale delle Ricerche, Milano, Italy.
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3
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Cámara-Checa A, Perin F, Rubio-Alarcón M, Dago M, Crespo-García T, Rapún J, Marín M, Cebrián J, Gómez R, Bermúdez-Jiménez F, Monserrat L, Tamargo J, Caballero R, Jiménez-Jáimez J, Delpón E. A gain-of-function HCN4 mutant in the HCN domain is responsible for inappropriate sinus tachycardia in a Spanish family. Proc Natl Acad Sci U S A 2023; 120:e2305135120. [PMID: 38032931 PMCID: PMC10710060 DOI: 10.1073/pnas.2305135120] [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: 03/29/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
In a family with inappropriate sinus tachycardia (IST), we identified a mutation (p.V240M) of the hyperpolarization-activated cyclic nucleotide-gated type 4 (HCN4) channel, which contributes to the pacemaker current (If) in human sinoatrial node cells. Here, we clinically study fifteen family members and functionally analyze the p.V240M variant. Macroscopic (IHCN4) and single-channel currents were recorded using patch-clamp in cells expressing human native (WT) and/or p.V240M HCN4 channels. All p.V240M mutation carriers exhibited IST that was accompanied by cardiomyopathy in adults. IHCN4 generated by p.V240M channels either alone or in combination with WT was significantly greater than that generated by WT channels alone. The variant, which lies in the N-terminal HCN domain, increased the single-channel conductance and opening frequency and probability of HCN4 channels. Conversely, it did not modify the channel sensitivity for cAMP and ivabradine or the level of expression at the membrane. Treatment with ivabradine based on functional data reversed the IST and the cardiomyopathy of the carriers. In computer simulations, the p.V240M gain-of-function variant increases If and beating rate and thus explains the IST of the carriers. The results demonstrate the importance of the unique HCN domain in HCN4, which stabilizes the channels in the closed state.
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Affiliation(s)
- Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Francesca Perin
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada18014, Spain
| | - Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Josu Rapún
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - María Marín
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Ricardo Gómez
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Francisco Bermúdez-Jiménez
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada18014, Spain
- Centro Nacional de Investigaciones Cardiovasculares, Madrid28029, Spain
| | - Lorenzo Monserrat
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
- Health in Code Sociedad Limitada, A Coruña15008, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Juan Jiménez-Jáimez
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada18014, Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
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4
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Olshansky B, Ricci F, Fedorowski A. Importance of resting heart rate. Trends Cardiovasc Med 2023; 33:502-515. [PMID: 35623552 DOI: 10.1016/j.tcm.2022.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
Abstract
Resting heart rate is a determinant of cardiac output and physiological homeostasis. Although a simple, but critical, parameter, this vital sign predicts adverse outcomes, including mortality, and development of diseases in otherwise normal and healthy individuals. Temporal changes in heart rate can have valuable predictive capabilities. Heart rate can reflect disease severity in patients with various medical conditions. While heart rate represents a compilation of physiological inputs, including sympathetic and parasympathetic tone, aside from the underlying intrinsic sinus rate, how resting heart rate affects outcomes is uncertain. Mechanisms relating resting heart rate to outcomes may be disease-dependent but why resting heart rate in otherwise healthy, normal individuals affects outcomes remains obscure. For specific conditions, physiologically appropriate heart rate reductions may improve outcomes. However, to date, in the normal population, evidence that interventions aimed at reducing heart rate improves outcomes remains undefined. Emerging data suggest that reduction in heart rate via vagal activation and/or sympathetic inhibition is propitious.
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Affiliation(s)
- Brian Olshansky
- Division of Cardiology, Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA.
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, "G.d'Annunzio" University of Chieti-Pescara, Via dei Vestini, 33, Chieti 66100, Italy; Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden; Department of Cardiology, Karolinska University Hospital, and Department of Medicine, Karolinska Institute, 171 76 Stockholm, Sweden
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5
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Henley T, Goudy J, Easterling M, Donley C, Wirka R, Bressan M. Local tissue mechanics control cardiac pacemaker cell embryonic patterning. Life Sci Alliance 2023; 6:e202201799. [PMID: 36973005 PMCID: PMC10043993 DOI: 10.26508/lsa.202201799] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
Cardiac pacemaker cells (CPCs) initiate the electric impulses that drive the rhythmic beating of the heart. CPCs reside in a heterogeneous, ECM-rich microenvironment termed the sinoatrial node (SAN). Surprisingly, little is known regarding the biochemical composition or mechanical properties of the SAN, and how the unique structural characteristics present in this region of the heart influence CPC function remains poorly understood. Here, we have identified that SAN development involves the construction of a "soft" macromolecular ECM that specifically encapsulates CPCs. In addition, we demonstrate that subjecting embryonic CPCs to substrate stiffnesses higher than those measured in vivo results in loss of coherent electrical oscillation and dysregulation of the HCN4 and NCX1 ion channels required for CPC automaticity. Collectively, these data indicate that local mechanics play a critical role in maintaining the embryonic CPC function while also quantitatively defining the range of material properties that are optimal for embryonic CPC maturation.
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Affiliation(s)
- Trevor Henley
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julie Goudy
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marietta Easterling
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carrie Donley
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robert Wirka
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael Bressan
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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6
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Ricci E, Bartolucci C, Severi S. The virtual sinoatrial node: What did computational models tell us about cardiac pacemaking? PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2023; 177:55-79. [PMID: 36374743 DOI: 10.1016/j.pbiomolbio.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/17/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022]
Abstract
Since its discovery, the sinoatrial node (SAN) has represented a fascinating and complex matter of research. Despite over a century of discoveries, a full comprehension of pacemaking has still to be achieved. Experiments often produced conflicting evidence that was used either in support or against alternative theories, originating intense debates. In this context, mathematical descriptions of the phenomena underlying the heartbeat have grown in importance in the last decades since they helped in gaining insights where experimental evaluation could not reach. This review presents the most updated SAN computational models and discusses their contribution to our understanding of cardiac pacemaking. Electrophysiological, structural and pathological aspects - as well as the autonomic control over the SAN - are taken into consideration to reach a holistic view of SAN activity.
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Affiliation(s)
- Eugenio Ricci
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena (FC), Italy
| | - Chiara Bartolucci
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena (FC), Italy
| | - Stefano Severi
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena (FC), Italy.
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7
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Fan W, Sun X, Yang C, Wan J, Luo H, Liao B. Pacemaker activity and ion channels in the sinoatrial node cells: MicroRNAs and arrhythmia. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2023; 177:151-167. [PMID: 36450332 DOI: 10.1016/j.pbiomolbio.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/13/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022]
Abstract
The primary pacemaking activity of the heart is determined by a spontaneous action potential (AP) within sinoatrial node (SAN) cells. This unique AP generation relies on two mechanisms: membrane clocks and calcium clocks. Nonhomologous arrhythmias are caused by several functional and structural changes in the myocardium. MicroRNAs (miRNAs) are essential regulators of gene expression in cardiomyocytes. These miRNAs play a vital role in regulating the stability of cardiac conduction and in the remodeling process that leads to arrhythmias. Although it remains unclear how miRNAs regulate the expression and function of ion channels in the heart, these regulatory mechanisms may support the development of emerging therapies. This study discusses the spread and generation of AP in the SAN as well as the regulation of miRNAs and individual ion channels. Arrhythmogenicity studies on ion channels will provide a research basis for miRNA modulation as a new therapeutic target.
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Affiliation(s)
- Wei Fan
- Department of Cardiovascular Surgery, Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiangyang District, Luzhou, Sichuan Province, 646000, China
| | - Xuemei Sun
- Department of Pharmacy, Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiangyang District, Luzhou, Sichuan Province, 646000, China
| | - Chao Yang
- Department of Cardiovascular Surgery, Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiangyang District, Luzhou, Sichuan Province, 646000, China
| | - Juyi Wan
- Department of Cardiovascular Surgery, Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiangyang District, Luzhou, Sichuan Province, 646000, China.
| | - Hongli Luo
- Department of Pharmacy, Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiangyang District, Luzhou, Sichuan Province, 646000, China.
| | - Bin Liao
- Department of Cardiovascular Surgery, Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiangyang District, Luzhou, Sichuan Province, 646000, China.
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8
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de Asmundis C, Pannone L, Lakkireddy D, Beaver TM, Brodt CR, Lee RJ, Sorgente A, Gauthey A, Monaco C, Overeinder I, Bala G, Almorad A, Ströker E, Sieira J, Brugada P, Chierchia GB, La Meir M, Olshansky B. Targeted Treatment of Inappropriate Sinoatrial Node Tachycardia Based on Electrophysiological and Structural Mechanisms. Am J Cardiol 2022; 183:24-32. [PMID: 36127177 DOI: 10.1016/j.amjcard.2022.07.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/01/2022]
Abstract
The purpose of this review is to determine the causal mechanisms and treatment of inappropriate sinoatrial tachycardia (IST), defined as a non-physiological elevation in resting heart rate. IST is defined as a resting daytime sinus rate >100 beats/minute and an average 24-hour heart rate >90 beats/minute. Potential causal mechanisms include sympathetic receptor hypersensitivity, blunted parasympathetic tone, or enhanced intrinsic automaticity within the sinoatrial node (SAN) pacemaker-conduction complex. These anomalies may coexist in the same patient. Recent ex-vivo near-infrared transmural optical imaging of the SAN in human and animal hearts provides important insights into the functional and molecular features of this complex structure. In particular, it reveals the existence of preferential sinoatrial conduction pathways that ensure robust SAN activation with electrical conduction. The mechanism of IST is debated because even high-resolution electroanatomical mapping approaches cannot reveal intramural conduction in the 3-dimensional SAN complex. It may be secondary to enhanced automaticity, intranodal re-entry, or sinoatrial conduction pathway re-entry. Different pharmacological approaches can target these mechanisms. Long-acting β blockers in IST can act on both primarily increased automaticity and dysregulated autonomic system. Ivabradine targets sources of increased SAN automaticity. Conventional or hybrid ablation may target all the described abnormalities. This review provides a state-of-the-art overview of putative IST mechanisms. In conclusion, based on current knowledge, pharmacological and ablation approaches for IST, including the novel hybrid SAN sparing ablation, are discussed.
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Affiliation(s)
- Carlo de Asmundis
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium.
| | - Luigi Pannone
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | | | - Thomas M Beaver
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, Florida
| | | | - Randall J Lee
- Section of Cardiology, University of California at San Francisco, San Francisco, California
| | - Antonio Sorgente
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Anaïs Gauthey
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Cinzia Monaco
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Ingrid Overeinder
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Gezim Bala
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Alexandre Almorad
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Erwin Ströker
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Juan Sieira
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Pedro Brugada
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Gian-Battista Chierchia
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Mark La Meir
- Cardiac Surgery Department, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Brussels, Belgium
| | - Brian Olshansky
- Division of Cardiology, University of Iowa Hospitals, Iowa City, Iowa
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9
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Chadda KR, Blakey EE, Huang CLH, Jeevaratnam K. Long COVID-19 and Postural Orthostatic Tachycardia Syndrome- Is Dysautonomia to Be Blamed? Front Cardiovasc Med 2022; 9:860198. [PMID: 35355961 PMCID: PMC8959615 DOI: 10.3389/fcvm.2022.860198] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 02/16/2022] [Indexed: 12/23/2022] Open
Abstract
While the increased arrhythmic tendency during acute COVID-19 infection is recognised, the long-term cardiac electrophysiological complications are less well known. There are a high number of patients reporting ongoing symptoms post-infection, termed long COVID. A recent hypothesis is that long COVID symptoms could be attributed to dysautonomia, defined as malfunction of the autonomic nervous system (ANS). The most prevalent cardiovascular dysautonomia amongst young people is postural orthostatic tachycardia syndrome (POTS). Numerous reports have described the development of POTS as part of long COVID. Possible underlying mechanisms, although not mutually exclusive or exhaustive, include hypovolaemia, neurotropism, inflammation and autoimmunity. Treatment options for POTS and other long COVID symptoms are currently limited. Future research studies should aim to elucidate the underlying mechanisms of dysautonomia to enable the development of targeted therapies. Furthermore, it is important to educate healthcare professionals to recognise complications and conditions arising from COVID-19, such as POTS, to allow prompt diagnosis and access to early treatment.
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Affiliation(s)
- Karan R. Chadda
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Ellen E. Blakey
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Christopher L. -H. Huang
- Physiological Laboratory, University of Cambridge, Cambridge, United Kingdom
- Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom
| | - Kamalan Jeevaratnam
- Physiological Laboratory, University of Cambridge, Cambridge, United Kingdom
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- *Correspondence: Kamalan Jeevaratnam,
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10
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Ng LCT, Li YX, Van Petegem F, Accili EA. Altered cyclic nucleotide-binding and pore opening in a diseased human HCN4 channel. Biophys J 2022; 121:1166-1183. [PMID: 35219649 PMCID: PMC9034293 DOI: 10.1016/j.bpj.2022.02.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/20/2021] [Accepted: 02/22/2022] [Indexed: 11/16/2022] Open
Abstract
A growing number of nonsynonymous mutations in the human HCN4 channel gene, the major component of the funny channel of the sinoatrial node, are associated with disease but how they impact channel structure and function, and, thus, how they result in disease, is not clear for any of them. Here, we study the S672R mutation, in the cyclic nucleotide-binding domain of the channel, which has been associated with an inherited bradycardia in an Italian family. This may be the best studied of all known mutations, yet the underlying molecular and atomistic mechanisms remain unclear and controversial. We combine measurements of binding by isothermal titration calorimetry to a naturally occurring tetramer of the HCN4 C-terminal region with a mathematical model to show that weaker binding of cAMP to the mutant channel contributes to a lower level of facilitation of channel opening at submicromolar ligand concentrations but that, in general, facilitation occurs over a range that is similar between the mutant and wild-type because of enhanced opening of the mutant channel when liganded. We also show that the binding affinity for cGMP, which produces the same maximum facilitation of HCN4 opening as cAMP, is weaker in the mutant HCN4 channel but that, for both wild-type and mutant, high-affinity binding of cGMP occurs in a range of concentrations below 1 μM. Thus, binding of cGMP to the HCN4 channel may be relevant normally in vivo and reduced binding of cGMP, as well as cAMP, to the mutant channel may contribute to the reduced resting heart rate observed in the affected family.
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Affiliation(s)
- Leo C T Ng
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, Canada
| | - Yue Xian Li
- Department of Mathematics, University of British Columbia, Vancouver, Canada
| | - Filip Van Petegem
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, Canada
| | - Eric A Accili
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, Canada.
