1
|
Moen JM, Morrell CH, Matt MG, Ahmet I, Tagirova S, Davoodi M, Petr M, Charles S, de Cabo R, Yaniv Y, Lakatta EG. Emergence of heartbeat frailty in advanced age I: perspectives from life-long EKG recordings in adult mice. GeroScience 2022; 44:2801-2830. [PMID: 35759167 PMCID: PMC9768068 DOI: 10.1007/s11357-022-00605-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/06/2022] [Indexed: 01/07/2023] Open
Abstract
The combined influences of sinoatrial nodal (SAN) pacemaker cell automaticity and its response to autonomic input determine the heart's beating interval variability and mean beating rate. To determine the intrinsic SAN and autonomic signatures buried within EKG RR interval time series change in advanced age, we measured RR interval variability before and during double autonomic blockade at 3-month intervals from 6 months of age until the end of life in long-lived (those that achieved the total cohort median life span of 24 months and beyond) C57/BL6 mice. Prior to 21 months of age, time-dependent changes in intrinsic RR interval variability and mean RR interval were relatively minor. Between 21 and 30 months of age, however, marked changes emerged in intrinsic SAN RR interval variability signatures, pointing to a reduction in the kinetics of pacemaker clock mechanisms, leading to reduced synchronization of molecular functions within and among SAN cells. This loss of high-frequency signal processing within intrinsic SAN signatures resulted in a marked increase in the mean intrinsic RR interval. The impact of autonomic signatures on RR interval variability were net sympathetic and partially compensated for the reduced kinetics of the intrinsic SAN RR interval variability signatures, and partially, but not completely, shifted the EKG RR time series intervals to a more youthful pattern. Cross-sectional analyses of other subsets of C57/BL6 ages indicated that at or beyond the median life span of our longitudinal cohort, noncardiac, constitutional, whole-body frailty was increased, energetic efficiency was reduced, and the respiratory exchange ratio increased. We interpret the progressive reduction in kinetics in intrinsic SAN RR interval variability signatures in this context of whole-body frailty beyond 21 months of age to be a manifestation of "heartbeat frailty."
Collapse
Affiliation(s)
- Jack M Moen
- Laboratory of Cardiovascular Science, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
- Department of Cellular and Molecular Pharmacology, UCSF, San Francisco, CA, USA
| | - Christopher H Morrell
- Laboratory of Cardiovascular Science, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
| | - Michael G Matt
- Laboratory of Cardiovascular Science, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
- Pediatric Residency Program, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ismayil Ahmet
- Laboratory of Cardiovascular Science, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
| | - Syevda Tagirova
- Laboratory of Cardiovascular Science, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
| | - Moran Davoodi
- Biomedical Engineering Faculty, Technion-IIT, Haifa, Israel
| | - Michael Petr
- Laboratory of Experimental Gerontology Intramural Research Program, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Shaquille Charles
- Laboratory of Cardiovascular Science, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
| | - Rafael de Cabo
- Laboratory of Experimental Gerontology Intramural Research Program, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
| | - Yael Yaniv
- Biomedical Engineering Faculty, Technion-IIT, Haifa, Israel
| | - Edward G Lakatta
- Laboratory of Cardiovascular Science, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA.
| |
Collapse
|
2
|
Moen JM, Matt MG, Ramirez C, Tarasov KV, Chakir K, Tarasova YS, Lukyanenko Y, Tsutsui K, Monfredi O, Morrell CH, Tagirova S, Yaniv Y, Huynh T, Pacak K, Ahmet I, Lakatta EG. Overexpression of a Neuronal Type Adenylyl Cyclase (Type 8) in Sinoatrial Node Markedly Impacts Heart Rate and Rhythm. Front Neurosci 2019; 13:615. [PMID: 31275103 PMCID: PMC6591434 DOI: 10.3389/fnins.2019.00615] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/29/2019] [Indexed: 12/21/2022] Open
Abstract
Heart rate (HR) and HR variability (HRV), predictors of over-all organism health, are widely believed to be driven by autonomic input to the sinoatrial node (SAN), with sympathetic input increasing HR and reducing HRV. However, variability in spontaneous beating intervals in isolated SAN tissue and single SAN cells, devoid of autonomic neural input, suggests that clocks intrinsic to SAN cells may also contribute to HR and HRV in vivo. We assessed contributions of both intrinsic and autonomic neuronal input mechanisms of SAN cell function on HR and HRV via in vivo, telemetric EKG recordings. This was done in both wild type (WT) mice, and those in which adenylyl cyclase type 8 (ADCY8), a main driver of intrinsic cAMP-PKA-Ca2+ mediated pacemaker function, was overexpressed exclusively in the heart (TGAC8). We hypothesized that TGAC8 mice would: (1) manifest a more coherent pattern of HRV in vivo, i.e., a reduced HRV driven by mechanisms intrinsic to SAN cells, and less so to modulation by autonomic input and (2) utilize unique adaptations to limit sympathetic input to a heart with high levels of intrinsic cAMP-Ca2+ signaling. Increased adenylyl cyclase (AC) activity in TGAC8 SAN tissue was accompanied by a marked increase in HR and a concurrent marked reduction in HRV, both in the absence or presence of dual autonomic blockade. The marked increase in intrinsic HR and coherence of HRV in TGAC8 mice occurred in the context of: (1) reduced HR and HRV responses to β-adrenergic receptor (β-AR) stimulation; (2) increased transcription of genes and expression of proteins [β-Arrestin, G Protein-Coupled Receptor Kinase 5 (GRK5) and Clathrin Adaptor Protein (Dab2)] that desensitize β-AR signaling within SAN tissue, (3) reduced transcripts or protein levels of enzymes [dopamine beta-hydorxylase (DBH) and phenylethanolamine N-methyltransferase (PNMT)] required for catecholamine production in intrinsic cardiac adrenergic cells, and (4) substantially reduced plasma catecholamine levels. Thus, mechanisms driven by cAMP-PKA-Ca2+ signaling intrinsic to SAN cells underlie the marked coherence of TGAC8 mice HRV. Adaptations to limit additional activation of AC signaling, via decreased neuronal sympathetic input, are utilized to ensure the hearts survival and prevent Ca2+ overload.
