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Dorey TW, Liu Y, Jansen HJ, Bohne LJ, Mackasey M, Atkinson L, Prasai S, Belke DD, Fatehi-Hassanabad A, Fedak PWM, Rose RA. Natriuretic Peptide Receptor B Protects Against Atrial Fibrillation by Controlling Atrial cAMP Via Phosphodiesterase 2. Circ Arrhythm Electrophysiol 2023; 16:e012199. [PMID: 37933567 DOI: 10.1161/circep.123.012199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND β-AR (β-adrenergic receptor) stimulation regulates atrial electrophysiology and Ca2+ homeostasis via cAMP-dependent mechanisms; however, enhanced β-AR signaling can promote atrial fibrillation (AF). CNP (C-type natriuretic peptide) can also regulate atrial electrophysiology through the activation of NPR-B (natriuretic peptide receptor B) and cGMP-dependent signaling. Nevertheless, the role of NPR-B in regulating atrial electrophysiology, Ca2+ homeostasis, and atrial arrhythmogenesis is incompletely understood. METHODS Studies were performed using atrial samples from human patients with AF or sinus rhythm and in wild-type and NPR-B-deficient (NPR-B+/-) mice. Studies were conducted in anesthetized mice by intracardiac electrophysiology, in isolated mouse atrial preparations using high-resolution optical mapping, in isolated mouse and human atrial myocytes using patch-clamping and Ca2+ imaging, and in mouse and human atrial tissues using molecular biology. RESULTS Atrial NPR-B protein levels were reduced in patients with AF, and NPR-B+/- mice were more susceptible to AF. Atrial cGMP levels and PDE2 (phosphodiesterase 2) activity were reduced in NPR-B+/- mice leading to larger increases in atrial cAMP in the presence of the β-AR agonist isoproterenol. NPR-B+/- mice displayed larger increases in action potential duration and L-type Ca2+ current in the presence of isoproterenol. This resulted in the occurrence of spontaneous sarcoplasmic reticulum Ca2+ release events and delayed afterdepolarizations in NPR-B+/- atrial myocytes. Phosphorylation of the RyR2 (ryanodine receptor) and phospholamban was increased in NPR-B+/- atria in the presence of isoproterenol compared with the wildtypes. C-type natriuretic peptide inhibited isoproterenol-stimulated L-type Ca2+ current through PDE2 in mouse and human atrial myocytes. CONCLUSIONS NPR-B protects against AF by preventing enhanced atrial responses to β-adrenergic receptor agonists.
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Affiliation(s)
- Tristan W Dorey
- Department of Cardiac Sciences (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., D.D.B, A.F.-H., P.W.M.F., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
- Department of Physiology and Pharmacology (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
| | - Yingjie Liu
- Department of Cardiac Sciences (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., D.D.B, A.F.-H., P.W.M.F., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
- Department of Physiology and Pharmacology (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
| | - Hailey J Jansen
- Department of Cardiac Sciences (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., D.D.B, A.F.-H., P.W.M.F., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
- Department of Physiology and Pharmacology (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
| | - Loryn J Bohne
- Department of Cardiac Sciences (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., D.D.B, A.F.-H., P.W.M.F., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
- Department of Physiology and Pharmacology (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
| | - Martin Mackasey
- Department of Cardiac Sciences (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., D.D.B, A.F.-H., P.W.M.F., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
- Department of Physiology and Pharmacology (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
| | - Logan Atkinson
- Department of Physiology and Biophysics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (L.A.)