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11
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Depuydt AS, Peigneur S, Tytgat J. Review: HCN Channels in the Heart. Curr Cardiol Rev 2022; 18:e040222200836. [PMID: 35125083 PMCID: PMC9893134 DOI: 10.2174/1573403x18666220204142436] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/13/2021] [Accepted: 12/23/2021] [Indexed: 11/22/2022] Open
Abstract
Pacemaker cells are the basis of rhythm in the heart. Cardiovascular diseases, and in particular, arrhythmias are a leading cause of hospital admissions and have been implicated as a cause of sudden death. The prevalence of people with arrhythmias will increase in the next years due to an increase in the ageing population and risk factors. The current therapies are limited, have a lot of side effects, and thus, are not ideal. Pacemaker channels, also called hyperpolarizationactivated cyclic nucleotide-gated (HCN) channels, are the molecular correlate of the hyperpolarization- activated current, called Ih (from hyperpolarization) or If (from funny), that contribute crucially to the pacemaker activity in cardiac nodal cells and impulse generation and transmission in neurons. HCN channels have emerged as interesting targets for the development of drugs, in particular, to lower the heart rate. Nonetheless, their pharmacology is still rather poorly explored in comparison to many other voltage-gated ion channels or ligand-gated ion channels. Ivabradine is the first and currently the only clinically approved compound that specifically targets HCN channels. The therapeutic indication of ivabradine is the symptomatic treatment of chronic stable angina pectoris in patients with coronary artery disease with a normal sinus rhythm. Several other pharmacological agents have been shown to exert an effect on heart rate, although this effect is not always desired. This review is focused on the pacemaking process taking place in the heart and summarizes the current knowledge on HCN channels.
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Affiliation(s)
- Anne-Sophie Depuydt
- Toxicology and Pharmacology, University of Leuven (KU Leuven), Campus Gasthuisberg, O&N2, PO Box 922, Herestraat 49, 3000Leuven, Belgium
| | - Steve Peigneur
- Toxicology and Pharmacology, University of Leuven (KU Leuven), Campus Gasthuisberg, O&N2, PO Box 922, Herestraat 49, 3000Leuven, Belgium
| | - Jan Tytgat
- Toxicology and Pharmacology, University of Leuven (KU Leuven), Campus Gasthuisberg, O&N2, PO Box 922, Herestraat 49, 3000Leuven, Belgium
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12
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Stavileci B, Özdemir E, Özdemir B, Ereren E, Cengiz M. De-novo development of fragmented QRS during a six-month follow-up period in patients with COVID-19 disease and its cardiac effects. J Electrocardiol 2022; 72:44-48. [PMID: 35306293 PMCID: PMC8917010 DOI: 10.1016/j.jelectrocard.2022.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study is to examine the probability of de-novo fQRS in patients with mild COVID-19 disease, as an indicator of cardiac injury. METHODS Data of 256 patients with normal admission electrocardiography and no comorbidities between 1.12.2020-31.12.2021, were examined retrospectively 6-month after mild COVID-19 disease. Patients were divided into two groups: fQRS+ group (n = 102) and non-fQRS group (n = 154). Relation between fQRS and other electrocardiography, echocardiographic and laboratory findings were investigated. RESULTS No significant difference was found between the groups among age and gender. Troponin-I and creatine kinase myocardial band values (retrospectively 9.10 ± 1.76 vs 0.74 ± 1.43, 34.05 ± 82.20 vs. 14.68 ± 4.42), COVID-19 IgG levels (45.78 ± 14.82 vs. 36.49 ± 17.68), diastolic dysfunction (39.21% vs. 15.07%), EF value (58.02 ± 1.95 vs. 64.27 ± 3.07), dyspnea (41.17% vs. 6.84%), post-COVID-19 tachycardia syndrome (19.6% vs. 2.74) were more frequent in fQRS+ group compared to non-fQRS group. The EF value was lower in the presence of fQRS in the high lateral leads (57.12 ± 1.99, 58.47 ± 1.79, p:0.018). There was a positive correlation between IgG value and endsystolic diameter, septum thickness and left atrium diameter. In multivariate analysis de-novo fQRS, dyspnea, high troponin and IgG values, diastolic dysfunction, low EF value and left atrial diameter were determined as independent risk factors for post-COVID-19 tachycardia syndrome in follow-up. CONCLUSION In COVID-19 disease de-novo fQRS, dyspnea, high IgG and troponin value, left atrial diameter, lower EF value, diastolic dysfunction were associated with post-COVID-19 tachycardia syndrome. The de-novo fQRS in SARS-COV-2 may be a predictor of future more important adverse cardiovascular outcomes and this should alert clinicians.
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Affiliation(s)
- Berna Stavileci
- Biruni University, Faculty of Medicine, Department of Cardiology, Beşyol Mah. Eski Londra Asfaltı No:10 Küçükçekmece, 34295 İstanbul, Turkey,Corresponding author
| | - Emrah Özdemir
- Biruni University, Faculty of Medicine, Department of Cardiology, Beşyol Mah. Eski Londra Asfaltı No:10 Küçükçekmece, 34295 İstanbul, Turkey
| | - Bahar Özdemir
- İstanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, Department of Internal Medicine, Zuhuratbaba Mh. Tevfik Sağlam Cd. No:11, 34147, Bakırköy, İstanbul, Turkey
| | - Emrah Ereren
- Samsun Training and Research Hospital, Department of Cardiovascular Surgery, Barış Bulvarı Kadıköy Mah. No:199, İlkadım, 55090 Samsun, Turkey
| | - Mahir Cengiz
- Biruni University, Faculty of Medicine, Department of Internal Medicine, Beşyol Mah. Eski Londra Asfaltı No:10 Küçükçekmece, 34295 İstanbul, Turkey
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13
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Ståhlberg M, Reistam U, Fedorowski A, Villacorta H, Horiuchi Y, Bax J, Pitt B, Matskeplishvili S, Lüscher TF, Weichert I, Thani KB, Maisel A. Post-COVID-19 Tachycardia Syndrome: A Distinct Phenotype of Post-Acute COVID-19 Syndrome. Am J Med 2021; 134:1451-1456. [PMID: 34390682 PMCID: PMC8356730 DOI: 10.1016/j.amjmed.2021.07.004] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/05/2021] [Accepted: 07/05/2021] [Indexed: 02/08/2023]
Abstract
In this paper we highlight the presence of tachycardia in post-acute COVID-19 syndrome by introducing a new label for this phenomenon-post-COVID-19 tachycardia syndrome-and argue that this constitutes a phenotype or sub-syndrome in post-acute COVID-19 syndrome. We also discuss epidemiology, putative mechanisms, treatment options, and future research directions in this novel clinical syndrome.
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Affiliation(s)
- Marcus Ståhlberg
- Cardiology, Heart, Vascular and Neuro Theme, Karolinska University Hospital and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Ulrika Reistam
- Cardiology, Heart, Vascular and Neuro Theme, Karolinska University Hospital and Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Artur Fedorowski
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Humberto Villacorta
- Division of Cardiology, Fluminense Federal University, Niterói, Rio de Janeiro State, Brazil
| | - Yu Horiuchi
- Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Jeroen Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Thomas F Lüscher
- Heart Division, Royal Brompton & Harefield Hospitals and National Heart and Lung Institute, Imperial College, London, UK; Center for Molecular Cardiology, University of Zurich, Switzerland
| | - Immo Weichert
- Acute Medicine Department, Ipswich Hospital, East Suffolk and North Essex NHS Foundation Trust, Ipswich, UK
| | - Khalid Bin Thani
- Department of Cardiology, Salmaniya Medical Complex, Manama, Bahrain
| | - Alan Maisel
- Division of Cardiovascular Medicine, University of California San Diego, La Jolla
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14
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Yu H, Gall B, Newman M, Hathaway Q, Brundage K, Ammer A, Mathers P, Siderovski D, Hull RW. Contribution of HCN1 variant to sinus bradycardia: A case report. J Arrhythm 2021; 37:1337-1347. [PMID: 34621433 PMCID: PMC8485797 DOI: 10.1002/joa3.12598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/08/2021] [Accepted: 06/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Missense mutations in the hyperpolarization-activated cyclic nucleotide-modulated (HCN) channel 4 (HCN4) are one of the genetic causes of cardiac sinus bradycardia. OBJECTIVE To investigate possible HCN4 channel mutation in a young patient with profound sinus bradycardia. METHODS Direct sequencing of HCN4 and whole-exome sequencing were performed on DNA samples from the indexed patient (P), the patient's son (PS), and a family unrelated healthy long-distance running volunteer (V). Resting heart rate was 31 bpm for P, 67 bpm for PS, and 50 bpm for V. Immunoblots, flow cytometry, and immunocytofluorescence confocal imaging were used to study cellular distribution of channel variants. Patch-clamp electrophysiology was used to investigate the properties of mutant HCN1 channels. RESULTS In P no missense mutations were found in the HCN4 gene; instead, we found two heterozygous variants in the HCN1 gene: deletion of an N-terminal glycine triplet (72GGG74, "N-del") and a novel missense variant, P851A, in the C-terminal region. N-del variant was found before and shared by PS. These two variations were not found in V. Compared to wild type, N-del and P851A reduced cell surface expression and negatively shifted voltage-activation with slower activation kinetics. CONCLUSION Decreased channel activity HCN1 mutant channel makes it unable to contribute to early depolarization of sinus node action potential, thus likely a main cause of the profound sinus bradycardia in this patient.
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Affiliation(s)
- Hangang Yu
- Department of Physiology and PharmacologySchool of MedicineWest Virginia UniversityMorgantownWVUSA
| | - Bryan Gall
- Department of Physiology and PharmacologySchool of MedicineWest Virginia UniversityMorgantownWVUSA
- Present address:
Variant Curator at NateraSan CarlosCAUSA
| | - Mackenzie Newman
- Department of Physiology and PharmacologySchool of MedicineWest Virginia UniversityMorgantownWVUSA
| | - Quincy Hathaway
- Department of Exercise PhysiologySchool of MedicineWest Virginia UniversityMorgantownWVUSA
| | - Kathleen Brundage
- Department of Microbiology, Immunology & Cell BiologySchool of MedicineWest Virginia UniversityMorgantownWVUSA
| | - Amanda Ammer
- Department of Microbiology, Immunology & Cell BiologySchool of MedicineWest Virginia UniversityMorgantownWVUSA
| | - Peter Mathers
- Department of NeuroscienceSchool of MedicineWest Virginia UniversityMorgantownWVUSA
| | - David Siderovski
- Department of Physiology and PharmacologySchool of MedicineWest Virginia UniversityMorgantownWVUSA
- Present address:
Pharmacology & NeuroscienceUniversity of North TexasDentonTXUSA
| | - Robert W. Hull
- Department of CardiologySchool of MedicineWest Virginia UniversityMorgantownWVUSA
- Present address:
Department of CardiologyMon General HospitalMorgantownWVUSA
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15
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Peters CH, Liu PW, Morotti S, Gantz SC, Grandi E, Bean BP, Proenza C. Bidirectional flow of the funny current (I f) during the pacemaking cycle in murine sinoatrial node myocytes. Proc Natl Acad Sci U S A 2021; 118:e2104668118. [PMID: 34260402 PMCID: PMC8285948 DOI: 10.1073/pnas.2104668118] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Sinoatrial node myocytes (SAMs) act as cardiac pacemaker cells by firing spontaneous action potentials (APs) that initiate each heartbeat. The funny current (If) is critical for the generation of these spontaneous APs; however, its precise role during the pacemaking cycle remains unresolved. Here, we used the AP-clamp technique to quantify If during the cardiac cycle in mouse SAMs. We found that If is persistently active throughout the sinoatrial AP, with surprisingly little voltage-dependent gating. As a consequence, it carries both inward and outward current around its reversal potential of -30 mV. Despite operating at only 2 to 5% of its maximal conductance, If carries a substantial fraction of both depolarizing and repolarizing net charge movement during the firing cycle. We also show that β-adrenergic receptor stimulation increases the percentage of net depolarizing charge moved by If, consistent with a contribution of If to the fight-or-flight increase in heart rate. These properties were confirmed by heterologously expressed HCN4 channels and by mathematical models of If Modeling further suggested that the slow rates of activation and deactivation of the HCN4 isoform underlie the persistent activity of If during the sinoatrial AP. These results establish a new conceptual framework for the role of If in pacemaking, in which it operates at a very small fraction of maximal activation but nevertheless drives membrane potential oscillations in SAMs by providing substantial driving force in both inward and outward directions.
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Affiliation(s)
- Colin H Peters
- Department of Physiology and Biophysics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045
| | - Pin W Liu
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115
| | - Stefano Morotti
- Department of Pharmacology, University of California, Davis, CA 95616
| | - Stephanie C Gantz
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242
| | - Eleonora Grandi
- Department of Pharmacology, University of California, Davis, CA 95616
| | - Bruce P Bean
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115
| | - Catherine Proenza
- Department of Physiology and Biophysics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045;
- Department of Medicine, Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045
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16
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Regulation of sinus node pacemaking and atrioventricular node conduction by HCN channels in health and disease. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2021; 166:61-85. [PMID: 34197836 DOI: 10.1016/j.pbiomolbio.2021.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 12/19/2022]
Abstract
The funny current, If, was first recorded in the heart 40 or more years ago by Dario DiFrancesco and others. Since then, we have learnt that If plays an important role in pacemaking in the sinus node, the innate pacemaker of the heart, and more recently evidence has accumulated to show that If may play an important role in action potential conduction through the atrioventricular (AV) node. Evidence has also accumulated to show that regulation of the transcription and translation of the underlying Hcn genes plays an important role in the regulation of sinus node pacemaking and AV node conduction under normal physiological conditions - in athletes, during the circadian rhythm, in pregnancy, and during postnatal development - as well as pathological states - ageing, heart failure, pulmonary hypertension, diabetes and atrial fibrillation. There may be yet more pathological conditions involving changes in the expression of the Hcn genes. Here, we review the role of If and the underlying HCN channels in physiological and pathological changes of the sinus and AV nodes and we begin to explore the signalling pathways (microRNAs, transcription factors, GIRK4, the autonomic nervous system and inflammation) involved in this regulation. This review is dedicated to Dario DiFrancesco on his retirement.
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17
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Hoekstra M, van Ginneken ACG, Wilders R, Verkerk AO. HCN4 current during human sinoatrial node-like action potentials. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2021; 166:105-118. [PMID: 34153331 DOI: 10.1016/j.pbiomolbio.2021.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/07/2021] [Accepted: 05/14/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Despite the many studies carried out over the past 40 years, the contribution of the HCN4 encoded hyperpolarization-activated 'funny' current (If) to pacemaker activity in the mammalian sinoatrial node (SAN), and the human SAN in particular, is still controversial and not fully established. OBJECTIVE To study the contribution of If to diastolic depolarization of human SAN cells and its dependence on heart rate, cAMP levels, and atrial load. METHODS HCN4 channels were expressed in human cardiac myocyte progenitor cells (CMPCs) and HCN4 currents assessed using perforated patch-clamp in traditional voltage clamp mode and during action potential clamp with human SAN-like action potential waveforms with 500-1500 ms cycle length, in absence or presence of forskolin to mimic β-adrenergic stimulation and a -15 mV command potential offset to mimic atrial load. RESULTS Forskolin significantly increased the fully-activated HCN4 current density at -140 mV by 14% and shifted the steady-state activation curve by +7.4 mV without affecting its slope. In addition, forskolin significantly accelerated current activation but slowed deactivation. The HCN4 current did not completely deactivate before the subsequent diastolic depolarization during action potential clamp. The amplitude of HCN4 current increased with increasing cycle length, was significantly larger in the presence of forskolin at all cycle lengths, and was significantly increased upon the negative offset to the command potential. CONCLUSIONS If is active during a human SAN action potential waveform and its amplitude is modulated by heart rate, β-adrenergic stimulation, and diastolic voltage range, such that If is under delicate control.