Collapse
Affiliation(s)
- Jack M Moen
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.,Cellular and Molecular Physiology, Yale University, New Haven, CT, United States
| | - Michael G Matt
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.,School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Christopher Ramirez
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Kirill V Tarasov
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Khalid Chakir
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Yelena S Tarasova
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Yevgeniya Lukyanenko
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Kenta Tsutsui
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Oliver Monfredi
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.,Department of Cardiovascular and Electrophysiology, The Johns Hopkins Hospital, Baltimore, MD, United States
| | - Christopher H Morrell
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.,Department of Mathematics, Loyola University Maryland, Baltimore, MD, United States
| | - Syevda Tagirova
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Yael Yaniv
- Faculty of Biomedical Engineering, Technion Israel Institute of Technology, Haifa, Israel
| | - Thanh Huynh
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Karel Pacak
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Ismayil Ahmet
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Edward G Lakatta
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| |
Collapse
|
4
|
Yavari A, Bellahcene M, Bucchi A, Sirenko S, Pinter K, Herring N, Jung JJ, Tarasov KV, Sharpe EJ, Wolfien M, Czibik G, Steeples V, Ghaffari S, Nguyen C, Stockenhuber A, Clair JRS, Rimmbach C, Okamoto Y, Yang D, Wang M, Ziman BD, Moen JM, Riordon DR, Ramirez C, Paina M, Lee J, Zhang J, Ahmet I, Matt MG, Tarasova YS, Baban D, Sahgal N, Lockstone H, Puliyadi R, de Bono J, Siggs OM, Gomes J, Muskett H, Maguire ML, Beglov Y, Kelly M, Dos Santos PPN, Bright NJ, Woods A, Gehmlich K, Isackson H, Douglas G, Ferguson DJP, Schneider JE, Tinker A, Wolkenhauer O, Channon KM, Cornall RJ, Sternick EB, Paterson DJ, Redwood CS, Carling D, Proenza C, David R, Baruscotti M, DiFrancesco D, Lakatta EG, Watkins H, Ashrafian H. Mammalian γ2 AMPK regulates intrinsic heart rate. Nat Commun 2017; 8:1258. [PMID: 29097735 PMCID: PMC5668267 DOI: 10.1038/s41467-017-01342-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/08/2017] [Indexed: 11/22/2022] Open
Abstract
AMPK is a conserved serine/threonine kinase whose activity maintains cellular energy homeostasis. Eukaryotic AMPK exists as αβγ complexes, whose regulatory γ subunit confers energy sensor function by binding adenine nucleotides. Humans bearing activating mutations in the γ2 subunit exhibit a phenotype including unexplained slowing of heart rate (bradycardia). Here, we show that γ2 AMPK activation downregulates fundamental sinoatrial cell pacemaker mechanisms to lower heart rate, including sarcolemmal hyperpolarization-activated current (I f) and ryanodine receptor-derived diastolic local subsarcolemmal Ca2+ release. In contrast, loss of γ2 AMPK induces a reciprocal phenotype of increased heart rate, and prevents the adaptive intrinsic bradycardia of endurance training. Our results reveal that in mammals, for which heart rate is a key determinant of cardiac energy demand, AMPK functions in an organ-specific manner to maintain cardiac energy homeostasis and determines cardiac physiological adaptation to exercise by modulating intrinsic sinoatrial cell behavior.
Collapse
Affiliation(s)
- Arash Yavari
- Experimental Therapeutics, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK.
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK.