| | - Shuvam Prasai
- Department of Cardiac Sciences (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., D.D.B, A.F.-H., P.W.M.F., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
- Department of Physiology and Pharmacology (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
| | - Darrell D Belke
- Department of Cardiac Sciences (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., D.D.B, A.F.-H., P.W.M.F., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
| | - Ali Fatehi-Hassanabad
- Department of Cardiac Sciences (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., D.D.B, A.F.-H., P.W.M.F., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
| | - Paul W M Fedak
- Department of Cardiac Sciences (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., D.D.B, A.F.-H., P.W.M.F., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
| | - Robert A Rose
- Department of Cardiac Sciences (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., D.D.B, A.F.-H., P.W.M.F., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
- Department of Physiology and Pharmacology (T.W.D., Y.L., H.J.J., L.J.B., M.M., S.P., R.A.R.), Libin Cardiovascular Institute, Cumming School of Medicine University of Calgary, Alberta, Canada
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Miller RJH, Hedman K, Amsallem M, Tulu Z, Kent W, Fatehi-Hassanabad A, Clarke B, Heidenreich P, Hiesinger W, Khush KK, Teuteberg J, Haddad F. Donor and Recipient Size Matching in Heart Transplantation With Predicted Heart and Lean Body Mass. Semin Thorac Cardiovasc Surg 2021; 34:158-167. [PMID: 33444763 DOI: 10.1053/j.semtcvs.2021.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/05/2021] [Indexed: 11/11/2022]
Abstract
Donor and recipient size matching during heart transplant can be assessed using weight or predicted heart mass (PHM) ratios. We developed sex-specific allomteric equations for PHM and predicted lean body mass (PLBM) using the United Kingdom Biobank (UKB) and evaluated their predictive value in the United Network of Organ Sharing database. Donor and recipient size matching was based on weight, PHM and PLBM ratios. PHM was calculated using the Multiethnic Study of Atherosclerosis and UKB equations. PLBM was calculated using the UKB and National Health and Nutrition Examination Survey equations. Relative prognostic utility was compared using multivariable Cox analysis, adjusted for predictors of 1-year survival in the Scientific Registry of Transplant Recipients model. Of 53,648 adult patients in the United Network of Organ Sharing database between 1996 and 2016, 6528 (12.2%) died within the first year. In multivariable analysis, undersized matches by any metric were associated with increased 1-year mortality (all P < 0.01). Oversized matches were at increased risk using PHM or PLBM (all P < 0.01), but not weight ratio. There were significant differences in classification of size matching by weight or PHM in sex-mismatched donor-recipient pairs. A significant interaction was observed between pulmonary hypertension and donor undersizing (hazard ratio 1.15, P = 0.026) suggesting increased risk of undersizing in pulmonary hypertension. Donor and recipient size matching with simplified PHM and PLBM offered an advantage over total body weight and may be more important for sex-mismatched donor-recipient pairs. Donor undersizing is associated with worse outcomes in patients with pulmonary hypertension.
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Affiliation(s)
- Robert J H Miller
- Division of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada.
| | - Kristofer Hedman
- Department of Clinical Physiology, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Myriam Amsallem
- Section of Heart Failure, Cardiac Transplant, and Mechanical Circulatory Support, and Department of Medicine, Stanford University, Stanford, California
| | - Zeynep Tulu
- Section of Heart Failure, Cardiac Transplant, and Mechanical Circulatory Support, and Department of Medicine, Stanford University, Stanford, California
| | - William Kent
- Division of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
| | - Ali Fatehi-Hassanabad
- Division of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
| | - Brian Clarke
- Division of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
| | - Paul Heidenreich
- Section of Heart Failure, Cardiac Transplant, and Mechanical Circulatory Support, and Department of Medicine, Stanford University, Stanford, California
| | - William Hiesinger
- Section of Heart Failure, Cardiac Transplant, and Mechanical Circulatory Support, and Department of Medicine, Stanford University, Stanford, California
| | - Kiran K Khush
- Section of Heart Failure, Cardiac Transplant, and Mechanical Circulatory Support, and Department of Medicine, Stanford University, Stanford, California
| | - Jeffrey Teuteberg
- Section of Heart Failure, Cardiac Transplant, and Mechanical Circulatory Support, and Department of Medicine, Stanford University, Stanford, California
| | - Francois Haddad
- Section of Heart Failure, Cardiac Transplant, and Mechanical Circulatory Support, and Department of Medicine, Stanford University, Stanford, California
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