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Affiliation(s)
- Maaike Hoekstra
- Department of Medical Biology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Antoni C G van Ginneken
- Department of Medical Biology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ronald Wilders
- Department of Medical Biology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Arie O Verkerk
- Department of Medical Biology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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18
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Hennis K, Rötzer RD, Piantoni C, Biel M, Wahl-Schott C, Fenske S. Speeding Up the Heart? Traditional and New Perspectives on HCN4 Function. Front Physiol 2021; 12:669029. [PMID: 34122140 PMCID: PMC8191466 DOI: 10.3389/fphys.2021.669029] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/19/2021] [Indexed: 01/20/2023] Open
Abstract
The sinoatrial node (SAN) is the primary pacemaker of the heart and is responsible for generating the intrinsic heartbeat. Within the SAN, spontaneously active pacemaker cells initiate the electrical activity that causes the contraction of all cardiomyocytes. The firing rate of pacemaker cells depends on the slow diastolic depolarization (SDD) and determines the intrinsic heart rate (HR). To adapt cardiac output to varying physical demands, HR is regulated by the autonomic nervous system (ANS). The sympathetic and parasympathetic branches of the ANS innervate the SAN and regulate the firing rate of pacemaker cells by accelerating or decelerating SDD-a process well-known as the chronotropic effect. Although this process is of fundamental physiological relevance, it is still incompletely understood how it is mediated at the subcellular level. Over the past 20 years, most of the work to resolve the underlying cellular mechanisms has made use of genetically engineered mouse models. In this review, we focus on the findings from these mouse studies regarding the cellular mechanisms involved in the generation and regulation of the heartbeat, with particular focus on the highly debated role of the hyperpolarization-activated cyclic nucleotide-gated cation channel HCN4 in mediating the chronotropic effect. By focusing on experimental data obtained in mice and humans, but not in other species, we outline how findings obtained in mice relate to human physiology and pathophysiology and provide specific information on how dysfunction or loss of HCN4 channels leads to human SAN disease.
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Affiliation(s)
- Konstantin Hennis
- Center for Drug Research, Department of Pharmacy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - René D. Rötzer
- Center for Drug Research, Department of Pharmacy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Chiara Piantoni
- Institute for Neurophysiology, Hannover Medical School, Hanover, Germany
| | - Martin Biel
- Center for Drug Research, Department of Pharmacy, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Christian Wahl-Schott
- Institute for Neurophysiology, Hannover Medical School, Hanover, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Stefanie Fenske
- Center for Drug Research, Department of Pharmacy, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
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19
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Brugada J, Katritsis DG, Arbelo E, Arribas F, Bax JJ, Blomström-Lundqvist C, Calkins H, Corrado D, Deftereos SG, Diller GP, Gomez-Doblas JJ, Gorenek B, Grace A, Ho SY, Kaski JC, Kuck KH, Lambiase PD, Sacher F, Sarquella-Brugada G, Suwalski P, Zaza A. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J 2021; 41:655-720. [PMID: 31504425 DOI: 10.1093/eurheartj/ehz467] [Citation(s) in RCA: 493] [Impact Index Per Article: 164.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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20
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Cappato R. Treatment of inappropriate sinus tachycardia: Still a long way to go. J Cardiovasc Electrophysiol 2021; 32:1062-1064. [DOI: 10.1111/jce.14940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Riccardo Cappato
- Arrhythmia & Electrophysiology Center, IRCCS, MultiMedica Group Sesto San Giovanni Milan Italy
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21
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RNAseq shows an all-pervasive day-night rhythm in the transcriptome of the pacemaker of the heart. Sci Rep 2021; 11:3565. [PMID: 33574422 PMCID: PMC7878777 DOI: 10.1038/s41598-021-82202-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/01/2021] [Indexed: 12/12/2022] Open
Abstract
Physiological systems vary in a day-night manner anticipating increased demand at a particular time. Heart is no exception. Cardiac output is primarily determined by heart rate and unsurprisingly this varies in a day-night manner and is higher during the day in the human (anticipating increased day-time demand). Although this is attributed to a day-night rhythm in post-translational ion channel regulation in the heart's pacemaker, the sinus node, by the autonomic nervous system, we investigated whether there is a day-night rhythm in transcription. RNAseq revealed that ~ 44% of the sinus node transcriptome (7134 of 16,387 transcripts) has a significant day-night rhythm. The data revealed the oscillating components of an intrinsic circadian clock. Presumably this clock (or perhaps the master circadian clock in the suprachiasmatic nucleus) is responsible for the rhythm observed in the transcriptional machinery, which in turn is responsible for the rhythm observed in the transcriptome. For example, there is a rhythm in transcripts responsible for the two principal pacemaker mechanisms (membrane and Ca2+ clocks), transcripts responsible for receptors and signalling pathways known to control pacemaking, transcripts from genes identified by GWAS as determinants of resting heart rate, and transcripts from genes responsible for familial and acquired sick sinus syndrome.
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22
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Benzoni P, Campostrini G, Landi S, Bertini V, Marchina E, Iascone M, Ahlberg G, Olesen MS, Crescini E, Mora C, Bisleri G, Muneretto C, Ronca R, Presta M, Poliani PL, Piovani G, Verardi R, Di Pasquale E, Consiglio A, Raya A, Torre E, Lodrini AM, Milanesi R, Rocchetti M, Baruscotti M, DiFrancesco D, Memo M, Barbuti A, Dell'Era P. Human iPSC modelling of a familial form of atrial fibrillation reveals a gain of function of If and ICaL in patient-derived cardiomyocytes. Cardiovasc Res 2021; 116:1147-1160. [PMID: 31504264 PMCID: PMC7177512 DOI: 10.1093/cvr/cvz217] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 07/19/2019] [Accepted: 08/26/2019] [Indexed: 12/16/2022] Open
Abstract
AIMS Atrial fibrillation (AF) is the most common type of cardiac arrhythmias, whose incidence is likely to increase with the aging of the population. It is considered a progressive condition, frequently observed as a complication of other cardiovascular disorders. However, recent genetic studies revealed the presence of several mutations and variants linked to AF, findings that define AF as a multifactorial disease. Due to the complex genetics and paucity of models, molecular mechanisms underlying the initiation of AF are still poorly understood. Here we investigate the pathophysiological mechanisms of a familial form of AF, with particular attention to the identification of putative triggering cellular mechanisms, using patient's derived cardiomyocytes (CMs) differentiated from induced pluripotent stem cells (iPSCs). METHODS AND RESULTS Here we report the clinical case of three siblings with untreatable persistent AF whose whole-exome sequence analysis revealed several mutated genes. To understand the pathophysiology of this multifactorial form of AF we generated three iPSC clones from two of these patients and differentiated these cells towards the cardiac lineage. Electrophysiological characterization of patient-derived CMs (AF-CMs) revealed that they have higher beating rates compared to control (CTRL)-CMs. The analysis showed an increased contribution of the If and ICaL currents. No differences were observed in the repolarizing current IKr and in the sarcoplasmic reticulum calcium handling. Paced AF-CMs presented significantly prolonged action potentials and, under stressful conditions, generated both delayed after-depolarizations of bigger amplitude and more ectopic beats than CTRL cells. CONCLUSIONS Our results demonstrate that the common genetic background of the patients induces functional alterations of If and ICaL currents leading to a cardiac substrate more prone to develop arrhythmias under demanding conditions. To our knowledge this is the first report that, using patient-derived CMs differentiated from iPSC, suggests a plausible cellular mechanism underlying this complex familial form of AF.
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Affiliation(s)
- Patrizia Benzoni
- Department of Biosciences, Università degli Studi di Milano, via Celoria 26, 20133 Milan, Italy
| | - Giulia Campostrini
- Department of Biosciences, Università degli Studi di Milano, via Celoria 26, 20133 Milan, Italy
| | - Sara Landi
- Department of Biosciences, Università degli Studi di Milano, via Celoria 26, 20133 Milan, Italy
| | - Valeria Bertini
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy
| | - Eleonora Marchina
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy
| | - Maria Iascone
- USSD Laboratorio di Genetica Medica, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Piazza OMS, 1, 24127 Bergamo, Italy
| | - Gustav Ahlberg
- The Heart Centre, Rigshospitalet, Laboratory for Molecular Cardiology, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Morten Salling Olesen
- The Heart Centre, Rigshospitalet, Laboratory for Molecular Cardiology, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Elisabetta Crescini
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy
| | - Cristina Mora
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy
| | - Gianluigi Bisleri
- Department of Surgery, Division of Cardiac Surgery, Queen's University, 99 University Avenue, Kingston, Ontario K7L 3N6, Canada
| | - Claudio Muneretto
- Clinical Department of Cardiovascular Surgery, University of Brescia, viale Europa 11, 25123 Brescia, Italy
| | - Roberto Ronca
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy
| | - Marco Presta
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy
| | - Pier Luigi Poliani
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy
| | - Giovanna Piovani
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy
| | - Rosanna Verardi
- Department of Trasfusion Medicine, Laboratory for Stem Cells Manipulation and Cryopreservation, ASST Spedali Civili, viale Europa 11, 25123 Brescia, Italy
| | - Elisa Di Pasquale
- Department of Cardiovascular Medicine, Humanitas Clinical and Research Center, Via Rita Levi Montalcini, 4, 20090 Pieve Emanuele, Milan, Italy
| | - Antonella Consiglio
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy.,Department of Pathology and Experimental Therapeutics, Bellvitge University Hospital-IDIBELL, 08908 Hospitalet de Llobregat, C/Feixa Larga s/n, 08907 Barcelona, Spain.,Institute of Biomedicine of the University of Barcelona (IBUB), Carrer Baldiri Reixac 15-21, Barcelona 08028, Spain
| | - Angel Raya
- Center of Regenerative Medicine in Barcelona (CMRB), Hospital Duran i Reynals, Hospitalet de Llobregat, 08908 Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Passeig Lluís Companys 23 08010 Barcelona, Spain.,Networking Center of Biomedical Research in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| | - Eleonora Torre
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, iazza dell'Ateneo Nuovo 1, 20126 Milan, Italy
| | - Alessandra Maria Lodrini
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, iazza dell'Ateneo Nuovo 1, 20126 Milan, Italy
| | - Raffaella Milanesi
- Department of Biosciences, Università degli Studi di Milano, via Celoria 26, 20133 Milan, Italy
| | - Marcella Rocchetti
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, iazza dell'Ateneo Nuovo 1, 20126 Milan, Italy
| | - Mirko Baruscotti
- Department of Biosciences, Università degli Studi di Milano, via Celoria 26, 20133 Milan, Italy
| | - Dario DiFrancesco
- Department of Biosciences, Università degli Studi di Milano, via Celoria 26, 20133 Milan, Italy
| | - Maurizio Memo
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy
| | - Andrea Barbuti
- Department of Biosciences, Università degli Studi di Milano, via Celoria 26, 20133 Milan, Italy
| | - Patrizia Dell'Era
- Department of Molecular and Translational Medicine, cFRU lab, Università degli Studi di Brescia, viale Europa 11, 25123 Brescia, Italy
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23
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Santoro B, Shah MM. Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels as Drug Targets for Neurological Disorders. Annu Rev Pharmacol Toxicol 2020; 60:109-131. [PMID: 31914897 DOI: 10.1146/annurev-pharmtox-010919-023356] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are voltage-gated ion channels that critically modulate neuronal activity. Four HCN subunits (HCN1-4) have been cloned, each having a unique expression profile and distinctive effects on neuronal excitability within the brain. Consistent with this, the expression and function of these subunits are altered in diverse ways in neurological disorders. Here, we review current knowledge on the structure and distribution of the individual HCN channel isoforms, their effects on neuronal activity under physiological conditions, and how their expression and function are altered in neurological disorders, particularly epilepsy, neuropathic pain, and affective disorders. We discuss the suitability of HCN channels as therapeutic targets and how drugs might be strategically designed to specifically act on particular isoforms. We conclude that medicines that target individual HCN isoforms and/or their auxiliary subunit, TRIP8b, may provide valuable means of treating distinct neurological conditions.
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Affiliation(s)
- Bina Santoro
- Department of Neuroscience, Columbia University, New York, NY 10027, USA
| | - Mala M Shah
- Department of Pharmacology, School of Pharmacy, University College London, London WC1N 1AX, United Kingdom;
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24
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Varró A, Tomek J, Nagy N, Virág L, Passini E, Rodriguez B, Baczkó I. Cardiac transmembrane ion channels and action potentials: cellular physiology and arrhythmogenic behavior. Physiol Rev 2020; 101:1083-1176. [PMID: 33118864 DOI: 10.1152/physrev.00024.2019] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cardiac arrhythmias are among the leading causes of mortality. They often arise from alterations in the electrophysiological properties of cardiac cells and their underlying ionic mechanisms. It is therefore critical to further unravel the pathophysiology of the ionic basis of human cardiac electrophysiology in health and disease. In the first part of this review, current knowledge on the differences in ion channel expression and properties of the ionic processes that determine the morphology and properties of cardiac action potentials and calcium dynamics from cardiomyocytes in different regions of the heart are described. Then the cellular mechanisms promoting arrhythmias in congenital or acquired conditions of ion channel function (electrical remodeling) are discussed. The focus is on human-relevant findings obtained with clinical, experimental, and computational studies, given that interspecies differences make the extrapolation from animal experiments to human clinical settings difficult. Deepening the understanding of the diverse pathophysiology of human cellular electrophysiology will help in developing novel and effective antiarrhythmic strategies for specific subpopulations and disease conditions.