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK.
| | - Mohamed Bellahcene
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Annalisa Bucchi
- Department of Biosciences, Università degli Studi di Milano, Milan, 20133, Italy
- Centro Interuniversitario di Medicina Molecolare e Biofisica Applicata, University of Milano, Milan, 20133, Italy
| | - Syevda Sirenko
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Katalin Pinter
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Neil Herring
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, OX1 3PT, UK
| | - Julia J Jung
- Department of Cardiac Surgery, Rostock University Medical Centre, 18057, Rostock, Germany
- Department Life, Light and Matter, Interdisciplinary Faculty, Rostock University, 18059, Rostock, Germany
| | - Kirill V Tarasov
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Emily J Sharpe
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Markus Wolfien
- Department of Systems Biology and Bioinformatics, University of Rostock, Rostock, 18051, Germany
| | - Gabor Czibik
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Violetta Steeples
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Sahar Ghaffari
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Chinh Nguyen
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Alexander Stockenhuber
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Joshua R St Clair
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Christian Rimmbach
- Department of Cardiac Surgery, Rostock University Medical Centre, 18057, Rostock, Germany
- Department Life, Light and Matter, Interdisciplinary Faculty, Rostock University, 18059, Rostock, Germany
| | - Yosuke Okamoto
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Dongmei Yang
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Mingyi Wang
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Bruce D Ziman
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Jack M Moen
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Daniel R Riordon
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Christopher Ramirez
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Manuel Paina
- Department of Biosciences, Università degli Studi di Milano, Milan, 20133, Italy
- Centro Interuniversitario di Medicina Molecolare e Biofisica Applicata, University of Milano, Milan, 20133, Italy
| | - Joonho Lee
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Jing Zhang
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Ismayil Ahmet
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Michael G Matt
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Yelena S Tarasova
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Dilair Baban
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Natasha Sahgal
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Helen Lockstone
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Rathi Puliyadi
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Joseph de Bono
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Owen M Siggs
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
- MRC Human Immunology Unit, Weatherall Institute for Molecular Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 9DS, UK
| | - John Gomes
- Department of Medicine, BHF Laboratories, The Rayne Institute, University College London, London, WC1E 6JJ, UK
| | - Hannah Muskett
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Mahon L Maguire
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Youlia Beglov
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Matthew Kelly
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Pedro P N Dos Santos
- Instituto de Pós-Graduação, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, 30.130-110, Brazil
| | - Nicola J Bright
- Cellular Stress Group, MRC London Institute of Medical Sciences, Imperial College London, London, W12 0NN, UK
| | - Angela Woods
- Cellular Stress Group, MRC London Institute of Medical Sciences, Imperial College London, London, W12 0NN, UK
| | - Katja Gehmlich
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Henrik Isackson
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
| | - Gillian Douglas
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - David J P Ferguson
- Nuffield Department of Clinical Laboratory Science, University of Oxford, Oxford, OX3 9DU, UK
| | - Jürgen E Schneider
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Andrew Tinker
- Department of Medicine, BHF Laboratories, The Rayne Institute, University College London, London, WC1E 6JJ, UK
- The Heart Centre, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, London, EC1M 6BQ, UK
| | - Olaf Wolkenhauer
- Department of Systems Biology and Bioinformatics, University of Rostock, Rostock, 18051, Germany
- Stellenbosch Institute of Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, 7602, South Africa
| | - Keith M Channon
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Richard J Cornall
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
- MRC Human Immunology Unit, Weatherall Institute for Molecular Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 9DS, UK
| | - Eduardo B Sternick
- Instituto de Pós-Graduação, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, 30.130-110, Brazil
| | - David J Paterson
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, OX1 3PT, UK
| | - Charles S Redwood
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
| | - David Carling
- Cellular Stress Group, MRC London Institute of Medical Sciences, Imperial College London, London, W12 0NN, UK
| | - Catherine Proenza
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Robert David
- Department of Cardiac Surgery, Rostock University Medical Centre, 18057, Rostock, Germany
- Department Life, Light and Matter, Interdisciplinary Faculty, Rostock University, 18059, Rostock, Germany
| | - Mirko Baruscotti
- Department of Biosciences, Università degli Studi di Milano, Milan, 20133, Italy
- Centro Interuniversitario di Medicina Molecolare e Biofisica Applicata, University of Milano, Milan, 20133, Italy
| | - Dario DiFrancesco
- Department of Biosciences, Università degli Studi di Milano, Milan, 20133, Italy
- Centro Interuniversitario di Medicina Molecolare e Biofisica Applicata, University of Milano, Milan, 20133, Italy
| | - Edward G Lakatta
- Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, 21224, USA
| | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK
| | - Houman Ashrafian
- Experimental Therapeutics, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK.
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK.
- The Wellcome Trust Centre for Human Genetics, Oxford, OX3 7BN, UK.
| |
Collapse
|