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Affiliation(s)
- András Varró
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary.,MTA-SZTE Cardiovascular Pharmacology Research Group, Hungarian Academy of Sciences, Szeged, Hungary
| | - Jakub Tomek
- Department of Computer Science, British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
| | - Norbert Nagy
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary.,MTA-SZTE Cardiovascular Pharmacology Research Group, Hungarian Academy of Sciences, Szeged, Hungary
| | - László Virág
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Elisa Passini
- Department of Computer Science, British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
| | - Blanca Rodriguez
- Department of Computer Science, British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
| | - István Baczkó
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
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25
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Petkova M, Atkinson AJ, Yanni J, Stuart L, Aminu AJ, Ivanova AD, Pustovit KB, Geragthy C, Feather A, Li N, Zhang Y, Oceandy D, Perde F, Molenaar P, D’Souza A, Fedorov VV, Dobrzynski H. Identification of Key Small Non-Coding MicroRNAs Controlling Pacemaker Mechanisms in the Human Sinus Node. J Am Heart Assoc 2020; 9:e016590. [PMID: 33059532 PMCID: PMC7763385 DOI: 10.1161/jaha.120.016590] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/27/2020] [Indexed: 01/01/2023]
Abstract
Background The sinus node (SN) is the primary pacemaker of the heart. SN myocytes possess distinctive action potential morphology with spontaneous diastolic depolarization because of a unique expression of ion channels and Ca2+-handling proteins. MicroRNAs (miRs) inhibit gene expression. The role of miRs in controlling the expression of genes responsible for human SN pacemaking and conduction has not been explored. The aim of this study was to determine miR expression profile of the human SN as compared with that of non-pacemaker atrial muscle. Methods and Results SN and atrial muscle biopsies were obtained from donor or post-mortem hearts (n=10), histology/immunolabeling were used to characterize the tissues, TaqMan Human MicroRNA Arrays were used to measure 754 miRs, Ingenuity Pathway Analysis was used to identify miRs controlling SN pacemaker gene expression. Eighteen miRs were significantly more and 48 significantly less abundant in the SN than atrial muscle. The most interesting miR was miR-486-3p predicted to inhibit expression of pacemaking channels: HCN1 (hyperpolarization-activated cyclic nucleotide-gated 1), HCN4, voltage-gated calcium channel (Cav)1.3, and Cav3.1. A luciferase reporter gene assay confirmed that miR-486-3p can control HCN4 expression via its 3' untranslated region. In ex vivo SN preparations, transfection with miR-486-3p reduced the beating rate by ≈35±5% (P<0.05) and HCN4 expression (P<0.05). Conclusions The human SN possesses a unique pattern of expression of miRs predicted to target functionally important genes. miR-486-3p has an important role in SN pacemaker activity by targeting HCN4, making it a potential target for therapeutic treatment of SN disease such as sinus tachycardia.
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Affiliation(s)
- Maria Petkova
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
| | - Andrew J. Atkinson
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
| | - Joseph Yanni
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
| | - Luke Stuart
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
| | - Abimbola J. Aminu
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
| | - Alexandra D. Ivanova
- Department of Human and Animal PhysiologyLomonosov Moscow State UniversityMoscowRussia
| | - Ksenia B. Pustovit
- Department of Human and Animal PhysiologyLomonosov Moscow State UniversityMoscowRussia
| | - Connor Geragthy
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
| | - Amy Feather
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
| | - Ning Li
- Physiology and Cell Biology DepartmentThe Bob and Corrine Frick Center for Heart Failure and ArrhythmiaThe Ohio State University Wexner Medical CenterColumbusOH
| | - Yu Zhang
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
| | - Delvac Oceandy
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
| | - Filip Perde
- National Institute of Legal MedicineBucharestRomania
| | - Peter Molenaar
- School of Biomedical SciencesQueensland University of TechnologyBrisbaneAustralia
- Cardiovascular Molecular & Therapeutics Translational Research GroupThe Prince Charles HospitalBrisbaneAustralia
| | - Alicia D’Souza
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
| | - Vadim V. Fedorov
- Physiology and Cell Biology DepartmentThe Bob and Corrine Frick Center for Heart Failure and ArrhythmiaThe Ohio State University Wexner Medical CenterColumbusOH
| | - Halina Dobrzynski
- Division of Cardiovascular SciencesUniversity of ManchesterUnited Kingdom
- Department of AnatomyJagiellonian University Medical CollegeKrakowPoland
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26
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Abstract
Cardiac pacemaking is a most fundamental cardiac function, thoroughly investigated for decades with a multiscale approach at organ, tissue, cell and molecular levels, to clarify the basic mechanisms underlying generation and control of cardiac rhythm. Understanding the processes involved in pacemaker activity is of paramount importance for a basic physiological knowledge, but also as a way to reveal details of pathological dysfunctions useful in the perspective of a therapeutic approach. Among the mechanisms involved in pacemaking, the "funny" (If) current has properties most specifically fitting the requirements for generation and control of repetitive activity, and has consequently received the most attention in studies of the pacemaker function. Present knowledge of the basic mechanisms of pacemaking and the properties of funny channels has led to important developments of clinical relevance. These include: (1) the successful development of heart rate-reducing agents, such as ivabradine, able to control cardiac rhythm and useful in the treatment of diseases such as coronary artery disease, heart failure and tachyarrhythmias; (2) the understanding of the genetic basis of disorders of cardiac rhythm caused by HCN channelopathies; (3) the design of strategies to implement biological pacemakers based on transfer of HCN channels or of stem cell-derived pacemaker cells expressing If, with the ultimate goal to replace electronic devices. In this review, I will give a brief historical account of the discovery of the funny current and the development of the concept of If-based pacemaking, in the context of a wider, more complex model of cardiac rhythmic function.
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Affiliation(s)
- Dario DiFrancesco
- Department of Biosciences, University of Milano, IBF-CNR University of Milano Unit, Milan, Italy
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27
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Cha YM, Li X, Yang M, Han J, Wu G, Kapa SC, McLeod CJ, Noseworthy PA, Mulpuru SK, Asirvatham SJ, Brady PA, Rho RH, Friedman PA, Lee HC, Tian Y, Zhou S, Munger TM, Ackerman MJ, Shen WK. Stellate ganglion block and cardiac sympathetic denervation in patients with inappropriate sinus tachycardia. J Cardiovasc Electrophysiol 2019; 30:2920-2928. [PMID: 31625219 PMCID: PMC6973270 DOI: 10.1111/jce.14233] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/18/2019] [Indexed: 12/20/2022]
Abstract
Background Inappropriate sinus tachycardia (IST) remains a clinical challenge because patients often are highly symptomatic and not responsive to medical therapy. Objective To study the safety and efficacy of stellate ganglion (SG) block and cardiac sympathetic denervation (CSD) in patients with IST. Methods Twelve consecutive patients who had drug‐refractory IST (10 women) were studied. According to a prospectively initiated protocol, five patients underwent an electrophysiologic study before and after SG block (electrophysiology study group). The subsequent seven patients had ambulatory Holter monitoring before and after SG block (ambulatory group). All patients underwent SG block on the right side first, and then on the left side. Selected patients who had heart rate reduction ≥15 beats per minute (bpm) were recommended to consider CSD. Results The mean (SD) baseline heart rate (HR) was 106 (21) bpm. The HR significantly decreased to 93 (20) bpm (P = .02) at 10 minutes after right SG block and remained significantly slower at 97(19) bpm at 60 minutes. Left SG block reduced HR from 99 (21) to 87(16) bpm (P = .02) at 60 minutes. SG block had no significant effect on blood pressure or HR response to isoproterenol or exercise (all P > .05). Five patients underwent right (n = 4) or bilateral (n = 1) CSD. The clinical outcomes were heterogeneous: one patient had complete and two had partial symptomatic relief, and two did not have improvement. Conclusion SG blockade modestly reduces resting HR but has no significant effect on HR during exercise. Permanent CSD may have a modest role in alleviating symptoms in selected patients with IST.
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Affiliation(s)
- Yong-Mei Cha
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Xuping Li
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.,Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Mei Yang
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.,Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Han
- Department of Cardiology and Atrial Fibrillation Center, The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Gang Wu
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Suraj C Kapa
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Peter A Noseworthy
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Siva K Mulpuru
- Department of Cardiovascular Diseases, Mayo Clinic Hospital, Phoenix, Arizona
| | | | - Peter A Brady
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Richard H Rho
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Paul A Friedman
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Hon-Chi Lee
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Ying Tian
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Shenghua Zhou
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Thomas M Munger
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michael J Ackerman
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Win-Kuang Shen
- Department of Cardiovascular Diseases, Mayo Clinic Hospital, Phoenix, Arizona
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28
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Kaczmarek K, Klingenheben T, Poddebska I, Urbanek I, Wranicz JK, Cygankiewicz I, Ptaszyński P. Baseline intrinsic heart rate and response to ivabradine treatment in patients with inappropriate sinus tachycardia. Ann Noninvasive Electrocardiol 2019; 25:e12709. [PMID: 31595620 PMCID: PMC7358846 DOI: 10.1111/anec.12709] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 09/14/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Treatment with ivabradine became a new therapeutic alternative for patients with inappropriate sinus tachycardia (IST). The aim was to determine a relation between intrinsic heart rate (IHR) and response to ivabradine treatment. METHODS Twenty-seven patients (mean age 37 ± 11; 23 women) with symptomatic IST despite medical treatment were recruited into the study. Resting ECG, 24-hr ECG monitoring (24hECG), exercise treadmill test, and symptoms evaluation were performed initially and after 60 days on ivabradine. IHR was acquired at baseline after pharmacological autonomic blockade. RESULTS Nineteen patients (70%) were classified as abnormal IHR group (AIHR) while eight showed normal IHR (NIHR). No significant differences in ECG parameters were found between NIHR and AIHR subgroups, while baseline exercise capacity was higher in AIHR patients (10.9 vs. 9.5 METs, p < .05). Ivabradine treatment resulted in significant reduction in resting heart rate, average 24hECG heart rate, improvement in exercise capacity and reduction of symptoms in both subgroups. Nevertheless, favorable influence of ivabradine was significantly more exaggerated in AIHR subgroup (HR 116 vs. 90 bpm, av. HR 98 vs. 79 bpm, 10.9 vs. 13.6 METS, EHRA score 3.1 vs. 1.1, p < .001 for all) than in NIHR patients (HR 112 vs. 98 bpm, av. HR 97 vs. 88 bpm, 9.5 vs. 11.1 METs, EHRA score 3.1 vs. 1.9; p < .05 for all). CONCLUSIONS Intrinsic heart rate may be useful in predicting response to ivabradine in patients with IST. More intense response to ivabradine in patients with AIHR may be attributed to different pathophysiological mechanisms underlying IST in AIHR and NIHR groups.
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Affiliation(s)
| | | | - Izabela Poddebska
- Department of Electrocardiology, Medical University of Lodz, Lodz, Poland
| | - Irmina Urbanek
- Department of Electrocardiology, Medical University of Lodz, Lodz, Poland
| | - Jerzy K Wranicz
- Department of Electrocardiology, Medical University of Lodz, Lodz, Poland
| | - Iwona Cygankiewicz
- Department of Electrocardiology, Medical University of Lodz, Lodz, Poland
| | - Pawel Ptaszyński
- Department of Electrocardiology, Medical University of Lodz, Lodz, Poland
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29
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The C-terminal HCN4 variant P883R alters channel properties and acts as genetic modifier of atrial fibrillation and structural heart disease. Biochem Biophys Res Commun 2019; 519:141-147. [DOI: 10.1016/j.bbrc.2019.08.150] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 08/26/2019] [Indexed: 12/18/2022]
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30
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Nakano Y, Ochi H, Sairaku A, Onohara Y, Tokuyama T, Motoda C, Matsumura H, Tomomori S, Amioka M, Hironobe N, Ohkubo Y, Okamura S, Makita N, Yoshida Y, Chayama K, Kihara Y. HCN4 Gene Polymorphisms Are Associated With Occurrence of Tachycardia-Induced Cardiomyopathy in Patients With Atrial Fibrillation. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2019; 11:e001980. [PMID: 29987112 DOI: 10.1161/circgen.117.001980] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 06/08/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Tachycardia-induced cardiomyopathy (TIC) is a reversible cardiomyopathy induced by tachyarrhythmia, and the genetic background of the TIC is not well understood. The hyperpolarization-activated cyclic nucleotide-gated channel gene HCN4 is highly expressed in the conduction system where it is involved in heart rate control. We speculated that the HCN4 gene is associated with TIC. METHODS We enrolled 930 Japanese patients with atrial fibrillation (AF) for screening, 350 Japanese patients with AF for replication, and 1635 non-AF controls. In the screening AF set, we compared HCN4 single-nucleotide polymorphism genotypes between AF subjects with TIC (TIC, n=73) and without TIC (non-TIC, n=857). Of 17 HCN4 gene-tag single-nucleotide polymorphisms, rs7172796, rs2680344, rs7164883, rs11631816, and rs12905211 were significantly associated with TIC. Among them, only rs7164883 was independently associated with TIC after conditional analysis (TIC versus non-TIC: minor allele frequency, 26.0% versus 9.7%; P=1.62×10-9; odds ratio=3.2). RESULTS We confirmed this association of HCN4 single-nucleotide polymorphism rs7164883 with TIC in the replication set (TIC=41 and non-TIC=309; minor allele frequency, 28% versus 9.9%; P=1.94×10-6; odds ratio=3.6). The minor allele frequency of rs7164883 was similar in patients with AF and non-AF controls (11% versus 10.9%; P=0.908). CONCLUSIONS The HCN4 gene single-nucleotide polymorphism rs7164883 may be a new genetic marker for TIC in patients with AF.
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Affiliation(s)
- Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.). .,Laboratory for Digestive Diseases, RIKEN Center for Integrative Medical Sciences, Hiroshima, Japan (Y.N., H.O., K.C.)
| | - Hidenori Ochi
- Laboratory for Digestive Diseases, RIKEN Center for Integrative Medical Sciences, Hiroshima, Japan (Y.N., H.O., K.C.).,Liver Research Project Center Hiroshima University, Hiroshima, Japan (H.O., K.C.).,Department of Internal Medicine, Chuden Hospital, The Chugoku Electric Power Company, Japan (H.O.).,Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (H.O., K.C.)
| | - Akinori Sairaku
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
| | - Yuko Onohara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
| | - Takehito Tokuyama
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
| | - Chikaaki Motoda
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
| | - Hiroya Matsumura
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
| | - Shunsuke Tomomori
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
| | - Michitaka Amioka
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
| | - Naoya Hironobe
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
| | - Yousaku Ohkubo
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
| | - Shou Okamura
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
| | - Naomasa Makita
- Department of Molecular Physiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (N.M.)
| | - Yukihiko Yoshida
- Department of Cardiology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan (Y.Y.)
| | - Kazuaki Chayama
- Laboratory for Digestive Diseases, RIKEN Center for Integrative Medical Sciences, Hiroshima, Japan (Y.N., H.O., K.C.).,Liver Research Project Center Hiroshima University, Hiroshima, Japan (H.O., K.C.).,Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (H.O., K.C.)
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (Y.N., A.S., Y.O., T.T., C.M., H.M., S.T., M.A., N.H., S.O., Y.K.)
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Banavalikar B, Shenthar J, Padmanabhan D, Valappil SP, Singha SI, Kottayan A, Ghadei M, Ali M. Clinical and Electrophysiological Correlates of Incessant Ivabradine-Sensitive Atrial Tachycardia. Circ Arrhythm Electrophysiol 2019; 12:e007387. [DOI: 10.1161/circep.119.007387] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Incessant focal atrial tachycardia (FAT), if untreated, can lead to ventricular dysfunction and heart failure (tachycardia-induced cardiomyopathy). Drug therapy of FAT is often difficult and ineffective. The efficacy of ivabradine has not been systematically evaluated in the treatment of FAT.
Methods:
The study group consisted of patients with incessant FAT (lasting >24 hours) and structurally normal hearts. Patients with ventricular dysfunction as a consequence of FAT were not excluded. All antiarrhythmic drugs were discontinued at least 5 half-lives before the initiation of ivabradine. Oral ivabradine (adults, 10 mg twice 12 hours apart; pediatric patients: 0.28 mg/kg in 2 divided doses) was initiated in the intensive care unit under continuous electrocardiographic monitoring. A positive response was defined as the termination of tachycardia with the restoration of sinus rhythm or suppression of the tachycardia to <100 beats per minute without termination within 12 hours of initiating ivabradine.
Results:
Twenty-eight patients (mean age, 34.6±21.5 years; women, 60.7%) were included in the study. The most common symptom was palpitation (85.7%) followed by shortness of breath (25%). The mean atrial rate during tachycardia was 170±21 beats per minute, and the mean left ventricular ejection fraction was 54.7±14.3%. Overall, 18 (64.3%) patients responded within 6 hours of the first dose of ivabradine. Thirteen of 18 ivabradine responders subsequently underwent successful catheter ablation. FAT originating in the atrial appendages was a predictor of ivabradine response compared with those arising from other atrial sites (
P
=0.046).
Conclusions:
Ivabradine-sensitive atrial tachycardia constitutes 64% of incessant FAT in patients without structural heart disease. Incessant FAT originating in the atrial appendages is more likely to respond to ivabradine than that arising from other atrial sites. Our findings implicate the funny current in the pathogenesis of FAT.
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Affiliation(s)
- Bharatraj Banavalikar
- Cardiac Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India
| | - Jayaprakash Shenthar
- Cardiac Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India
| | - Deepak Padmanabhan
- Cardiac Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India
| | - Sanjai Pattu Valappil
- Cardiac Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India
| | - Sinam Inaoton Singha
- Cardiac Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India
| | - Anju Kottayan
- Cardiac Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India
| | - Milan Ghadei
- Cardiac Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India
| | - Muzaffar Ali
- Cardiac Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India
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32
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Servatius H, Porro A, Pless SA, Schaller A, Asatryan B, Tanner H, de Marchi SF, Roten L, Seiler J, Haeberlin A, Baldinger SH, Noti F, Lam A, Fuhrer J, Moroni A, Medeiros-Domingo A. Phenotypic Spectrum of HCN4 Mutations: A Clinical Case. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2019; 11:e002033. [PMID: 29440115 DOI: 10.1161/circgen.117.002033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Helge Servatius
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Alessandro Porro
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Stephan A Pless
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - André Schaller
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Babken Asatryan
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Hildegard Tanner
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Stefano F de Marchi
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Laurent Roten
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Jens Seiler
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Andreas Haeberlin
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Samuel H Baldinger
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Fabian Noti
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Anna Lam
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Juerg Fuhrer
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Anna Moroni
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.)
| | - Argelia Medeiros-Domingo
- From the Department of Cardiology (H.S., B.A., H.T., S.F.d.M., L.R., J.S., A.H., S.H.B., F.N., A.L., J.F., A.M.-D.) and Division of Human Genetics, Department of Pediatrics (A.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Artificial Organ Center for Biomedical Engineering Research, University of Bern, Switzerland (A.H.); Department of Biosciences, CNR IBF-Milano, Università degli Studi di Milano, Italy (A.P., A.M.); and Department of Drug Design and Pharmacology, Center for Biopharmaceuticals, University of Copenhagen, Denmark (S.A.P.).
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33
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Affiliation(s)
- Brian Olshansky
- Professor Emeritus, Cardiology, University of Iowa Hospitals, 200 Hawkins Drive, Iowa, IA, USA
- Mercy Hospital-North Iowa, 1000 4th St SW, Mason, IA, USA
| | - Renee M Sullivan
- Medical Director, Clinical development Services, Covance, 2501 McGavock Pike, Nashville, TN, USA
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34
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Gorabi AM, Hajighasemi S, Khori V, Soleimani M, Rajaei M, Rabbani S, Atashi A, Ghiaseddin A, Saeid AK, Ahmadi Tafti H, Sahebkar A. Functional biological pacemaker generation by T-Box18 protein expression via stem cell and viral delivery approaches in a murine model of complete heart block. Pharmacol Res 2019; 141:443-450. [PMID: 30677516 DOI: 10.1016/j.phrs.2019.01.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/09/2019] [Accepted: 01/17/2019] [Indexed: 11/26/2022]
Abstract
Despite recent advances in the treatment of cardiac arrhythmia, the available options are still limited and associated with some complications. Induction of biological pacemakers via Tbx18 gene insertion in the heart tissue has been suggested as a promising therapeutic strategy for cardiac arrhythmia. Following a previous in vitro study reporting the production of Tbx18-expressing human induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs), we aimed to investigate the efficacy of these engineered cells to generate pacemaker rhythms in a murine model of complete heart block. We also attempted to generate a functional pacemaker by Tbx18 overexpression in native cardiac cells of rat heart. The hiPSC-derived pacemaker cells were produced by lentiviral delivery of Tbx18 gene to stem cells during a small molecule-based differentiation process. In the present study, 16 male albino Wistar rats were randomly assigned to Tbx18-lentivirus (n = 4) and Tbx18-pacemaker cells (n = 4) administered via injection into the left ventricular anterolateral wall. The control rats received GFP-lentiviruses (n = 4) and GFP-pacemaker cells (n = 4). Fourteen days after the injection, the rats were sacrificed and analyzed by electrocardiography (ECG) recording using a Langendorff-perfused heart model following complete heart block induced by hypokalemia and crashing. Immunofluorescence staining was used to investigate the expression of Tbx18, HCN4 and connexin 43 (Cx43) proteins in Tbx18-delivered cells of heart tissues. The heart rate was significantly reduced after complete heart block in all of the experimental rats (P < 0.05). Heart beating in the Tbx18-transduced hearts was slower compared with rats receiving Tbx18-pacemaker cells (P = 0.04). The duration of ventricular fibrillation (VF) was higher in the lentiviral Tbx18 group compared with the GFP-injected controls (P = 0.02) and the Tbx18-pacemaker cell group (P = 0.02). The ECG recording data showed spontaneous pacemaker rhythms in both intervention groups with signal propagation in Tbx18-transduced ventricles. Immunostaining results confirmed the overexpression of HCN4 and downregulation of Cx43 as a result of the expression of the Tbx18 gene and spontaneously contracting myocyte formation. We confirmed the formation of a functional pacemaker after introduction of Tbx18 via cell and gene therapy strategies. Although the pacemaker activity was better in gene-received hearts since there were longer VF duration and signal propagation from the injection site, more data should be gathered from the long-term activity of such pacemakers in different hosts.
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Affiliation(s)
- Armita Mahdavi Gorabi
- Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Iran
| | - Saeideh Hajighasemi
- Department of Medical Biotechnology, Faculty of Paramedicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Vahid Khori
- Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Masoud Soleimani
- Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Maryam Rajaei
- Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shahram Rabbani
- Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Iran
| | - Amir Atashi
- Stem Cell and Tissue Engineering Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Ali Kazemi Saeid
- Department of Cardiology, Tehran University of Medical Science, Tehran, Iran; Research Department, Laboratory of Dr. Stanley Nattel, Montreal Heart Institute Research Center, Montreal University, Montreal, Canada.
| | - Hossein Ahmadi Tafti
- Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Iran.
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Tehran, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Tehran, Iran; School of Medicine, Mashhad University of Medical Sciences, Tehran, Iran
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35
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Dong J, Subbotina E, Williams N, Sampson BA, Tang Y, Coetzee WA. Functional reclassification of variants of uncertain significance in the HCN4 gene identified in sudden unexpected death. Pacing Clin Electrophysiol 2019; 42:275-282. [PMID: 30578647 DOI: 10.1111/pace.13593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/07/2018] [Accepted: 12/18/2018] [Indexed: 11/28/2022]
Abstract
The HCN4 gene encodes a subunit of the hyperpolarization-activated cyclic nucleotide-gated channel, type 4 that is essential for the proper generation of pacemaker potentials in the sinoatrial node. The HCN4 gene is often present in targeted genetic testing panels for various cardiac conduction system disorders and there are several reports of HCN4 variants associated with conduction disorders. Here, we report the in vitro functional characterization of four rare variants of uncertain significance (VUS) in HCN4, identified through testing a cohort of 296 sudden unexpected natural deaths. The variants are all missense alterations, leading to single amino acid changes: p.E66Q in the N-terminus, p.D546N in the C-linker domain, and both p.S935Y and p.R1044Q in the C-terminus distal to the CNBD. We also identified a likely benign variant, p. P1063T, which has a high minor allele frequency in the gnomAD, which is utilized here as a negative control. Three of the HCN4 VUS (p.E66Q, p.S935Y, and p.R1044Q) had electrophysiological characteristics similar to the wild-type channel, suggesting that these variants are benign. In contrast, the p.D546N variant in the C-linker domain exhibited a larger current density, slower activation, and was unresponsive to cyclic adenosine monophosphate (cAMP) compared to wild-type. With functional assays, we reclassified three rare HCN4 VUS to likely benign variants, eliminating the necessity for costly and time-consuming further study. Our studies also provide a new lead to investigate how a VUS located in the C-linker connecting the pore to the cAMP binding domain may affect the channel open state probability and cAMP response.
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Affiliation(s)
- Jingyun Dong
- Departments of Pediatrics, NYU School of Medicine, New York, New York
| | | | - Nori Williams
- Molecular Genetics Laboratory, New York City Office of Chief Medical Examiner, New York, New York
| | - Barbara A Sampson
- Department of Forensic Pathology, New York City Office of Chief Medical Examiner, New York, New York
| | - Yingying Tang
- Molecular Genetics Laboratory, New York City Office of Chief Medical Examiner, New York, New York
| | - William A Coetzee
- Departments of Pediatrics, NYU School of Medicine, New York, New York.,Departments of Biochemistry and Molecular Pharmacology, NYU School of Medicine, New York, New York.,Departments of Physiology and Neurosciences, NYU School of Medicine, New York, New York
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36
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Thomas D, Christ T, Fabritz L, Goette A, Hammwöhner M, Heijman J, Kockskämper J, Linz D, Odening KE, Schweizer PA, Wakili R, Voigt N. German Cardiac Society Working Group on Cellular Electrophysiology state-of-the-art paper: impact of molecular mechanisms on clinical arrhythmia management. Clin Res Cardiol 2018; 108:577-599. [PMID: 30306295 DOI: 10.1007/s00392-018-1377-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/24/2018] [Indexed: 12/19/2022]
Abstract
Cardiac arrhythmias remain a common challenge and are associated with significant morbidity and mortality. Effective and safe rhythm control strategies are a primary, yet unmet need in everyday clinical practice. Despite significant pharmacological and technological advances, including catheter ablation and device-based therapies, the development of more effective alternatives is of significant interest to increase quality of life and to reduce symptom burden, hospitalizations and mortality. The mechanistic understanding of pathophysiological pathways underlying cardiac arrhythmias has advanced profoundly, opening up novel avenues for mechanism-based therapeutic approaches. Current management of arrhythmias, however, is primarily guided by clinical and demographic characteristics of patient groups as opposed to individual, patient-specific mechanisms and pheno-/genotyping. With this state-of-the-art paper, the Working Group on Cellular Electrophysiology of the German Cardiac Society aims to close the gap between advanced molecular understanding and clinical decision-making in cardiac electrophysiology. The significance of cellular electrophysiological findings for clinical arrhythmia management constitutes the main focus of this document. Clinically relevant knowledge of pathophysiological pathways of arrhythmias and cellular mechanisms of antiarrhythmic interventions are summarized. Furthermore, the specific molecular background for the initiation and perpetuation of atrial and ventricular arrhythmias and mechanism-based strategies for therapeutic interventions are highlighted. Current "hot topics" in atrial fibrillation are critically appraised. Finally, the establishment and support of cellular and translational electrophysiology programs in clinical rhythmology departments is called for to improve basic-science-guided patient management.
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Affiliation(s)
- Dierk Thomas
- Department of Cardiology, Medical University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. .,HCR (Heidelberg Center for Heart Rhythm Disorders), Heidelberg, Germany. .,DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg, Germany.
| | - Torsten Christ
- Department of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Larissa Fabritz
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.,Department of Cardiology, UHB NHS Trust, Birmingham, UK.,Department of Cardiovascular Medicine, Division of Rhythmology, University Hospital Münster, Münster, Germany
| | - Andreas Goette
- St. Vincenz-Hospital, Paderborn, Germany.,Working Group: Molecular Electrophysiology, University Hospital Magdeburg, Magdeburg, Germany
| | - Matthias Hammwöhner
- St. Vincenz-Hospital, Paderborn, Germany.,Working Group: Molecular Electrophysiology, University Hospital Magdeburg, Magdeburg, Germany
| | - Jordi Heijman
- Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, Essen, Germany.,Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jens Kockskämper
- Biochemical and Pharmacological Center (BPC) Marburg, Institute of Pharmacology and Clinical Pharmacy, University of Marburg, Marburg, Germany
| | - Dominik Linz
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia.,Experimental Electrophysiology, University Hospital of Saarland, Homburg, Saar, Germany
| | - Katja E Odening
- Department of Cardiology and Angiology I, Heart Center University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Experimental Cardiovascular Medicine, Heart Center University of Freiburg, Freiburg, Germany
| | - Patrick A Schweizer
- Department of Cardiology, Medical University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.,HCR (Heidelberg Center for Heart Rhythm Disorders), Heidelberg, Germany.,DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg, Germany.,Heidelberg Research Center for Molecular Medicine (HRCMM), Heidelberg, Germany
| | - Reza Wakili
- Department of Cardiology and Vascular Medicine, Medical Faculty, West German Heart Center, University Hospital Essen, Essen, Germany
| | - Niels Voigt
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany. .,DZHK (German Center for Cardiovascular Research), partner site Göttingen, Göttingen, Germany.
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Byun JA, Melacini G. NMR methods to dissect the molecular mechanisms of disease-related mutations (DRMs): Understanding how DRMs remodel functional free energy landscapes. Methods 2018; 148:19-27. [DOI: 10.1016/j.ymeth.2018.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/19/2018] [Accepted: 05/22/2018] [Indexed: 10/14/2022] Open
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Campostrini G, DiFrancesco JC, Castellotti B, Milanesi R, Gnecchi-Ruscone T, Bonzanni M, Bucchi A, Baruscotti M, Ferrarese C, Franceschetti S, Canafoglia L, Ragona F, Freri E, Labate A, Gambardella A, Costa C, Gellera C, Granata T, Barbuti A, DiFrancesco D. A Loss-of-Function HCN4 Mutation Associated With Familial Benign Myoclonic Epilepsy in Infancy Causes Increased Neuronal Excitability. Front Mol Neurosci 2018; 11:269. [PMID: 30127718 PMCID: PMC6089338 DOI: 10.3389/fnmol.2018.00269] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/16/2018] [Indexed: 01/03/2023] Open
Abstract
HCN channels are highly expressed and functionally relevant in neurons and increasing evidence demonstrates their involvement in the etiology of human epilepsies. Among HCN isoforms, HCN4 is important in cardiac tissue, where it underlies pacemaker activity. Despite being expressed also in deep structures of the brain, mutations of this channel functionally shown to be associated with epilepsy have not been reported yet. Using Next Generation Sequencing for the screening of patients with idiopathic epilepsy, we identified the p.Arg550Cys (c.1648C>T) heterozygous mutation on HCN4 in two brothers affected by benign myoclonic epilepsy of infancy. Functional characterization in heterologous expression system and in neurons showed that the mutation determines a loss of function of HCN4 contribution to activity and an increase of neuronal discharge, potentially predisposing to epilepsy. Expressed in cardiomyocytes, mutant channels activate at slightly more negative voltages than wild-type (WT), in accordance with borderline bradycardia. While HCN4 variants have been frequently associated with cardiac arrhythmias, these data represent the first experimental evidence that functional alteration of HCN4 can also be involved in human epilepsy through a loss-of-function effect and associated increased neuronal excitability. Since HCN4 appears to be highly expressed in deep brain structures only early during development, our data provide a potential explanation for a link between dysfunctional HCN4 and infantile epilepsy. These findings suggest that it may be useful to include HCN4 screening to extend the knowledge of the genetic causes of infantile epilepsies, potentially paving the way for the identification of innovative therapeutic strategies.
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Affiliation(s)
- Giulia Campostrini
- Molecular Physiology and Neurobiology, The PaceLab, Department of Biosciences, Università degli Studi di Milano, Milan, Italy
| | - Jacopo C DiFrancesco
- Clinical Neurophysiology and Epilepsy Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,Laboratory of Neurobiology, Department of Neurology, Milan Center for Neuroscience, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Barbara Castellotti
- Unit of Genetics of Neurodegenerative and Metabolic Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Raffaella Milanesi
- Molecular Physiology and Neurobiology, The PaceLab, Department of Biosciences, Università degli Studi di Milano, Milan, Italy
| | | | - Mattia Bonzanni
- Molecular Physiology and Neurobiology, The PaceLab, Department of Biosciences, Università degli Studi di Milano, Milan, Italy
| | - Annalisa Bucchi
- Molecular Physiology and Neurobiology, The PaceLab, Department of Biosciences, Università degli Studi di Milano, Milan, Italy
| | - Mirko Baruscotti
- Molecular Physiology and Neurobiology, The PaceLab, Department of Biosciences, Università degli Studi di Milano, Milan, Italy
| | - Carlo Ferrarese
- Laboratory of Neurobiology, Department of Neurology, Milan Center for Neuroscience, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Silvana Franceschetti
- Clinical Neurophysiology and Epilepsy Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Laura Canafoglia
- Clinical Neurophysiology and Epilepsy Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Francesca Ragona
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Elena Freri
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Angelo Labate
- Institute of Neurology, Università degli Studi Magna Græcia di Catanzaro, Catanzaro, Italy
| | - Antonio Gambardella
- Institute of Neurology, Università degli Studi Magna Græcia di Catanzaro, Catanzaro, Italy
| | - Cinzia Costa
- Neurology Unit, Ospedale S. Maria della Misericordia, Department of Medicine, University of Perugia, Perugia, Italy
| | - Cinzia Gellera
- Unit of Genetics of Neurodegenerative and Metabolic Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Tiziana Granata
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Andrea Barbuti
- Molecular Physiology and Neurobiology, The PaceLab, Department of Biosciences, Università degli Studi di Milano, Milan, Italy
| | - Dario DiFrancesco
- Molecular Physiology and Neurobiology, The PaceLab, Department of Biosciences, Università degli Studi di Milano, Milan, Italy
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Tsai CT. HCN4 Gene Polymorphisms and Tachycardia-Induced Cardiomyopathy. Circ Genom Precis Med 2018; 11:e002223. [DOI: 10.1161/circgen.118.002223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Chia-Ti Tsai
- Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei
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Campostrini G, Bonzanni M, Lissoni A, Bazzini C, Milanesi R, Vezzoli E, Francolini M, Baruscotti M, Bucchi A, Rivolta I, Fantini M, Severi S, Cappato R, Crotti L, J Schwartz P, DiFrancesco D, Barbuti A. The expression of the rare caveolin-3 variant T78M alters cardiac ion channels function and membrane excitability. Cardiovasc Res 2018; 113:1256-1265. [PMID: 28898996 PMCID: PMC5852518 DOI: 10.1093/cvr/cvx122] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 06/19/2017] [Indexed: 01/03/2023] Open
Abstract
Aims Caveolinopathies are a family of genetic disorders arising from alterations of the caveolin-3 (cav-3) gene. The T78M cav-3 variant has been associated with both skeletal and cardiac muscle pathologies but its functional contribution, especially to cardiac diseases, is still controversial. Here, we evaluated the effect of the T78M cav-3 variant on cardiac ion channel function and membrane excitability. Methods and results We transfected either the wild type (WT) or T78M cav-3 in caveolin-1 knock-out mouse embryonic fibroblasts and found by immunofluorescence and electron microscopy that both are expressed at the plasma membrane and form caveolae. Two ion channels known to interact and co-immunoprecipitate with the cav-3, hKv1.5 and hHCN4, interact also with T78M cav-3 and reside in lipid rafts. Electrophysiological analysis showed that the T78M cav-3 causes hKv1.5 channels to activate and inactivate at more hyperpolarized potentials and the hHCN4 channels to activate at more depolarized potentials, in a dominant way. In spontaneously beating neonatal cardiomyocytes, the expression of the T78M cav-3 significantly increased action potential peak-to-peak variability without altering neither the mean rate nor the maximum diastolic potential. We also found that in a small cohort of patients with supraventricular arrhythmias, the T78M cav-3 variant is more frequent than in the general population. Finally, in silico analysis of both sinoatrial and atrial cell models confirmed that the T78M-dependent changes are compatible with a pro-arrhythmic effect. Conclusion This study demonstrates that the T78M cav-3 induces complex modifications in ion channel function that ultimately alter membrane excitability. The presence of the T78M cav-3 can thus generate a susceptible substrate that, in concert with other structural alterations and/or genetic mutations, may become arrhythmogenic.
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Affiliation(s)
- Giulia Campostrini
- Department of Biosciences, The PaceLab, Università degli Studi di Milano, Milano, Italy
| | - Mattia Bonzanni
- Department of Biosciences, The PaceLab, Università degli Studi di Milano, Milano, Italy
| | - Alessio Lissoni
- Department of Biosciences, The PaceLab, Università degli Studi di Milano, Milano, Italy
| | - Claudia Bazzini
- Department of Biosciences, The PaceLab, Università degli Studi di Milano, Milano, Italy
| | - Raffaella Milanesi
- Department of Biosciences, The PaceLab, Università degli Studi di Milano, Milano, Italy
| | - Elena Vezzoli
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy.,Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy
| | - Maura Francolini
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
| | - Mirko Baruscotti
- Department of Biosciences, The PaceLab, Università degli Studi di Milano, Milano, Italy.,Centro Interuniversitario di Medicina Molecolare e Biofisica Applicata (CIMMBA), Università degli Studi di Milano, Milano, Italy
| | - Annalisa Bucchi
- Department of Biosciences, The PaceLab, Università degli Studi di Milano, Milano, Italy
| | - Ilaria Rivolta
- Department of Health Science, Università di Milano Bicocca, Monza, Italy
| | - Matteo Fantini
- Cellular and Molecular Engineering Laboratory 'S. Cavalcanti', Department of Electrical, Electronic and Information Engineering 'Guglielmo Marconi', University of Bologna, Bologna, Italy
| | - Stefano Severi
- Cellular and Molecular Engineering Laboratory 'S. Cavalcanti', Department of Electrical, Electronic and Information Engineering 'Guglielmo Marconi', University of Bologna, Bologna, Italy
| | - Riccardo Cappato
- Arrhythmia & Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Italy.,Arrhythmia & Electrophysiology Research Center, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
| | - Lia Crotti
- Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Milano, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Peter J Schwartz
- Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Dario DiFrancesco
- Department of Biosciences, The PaceLab, Università degli Studi di Milano, Milano, Italy.,Centro Interuniversitario di Medicina Molecolare e Biofisica Applicata (CIMMBA), Università degli Studi di Milano, Milano, Italy
| | - Andrea Barbuti
- Department of Biosciences, The PaceLab, Università degli Studi di Milano, Milano, Italy.,Centro Interuniversitario di Medicina Molecolare e Biofisica Applicata (CIMMBA), Università degli Studi di Milano, Milano, Italy
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Field ME, Donateo P, Bottoni N, Iori M, Brignole M, Kipp RT, Kopp DE, Leal MA, Eckhardt LL, Wright JM, Walsh KE, Page RL, Hamdan MH. P-Wave Amplitude and PR Changes in Patients With Inappropriate Sinus Tachycardia: Findings Supportive of a Central Mechanism. J Am Heart Assoc 2018; 7:JAHA.118.008528. [PMID: 29674334 PMCID: PMC6015284 DOI: 10.1161/jaha.118.008528] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The mechanism of inappropriate sinus tachycardia (IST) remains incompletely understood. METHODS AND RESULTS We prospectively compared 3 patient groups: 11 patients with IST (IST Group), 9 control patients administered isoproterenol (Isuprel Group), and 15 patients with cristae terminalis atrial tachycardia (AT Group). P-wave amplitude in lead II and PR interval were measured at a lower and higher heart rate (HR1 and HR2, respectively). P-wave amplitude increased significantly with the increase in HR in the IST Group (0.16±0.07 mV at HR1=97±12 beats per minute versus 0.21±0.08 mV at HR2=135±21 beats per minute, P=0.001). The average increase in P-wave amplitude in the IST Group was similar to the Isuprel Group (P=0.26). PR interval significantly shortened with the increases in HR in the IST Group (146±15 ms at HR1 versus 128±16 ms at HR2, P<0.001). A similar decrease in the PR interval was noted in the Isuprel Group (P=0.6). In contrast, patients in the atrial tachycardia Group experienced PR lengthening during atrial tachycardia when compared with baseline normal sinus rhythm (153±25 ms at HR1=78±17 beats per minute versus 179±29 ms at HR2=140±28 beats per minute, P<0.01). CONCLUSIONS We have shown that HR increases in patients with IST were associated with an increase in P-wave amplitude in lead II and PR shortening similar to what is seen in healthy controls following isoproterenol infusion. The increase in P-wave amplitude and absence of PR lengthening in IST support an extrinsic mechanism consistent with a state of sympatho-excitation with cephalic shift in sinus node activation and enhanced atrioventricular nodal conduction.
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Affiliation(s)
- Michael E Field
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Paolo Donateo
- Department of Cardiology, Arrhythmologic Centre, Ospedali del Tigullio, Lavagna, Italy
| | - Nicola Bottoni
- Department of Cardiology, Arrhythmology Centre, Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Matteo Iori
- Department of Cardiology, Arrhythmology Centre, Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Michele Brignole
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.,Department of Cardiology, Arrhythmologic Centre, Ospedali del Tigullio, Lavagna, Italy
| | - Ryan T Kipp
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Douglas E Kopp
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Miguel A Leal
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Lee L Eckhardt
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Jennifer M Wright
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Kathleen E Walsh
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Richard L Page
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Mohamed H Hamdan
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Ionic mechanisms of the action of anaesthetics on sinoatrial node automaticity. Eur J Pharmacol 2017; 814:63-72. [DOI: 10.1016/j.ejphar.2017.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/06/2017] [Accepted: 08/07/2017] [Indexed: 12/11/2022]
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Phosphodiesterases 3 and 4 Differentially Regulate the Funny Current, I f, in Mouse Sinoatrial Node Myocytes. J Cardiovasc Dev Dis 2017; 4. [PMID: 28868308 PMCID: PMC5573264 DOI: 10.3390/jcdd4030010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Cardiac pacemaking, at rest and during the sympathetic fight-or-flight response, depends on cAMP (3',5'-cyclic adenosine monophosphate) signaling in sinoatrial node myocytes (SAMs). The cardiac "funny current" (If) is among the cAMP-sensitive effectors that drive pacemaking in SAMs. If is produced by hyperpolarization-activated, cyclic nucleotide-sensitive (HCN) channels. Voltage-dependent gating of HCN channels is potentiated by cAMP, which acts either by binding directly to the channels or by activating the cAMP-dependent protein kinase (PKA), which phosphorylates them. PKA activity is required for signaling between β adrenergic receptors (βARs) and HCN channels in SAMs but the mechanism that constrains cAMP signaling to a PKA-dependent pathway is unknown. Phosphodiesterases (PDEs) hydrolyze cAMP and form cAMP signaling domains in other types of cardiomyocytes. Here we examine the role of PDEs in regulation of If in SAMs. If was recorded in whole-cell voltage-clamp experiments from acutely-isolated mouse SAMs in the absence or presence of PDE and PKA inhibitors, and before and after βAR stimulation. General PDE inhibition caused a PKA-independent depolarizing shift in the midpoint activation voltage (V1/2) of If at rest and removed the requirement for PKA in βAR-to-HCN signaling. PDE4 inhibition produced a similar PKA-independent depolarizing shift in the V1/2 of If at rest, but did not remove the requirement for PKA in βAR-to-HCN signaling. PDE3 inhibition produced PKA-dependent changes in If both at rest and in response to βAR stimulation. Our results suggest that PDE3 and PDE4 isoforms create distinct cAMP signaling domains that differentially constrain access of cAMP to HCN channels and establish the requirement for PKA in signaling between βARs and HCN channels in SAMs.
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Šatrauskienė A, Navickas R, Laucevičius A, Huber HJ. Identifying differential miR and gene consensus patterns in peripheral blood of patients with cardiovascular diseases from literature data. BMC Cardiovasc Disord 2017; 17:173. [PMID: 28666417 PMCID: PMC5493858 DOI: 10.1186/s12872-017-0609-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/22/2017] [Indexed: 01/13/2023] Open
Abstract
Background Numerous recent studies suggest the potential of circulating MicroRNAs (miRs) in peripheral blood samples as diagnostic or prognostic markers for coronary artery disease (CAD), acute coronary syndrome (ACS) and heart failure (HF). However, literature often remains inconclusive regarding as to which markers are most indicative for which of the above diseases. This shortcoming is mainly due to the lack of a systematic analyses and absence of information on the functional pathophysiological role of these miRs and their target genes. Methods We here provide an-easy-to-use scoring approach to investigate the likelihood of regulation of several miRs and their target genes from literature by identifying consensus patterns of regulation. We therefore have screened over 1000 articles that study mRNA markers in cardiovascular and metabolic diseases, and devised a scoring algorithm to identify consensus means for miRs and genes regulation across several studies. We then aimed to identify differential markers between CAD, ACS and HF. Results We first identified miRs (miR-122, −126, −223, −138 and −370) as commonly regulated within a group of metabolic disease, while investigating cardiac-related pathologies (CAD, ACS, HF) revealed a decisive role of miR-1, −499, −208b, and -133a. Looking at differential markers between cardiovascular disease revealed miR-1, miR-208a and miR-133a to distinguish ACS and CAD to HF. Relating differentially expressed miRs to their putative gene targets using MirTarBase, we further identified HCN2/4 and LASP1 as potential markers of CAD and ACS, but not in HF. Likewise, BLC-2 was found oppositely regulated between CAD and HF. Interestingly, while studying overlap in target genes between CAD, ACS and HF only revealed little similarities, mapping these genes to gene ontology terms revealed a surprising similarity between CAD and ACS compared to HF. Conclusion We conclude that our analysis using gene and miR scores allows the extraction of meaningful markers and the elucidation of differential pathological functions between cardiac diseases and provides a novel approach for literature screening for miR and gene consensus patterns. The analysis is easy to use and extendable upon further emergent literature as we provide an Excel sheet for this analysis to the community. Electronic supplementary material The online version of this article (doi:10.1186/s12872-017-0609-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Agnė Šatrauskienė
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania.,Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania
| | - Rokas Navickas
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania.,Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania
| | - Aleksandras Laucevičius
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania.,Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania
| | - Heinrich J Huber
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. .,Institute for Automation Engineering (IFAT), Laboratory for Systems Theory and Automatic Control, Otto-von-Guericke University Magdeburg, 39106, Magdeburg, Germany.
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Nolte IM, Munoz ML, Tragante V, Amare AT, Jansen R, Vaez A, von der Heyde B, Avery CL, Bis JC, Dierckx B, van Dongen J, Gogarten SM, Goyette P, Hernesniemi J, Huikari V, Hwang SJ, Jaju D, Kerr KF, Kluttig A, Krijthe BP, Kumar J, van der Laan SW, Lyytikäinen LP, Maihofer AX, Minassian A, van der Most PJ, Müller-Nurasyid M, Nivard M, Salvi E, Stewart JD, Thayer JF, Verweij N, Wong A, Zabaneh D, Zafarmand MH, Abdellaoui A, Albarwani S, Albert C, Alonso A, Ashar F, Auvinen J, Axelsson T, Baker DG, de Bakker PIW, Barcella M, Bayoumi R, Bieringa RJ, Boomsma D, Boucher G, Britton AR, Christophersen I, Dietrich A, Ehret GB, Ellinor PT, Eskola M, Felix JF, Floras JS, Franco OH, Friberg P, Gademan MGJ, Geyer MA, Giedraitis V, Hartman CA, Hemerich D, Hofman A, Hottenga JJ, Huikuri H, Hutri-Kähönen N, Jouven X, Junttila J, Juonala M, Kiviniemi AM, Kors JA, Kumari M, Kuznetsova T, Laurie CC, Lefrandt JD, Li Y, Li Y, Liao D, Limacher MC, Lin HJ, Lindgren CM, Lubitz SA, Mahajan A, McKnight B, Zu Schwabedissen HM, Milaneschi Y, Mononen N, Morris AP, Nalls MA, Navis G, Neijts M, Nikus K, North KE, O'Connor DT, Ormel J, Perz S, Peters A, Psaty BM, Raitakari OT, Risbrough VB, Sinner MF, Siscovick D, Smit JH, Smith NL, Soliman EZ, Sotoodehnia N, Staessen JA, Stein PK, Stilp AM, Stolarz-Skrzypek K, Strauch K, Sundström J, Swenne CA, Syvänen AC, Tardif JC, Taylor KD, Teumer A, Thornton TA, Tinker LE, Uitterlinden AG, van Setten J, Voss A, Waldenberger M, Wilhelmsen KC, Willemsen G, Wong Q, Zhang ZM, Zonderman AB, Cusi D, Evans MK, Greiser HK, van der Harst P, Hassan M, Ingelsson E, Järvelin MR, Kääb S, Kähönen M, Kivimaki M, Kooperberg C, Kuh D, Lehtimäki T, Lind L, Nievergelt CM, O'Donnell CJ, Oldehinkel AJ, Penninx B, Reiner AP, Riese H, van Roon AM, Rioux JD, Rotter JI, Sofer T, Stricker BH, Tiemeier H, Vrijkotte TGM, Asselbergs FW, Brundel BJJM, Heckbert SR, Whitsel EA, den Hoed M, Snieder H, de Geus EJC. Genetic loci associated with heart rate variability and their effects on cardiac disease risk. Nat Commun 2017; 8:15805. [PMID: 28613276 PMCID: PMC5474732 DOI: 10.1038/ncomms15805] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 05/08/2017] [Indexed: 01/15/2023] Open
Abstract
Reduced cardiac vagal control reflected in low heart rate variability (HRV) is associated with greater risks for cardiac morbidity and mortality. In two-stage meta-analyses of genome-wide association studies for three HRV traits in up to 53,174 individuals of European ancestry, we detect 17 genome-wide significant SNPs in eight loci. HRV SNPs tag non-synonymous SNPs (in NDUFA11 and KIAA1755), expression quantitative trait loci (eQTLs) (influencing GNG11, RGS6 and NEO1), or are located in genes preferentially expressed in the sinoatrial node (GNG11, RGS6 and HCN4). Genetic risk scores account for 0.9 to 2.6% of the HRV variance. Significant genetic correlation is found for HRV with heart rate (-0.74<rg<-0.55) and blood pressure (-0.35<rg<-0.20). These findings provide clinically relevant biological insight into heritable variation in vagal heart rhythm regulation, with a key role for genetic variants (GNG11, RGS6) that influence G-protein heterotrimer action in GIRK-channel induced pacemaker membrane hyperpolarization.
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Affiliation(s)
- Ilja M Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - M Loretto Munoz
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Vinicius Tragante
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584CX, The Netherlands
| | - Azmeraw T Amare
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands.,Department of Epidemiology, School of Medicine, University of Adelaide, Adelaide, South Australia 5005, Australia.,College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar 6000, Ethiopia
| | - Rick Jansen
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center/GGZ inGeest, Amsterdam 1081 BT, The Netherlands
| | - Ahmad Vaez
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands.,School of Medicine, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Benedikt von der Heyde
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala 75237, Sweden.,Science for Life Laboratory, Uppsala University, Uppsala 75237, Sweden
| | - Christy L Avery
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington 98104, USA
| | - Bram Dierckx
- Department of Child and Adolescent Psychiatry/Psychology, Department of Child and Adolescent Psychiatry, PO Box 2060, Rotterdam 3000 CB, The Netherlands.,The Generation R Study Group, Erasmus MC, PO Box 2060, Rotterdam 3000 CB, The Netherlands
| | - Jenny van Dongen
- Department of Biological Psychology, Behavioral and Movement Sciences, VU University, Amsterdam 1081 BT, The Netherlands
| | - Stephanie M Gogarten
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington 98195, USA
| | | | - Jussi Hernesniemi
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere 33520, Finland.,Department of Clinical Chemistry, University of Tampere School of Medicine, Tampere 33014, Finland.,Department of Cardiology, Heart Hospital, Tampere University Hospital, Tampere 33521, Finland
| | - Ville Huikari
- Center for Life Course Health Research, University of Oulu, Oulu 90014, Finland
| | - Shih-Jen Hwang
- Framingham Heart Study, Framingham, Massachusetts 01702, USA.,Population Sciences Branch, National Heart, Lung and Blood Institute, Bethesda, Maryland 20892, USA
| | - Deepali Jaju
- Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat-Al Khoudh 123, Sultanate of Oman
| | - Kathleen F Kerr
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington 98195, USA
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 06097, Germany
| | - Bouwe P Krijthe
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2060, Rotterdam 3000 CB, The Netherlands
| | - Jitender Kumar
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala 75237, Sweden.,Science for Life Laboratory, Uppsala University, Uppsala 75237, Sweden
| | - Sander W van der Laan
- Laboratory of Experimental Cardiology, Department of Heart and Lung, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere 33520, Finland.,Department of Clinical Chemistry, University of Tampere School of Medicine, Tampere 33014, Finland
| | - Adam X Maihofer
- Department of Psychiatry, University of California, San Diego, San Diego, California 92093, USA.,Center for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, California 92161, USA
| | - Arpi Minassian
- Department of Psychiatry, University of California, San Diego, San Diego, California 92093, USA.,Center for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, California 92161, USA
| | - Peter J van der Most
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg 85764, Germany.,Department of Medicine, University Hospital Munich, Ludwig-Maximilians-University, Munich 80539, Germany.,DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich 80336, Germany
| | - Michel Nivard
- Department of Biological Psychology, Behavioral and Movement Sciences, VU University, Amsterdam 1081 BT, The Netherlands.,EMGO+ Institute for Health and Care Research, VU University &VU University Medical Center, Amsterdam 1081 HV, The Netherlands
| | - Erika Salvi
- Department of Health Sciences, University of Milano, Milano 20122, Italy
| | - James D Stewart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, USA.,Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Julian F Thayer
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, Ohio 43210, USA
| | - Niek Verweij
- Department of Cardiology, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing, University College London, 33 Bedford Place, London WC1B 5JU, UK
| | - Delilah Zabaneh
- Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK.,University College London Genetics Institute, University College London, London WC1E 6BT, UK
| | - Mohammad H Zafarmand
- Department of Public Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam 1105 AZ, The Netherlands.,Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Abdel Abdellaoui
- Department of Biological Psychology, Behavioral and Movement Sciences, VU University, Amsterdam 1081 BT, The Netherlands.,EMGO+ Institute for Health and Care Research, VU University &VU University Medical Center, Amsterdam 1081 HV, The Netherlands
| | - Sulayma Albarwani
- Department of Physiology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat Al-Khoudh 123, Sultanate of Oman
| | - Christine Albert
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
| | - Foram Ashar
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu 90014, Finland.,Unit of Primary Health Care, Oulu University Hospital, Oulu 90220, Finland
| | - Tomas Axelsson
- Department of Medical Sciences, Molecular Medicine, Uppsala University, Uppsala 75237, Sweden
| | - Dewleen G Baker
- Center for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, California 92161, USA.,Department of Psychiatry, University of California, San Diego, San Diego, California 92093, USA
| | - Paul I W de Bakker
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht 3584 CX, The Netherlands.,Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Matteo Barcella
- Department of Health Sciences, University of Milano, Milano 20122, Italy
| | - Riad Bayoumi
- College of Medicine, Mohammed Bin Rashid University, PO Box 505055, Dubai Healthcare City, United Arab Emirates
| | - Rob J Bieringa
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Dorret Boomsma
- Department of Biological Psychology, Behavioral and Movement Sciences, VU University, Amsterdam 1081 BT, The Netherlands.,EMGO+ Institute for Health and Care Research, VU University &VU University Medical Center, Amsterdam 1081 HV, The Netherlands
| | | | - Annie R Britton
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Ingrid Christophersen
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.,Program in Medical and Population Genetics, The Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02114, USA.,Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Rud 1346, Norway
| | - Andrea Dietrich
- Department of Child- and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - George B Ehret
- Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.,Cardiology, Department of Specialties of Internal Medicine, Geneva University Hospital, Geneva 1211, Switzerland
| | - Patrick T Ellinor
- Program in Medical and Population Genetics, The Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02114, USA.,Cardiac Arrhythmia Service &Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Markku Eskola
- Department of Cardiology, Heart Hospital, Tampere University Hospital, Tampere 33521, Finland.,Department of Cardiology, University of Tampere School of Medicine, Tampere 33014, Finland
| | - Janine F Felix
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2060, Rotterdam 3000 CB, The Netherlands
| | - John S Floras
- University Health Network and Mount Sinai Hospital Division of Cardiology, Department of Medicine, University of Toronto, Ontario, Canada M5S.,Toronto General Research Institute, University Health Network, Toronto, Canada
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2060, Rotterdam 3000 CB, The Netherlands
| | - Peter Friberg
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Maaike G J Gademan
- Department of Public Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Mark A Geyer
- Department of Psychiatry, University of California, San Diego, San Diego, California 92093, USA
| | - Vilmantas Giedraitis
- Department of Public Health and Caring Sciences, Molecular Geriatrics, Uppsala University, Uppsala 75237, Sweden
| | - Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Daiane Hemerich
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584CX, The Netherlands.,CAPES Foundation, Ministry of Education of Brazil, Brasília DF 70040-020, Brazil
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2060, Rotterdam 3000 CB, The Netherlands
| | - Jouke-Jan Hottenga
- Department of Biological Psychology, Behavioral and Movement Sciences, VU University, Amsterdam 1081 BT, The Netherlands.,EMGO+ Institute for Health and Care Research, VU University &VU University Medical Center, Amsterdam 1081 HV, The Netherlands
| | - Heikki Huikuri
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu 90220, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital, Tampere 33521, Finland.,Department of Pediatrics, University of Tampere School of Medicine, Tampere 33014, Finland
| | - Xavier Jouven
- INSERM U970, Paris Descartes University, Paris 75006, France
| | - Juhani Junttila
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu 90220, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku 20520, Finland.,Division of Medicine, Turku University Hospital, Turku 20521, Finland
| | - Antti M Kiviniemi
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu 90220, Finland
| | - Jan A Kors
- Department of Medical Informatics, Erasmus Medical Center, Rotterdam 3015 CE, The Netherlands
| | - Meena Kumari
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.,ISER, Essex University, Colchester, Essex CO4 3SQ, UK
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven 3000, Belgium
| | - Cathy C Laurie
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington 98195, USA
| | - Joop D Lefrandt
- Department of Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Yong Li
- Division of Genetic Epidemiology, Institute for Medical Biometry and Statistics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79110, Germany
| | - Yun Li
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599, USA.,Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina 27599, USA.,Department of Computer Science, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Duanping Liao
- Division of Epidemiology, Department of Public Health Sciences, Penn State University College of Medicine, Hershey, Pennsylvania 17033, USA
| | - Marian C Limacher
- Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida 32611, USA
| | - Henry J Lin
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California 90502, USA.,Division of Medical Genetics, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California 90502, USA
| | - Cecilia M Lindgren
- Li Ka Shing Centre for Health Information and Discovery, The Big Data Institute, University of Oxford, Oxford OX3 7BN, UK.,Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Steven A Lubitz
- Program in Medical and Population Genetics, The Broad Institute of Harvard and MIT, Cambridge, Massachusetts 02114, USA.,Cardiac Arrhythmia Service &Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Anubha Mahajan
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Barbara McKnight
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington 98104, USA.,Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington 98195, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA
| | | | - Yuri Milaneschi
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center/GGZ inGeest, Amsterdam 1081 BT, The Netherlands
| | - Nina Mononen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere 33520, Finland.,Department of Clinical Chemistry, University of Tampere School of Medicine, Tampere 33014, Finland
| | - Andrew P Morris
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK.,Department of Biostatistics, University of Liverpool, Liverpool L69 3GL, UK
| | - Mike A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Gerjan Navis
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Melanie Neijts
- Department of Biological Psychology, Behavioral and Movement Sciences, VU University, Amsterdam 1081 BT, The Netherlands.,EMGO+ Institute for Health and Care Research, VU University &VU University Medical Center, Amsterdam 1081 HV, The Netherlands
| | - Kjell Nikus
- Department of Cardiology, Heart Hospital, Tampere University Hospital, Tampere 33521, Finland.,Department of Cardiology, University of Tampere, School of Medicine, Tampere 33014, Finland
| | - Kari E North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, USA.,Carolina Center for Genome Sciences, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Daniel T O'Connor
- Department of Medicine, University of California, San Diego, San Diego, California 92093, USA
| | - Johan Ormel
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Siegfried Perz
- Institute of Epidemiology II, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg 85764, Germany
| | - Annette Peters
- DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich 80336, Germany.,Institute of Epidemiology II, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg 85764, Germany.,German Center for Diabetes Research, Neuherberg 85764, Germany
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington 98104, USA.,Departments of Epidemiology and Health Services, University of Washington, Seattle, Washington 98195, USA.,Group Health Research Institute, Group Health Cooperative, Seattle, Washington 98101, USA
| | - Olli T Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku 20521, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku 20520, Finland
| | - Victoria B Risbrough
- Department of Psychiatry, University of California, San Diego, San Diego, California 92093, USA.,Center for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, California 92161, USA
| | - Moritz F Sinner
- Department of Medicine, University Hospital Munich, Ludwig-Maximilians-University, Munich 80539, Germany.,DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich 80336, Germany
| | - David Siscovick
- The New York Academy of Medicine, New York, New York 10029, USA
| | - Johannes H Smit
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center/GGZ inGeest, Amsterdam 1081 BT, The Netherlands
| | - Nicholas L Smith
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington 98101, USA.,Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington 98195, USA.,Seattle Epidemiologic Research and Information Center, Veterans Affairs Office of Research and Development, Seattle, Washington 98108, USA
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157, USA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Division of Cardiology, Departments of Medicine and Epidemiology, University of Washington, Seattle, Washington 98101, USA
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven 3000, Belgium
| | - Phyllis K Stein
- Heart Rate Variability Lab, Washington University School of Medicine, St Louis, Missouri 63108, USA
| | - Adrienne M Stilp
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington 98195, USA
| | - Katarzyna Stolarz-Skrzypek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Cracow 31-008, Poland
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg 85764, Germany.,Institute of Medical Informatics, Biometry and Epidemiology, Chair of Genetic Epidemiology, Ludwig-Maximilians-Universität, Munich 81377, Germany
| | - Johan Sundström
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala 751 85, Sweden
| | - Cees A Swenne
- Department of Cardiology, Leiden University Medical Center, Leiden 2300 RC, The Netherlands
| | - Ann-Christine Syvänen
- Department of Medical Sciences, Molecular Medicine, Uppsala University, Uppsala 75237, Sweden
| | - Jean-Claude Tardif
- Montreal Heart Institute, Montreal, Quebec, Canada H1T 1C8.,Université de Montréal, Montreal, Quebec, Canada H3T IJ4
| | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California 90509, USA
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald 17475, Germany
| | - Timothy A Thornton
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington 98195, USA
| | - Lesley E Tinker
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2060, Rotterdam 3000 CB, The Netherlands.,Department of Internal Medicine, Erasmus University Medical Center, Rotterdam 3015 CE, The Netherlands.,Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging NCHA), Leiden 2300 RC, The Netherlands
| | - Jessica van Setten
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584CX, The Netherlands
| | - Andreas Voss
- Institute of Innovative Health Technologies-IGHT Jena Ernst-Abbe-Hochschule Jena, Jena 07745, Germany
| | - Melanie Waldenberger
- Institute of Epidemiology II, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg 85764, Germany.,Research Unit of Molecular Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg 85764, Germany
| | - Kirk C Wilhelmsen
- Departments of Genetics and Neurology University of North Carolina, Chapel Hill, North Carolina 27599, USA.,The Renaissance Computing Institute, Chapel Hill, North Carolina 27599, USA
| | - Gonneke Willemsen
- Department of Biological Psychology, Behavioral and Movement Sciences, VU University, Amsterdam 1081 BT, The Netherlands.,EMGO+ Institute for Health and Care Research, VU University &VU University Medical Center, Amsterdam 1081 HV, The Netherlands
| | - Quenna Wong
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington 98195, USA
| | - Zhu-Ming Zhang
- Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157, USA.,Department of Epidemiology &Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224, USA
| | - Daniele Cusi
- Institute of Biomedical Technologies, CNR-Italian National Research Council, Milan 20090, Italy.,KOS Genetic SRL, Bresso (Milano) 20091, Italy
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224, USA
| | - Halina K Greiser
- German Cancer Research Centre, Division of Cancer Epidemiology, Heidelberg 69210, Germany
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Mohammad Hassan
- Department of Physiology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat Al-Khoudh 123, Sultanate of Oman
| | - Erik Ingelsson
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala 75237, Sweden.,Science for Life Laboratory, Uppsala University, Uppsala 75237, Sweden.,Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California 94305, USA
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu 90014, Finland.,Unit of Primary Health Care, Oulu University Hospital, Oulu 90220, Finland.,Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, St Mary's campus, Imperial College London, London W2 1PG, UK.,Biocenter Oulu University of Oulu, Oulu 90014, Finland
| | - Stefan Kääb
- Department of Medicine, University Hospital Munich, Ludwig-Maximilians-University, Munich 80539, Germany.,DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich 80336, Germany
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere 33521, Finland.,Department of Clinical Physiology, University of Tampere, School of Medicine, Tampere 33014, Finland
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Charles Kooperberg
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, University College London, 33 Bedford Place, London WC1B 5JU, UK
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere 33520, Finland.,Department of Clinical Chemistry, University of Tampere School of Medicine, Tampere 33014, Finland
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala 751 85, Sweden
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California, San Diego, San Diego, California 92093, USA.,Center for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, California 92161, USA
| | - Chris J O'Donnell
- Framingham Heart Study, Framingham, Massachusetts 01702, USA.,Population Sciences Branch, National Heart, Lung and Blood Institute, Bethesda, Maryland 20892, USA.,Cardiology Section, Boston Veteran's Administration Healthcare, Boston, Maryland 02132, USA
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Brenda Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center/GGZ inGeest, Amsterdam 1081 BT, The Netherlands
| | - Alexander P Reiner
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.,Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington 98195, USA
| | - Harriëtte Riese
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Arie M van Roon
- Department of Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - John D Rioux
- Montreal Heart Institute, Montreal, Quebec, Canada H1T 1C8.,Université de Montréal, Montreal, Quebec, Canada H3T IJ4
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California 90509, USA
| | - Tamar Sofer
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington 98195, USA
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2060, Rotterdam 3000 CB, The Netherlands.,Inspectorate for Health Care, The Hague 2511 VX, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Department of Child and Adolescent Psychiatry, PO Box 2060, Rotterdam 3000 CB, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2060, Rotterdam 3000 CB, The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584CX, The Netherlands.,Institute of Cardiovascular Science, University College London, 222 Euston Road, London NW1 2DA, UK.,Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht 3501 DG, The Netherlands
| | - Bianca J J M Brundel
- Department of Physiology, Institute for Cardiovascular Research, VU University Medical Center, De Boelelaan 1118, Amsterdam 1081 HV, The Netherlands
| | - Susan R Heckbert
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington 98104, USA.,Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington 98195, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, USA.,Department of Medicine, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Marcel den Hoed
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala 75237, Sweden.,Science for Life Laboratory, Uppsala University, Uppsala 75237, Sweden
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology, Behavioral and Movement Sciences, VU University, Amsterdam 1081 BT, The Netherlands.,EMGO+ Institute for Health and Care Research, VU University &VU University Medical Center, Amsterdam 1081 HV, The Netherlands
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Fabbri A, Fantini M, Wilders R, Severi S. Computational analysis of the human sinus node action potential: model development and effects of mutations. J Physiol 2017; 595:2365-2396. [PMID: 28185290 PMCID: PMC5374121 DOI: 10.1113/jp273259] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 02/02/2017] [Indexed: 12/12/2022] Open
Abstract
KEY POINTS We constructed a comprehensive mathematical model of the spontaneous electrical activity of a human sinoatrial node (SAN) pacemaker cell, starting from the recent Severi-DiFrancesco model of rabbit SAN cells. Our model is based on electrophysiological data from isolated human SAN pacemaker cells and closely matches the action potentials and calcium transient that were recorded experimentally. Simulated ion channelopathies explain the clinically observed changes in heart rate in corresponding mutation carriers, providing an independent qualitative validation of the model. The model shows that the modulatory role of the 'funny current' (If ) in the pacing rate of human SAN pacemaker cells is highly similar to that of rabbit SAN cells, despite its considerably lower amplitude. The model may prove useful in the design of experiments and the development of heart-rate modulating drugs. ABSTRACT The sinoatrial node (SAN) is the normal pacemaker of the mammalian heart. Over several decades, a large amount of data on the ionic mechanisms underlying the spontaneous electrical activity of SAN pacemaker cells has been obtained, mostly in experiments on single cells isolated from rabbit SAN. This wealth of data has allowed the development of mathematical models of the electrical activity of rabbit SAN pacemaker cells. The present study aimed to construct a comprehensive model of the electrical activity of a human SAN pacemaker cell using recently obtained electrophysiological data from human SAN pacemaker cells. We based our model on the recent Severi-DiFrancesco model of a rabbit SAN pacemaker cell. The action potential and calcium transient of the resulting model are close to the experimentally recorded values. The model has a much smaller 'funny current' (If ) than do rabbit cells, although its modulatory role is highly similar. Changes in pacing rate upon the implementation of mutations associated with sinus node dysfunction agree with the clinical observations. This agreement holds for both loss-of-function and gain-of-function mutations in the HCN4, SCN5A and KCNQ1 genes, underlying ion channelopathies in If , fast sodium current and slow delayed rectifier potassium current, respectively. We conclude that our human SAN cell model can be a useful tool in the design of experiments and the development of drugs that aim to modulate heart rate.
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Affiliation(s)
- Alan Fabbri
- Computational Physiopathology Unit, Department of Electrical, Electronic and Information Engineering “Guglielmo Marconi”University of BolognaCesenaItaly
| | - Matteo Fantini
- Computational Physiopathology Unit, Department of Electrical, Electronic and Information Engineering “Guglielmo Marconi”University of BolognaCesenaItaly
| | - Ronald Wilders
- Department of Anatomy, Embryology and Physiology, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
| | - Stefano Severi
- Computational Physiopathology Unit, Department of Electrical, Electronic and Information Engineering “Guglielmo Marconi”University of BolognaCesenaItaly
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48
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Sekulić V, Skinner FK. Computational models of O-LM cells are recruited by low or high theta frequency inputs depending on h-channel distributions. eLife 2017; 6. [PMID: 28318488 PMCID: PMC5409828 DOI: 10.7554/elife.22962] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 03/19/2017] [Indexed: 01/06/2023] Open
Abstract
Although biophysical details of inhibitory neurons are becoming known, it is challenging to map these details onto function. Oriens-lacunosum/moleculare (O-LM) cells are inhibitory cells in the hippocampus that gate information flow, firing while phase-locked to theta rhythms. We build on our existing computational model database of O-LM cells to link model with function. We place our models in high-conductance states and modulate inhibitory inputs at a wide range of frequencies. We find preferred spiking recruitment of models at high (4-9 Hz) or low (2-5 Hz) theta depending on, respectively, the presence or absence of h-channels on their dendrites. This also depends on slow delayed-rectifier potassium channels, and preferred theta ranges shift when h-channels are potentiated by cyclic AMP. Our results suggest that O-LM cells can be differentially recruited by frequency-modulated inputs depending on specific channel types and distributions. This work exposes a strategy for understanding how biophysical characteristics contribute to function.
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Affiliation(s)
- Vladislav Sekulić
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Frances K Skinner
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Departments of Medicine (Neurology) and Physiology, University of Toronto, Toronto, Ontario, Canada
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Boulton S, Akimoto M, Akbarizadeh S, Melacini G. Free energy landscape remodeling of the cardiac pacemaker channel explains the molecular basis of familial sinus bradycardia. J Biol Chem 2017; 292:6414-6428. [PMID: 28174302 DOI: 10.1074/jbc.m116.773697] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 01/28/2017] [Indexed: 12/21/2022] Open
Abstract
The hyperpolarization-activated and cyclic nucleotide-modulated ion channel (HCN) drives the pacemaker activity in the heart, and its malfunction can result in heart disorders. One such disorder, familial sinus bradycardia, is caused by the S672R mutation in HCN, whose electrophysiological phenotypes include a negative shift in the channel activation voltage and an accelerated HCN deactivation. The outcomes of these changes are abnormally low resting heart rates. However, the molecular mechanism underlying these electrophysiological changes is currently not fully understood. Crystallographic investigations indicate that the S672R mutation causes limited changes in the structure of the HCN intracellular gating tetramer, but its effects on protein dynamics are unknown. Here, we utilize comparative S672R versus WT NMR analyses to show that the S672R mutation results in extensive perturbations of the dynamics in both apo- and holo-forms of the HCN4 isoform, reflecting how S672R remodels the free energy landscape for the modulation of HCN4 by cAMP, i.e. the primary cyclic nucleotide modulator of HCN channels. We show that the S672R mutation results in a constitutive shift of the dynamic auto-inhibitory equilibrium toward inactive states of HCN4 and broadens the free-energy well of the apo-form, enhancing the millisecond to microsecond dynamics of the holo-form at sites critical for gating cAMP binding. These S672R-induced variations in dynamics provide a molecular basis for the electrophysiological phenotypes of this mutation and demonstrate that the pathogenic effects of the S672R mutation can be rationalized primarily in terms of modulations of protein dynamics.
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Affiliation(s)
- Stephen Boulton
- From the Departments of Biochemistry and Biomedical Sciences and
| | - Madoka Akimoto
- Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4M1, Canada
| | - Sam Akbarizadeh
- Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4M1, Canada
| | - Giuseppe Melacini
- From the Departments of Biochemistry and Biomedical Sciences and .,Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4M1, Canada
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50
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Lüscher TF. An update on arrhythmias: mechanisms and novel devices. Eur Heart J 2017; 38:219-221. [DOI: 10.1093/eurheartj/ehx006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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