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Bauer J, Vlcek J, Pauly V, Hesse N, Xia R, Mo L, Chivukula AS, Villgrater H, Dressler M, Hildebrand B, Wolf E, Rizas KD, Bauer A, Kääb S, Tomsits P, Schüttler D, Clauss S. Biomarker Periodic Repolarization Dynamics Indicates Enhanced Risk for Arrhythmias and Sudden Cardiac Death in Myocardial Infarction in Pigs. J Am Heart Assoc 2024:e032405. [PMID: 38639363 DOI: 10.1161/jaha.123.032405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 03/08/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Periodic repolarization dynamics (PRD) is an electrocardiographic biomarker that captures repolarization instability in the low frequency spectrum and is believed to estimate the sympathetic effect on the ventricular myocardium. High PRD indicates an increased risk for postischemic sudden cardiac death (SCD). However, a direct link between PRD and proarrhythmogenic autonomic remodeling has not yet been shown. METHODS AND RESULTS We investigated autonomic remodeling in pigs with myocardial infarction (MI)-related ischemic heart failure induced by balloon occlusion of the left anterior descending artery (n=17) compared with pigs without MI (n=11). Thirty days after MI, pigs demonstrated enhanced sympathetic innervation in the infarct area, border zone, and remote left ventricle paralleled by altered expression of autonomic marker genes/proteins. PRD was enhanced 30 days after MI compared with baseline (pre-MI versus post-MI: 1.75±0.30 deg2 versus 3.29±0.79 deg2, P<0.05) reflecting pronounced autonomic alterations on the level of the ventricular myocardium. Pigs with MI-related ventricular fibrillation and SCD had significantly higher pre-MI PRD than pigs without tachyarrhythmias, suggesting a potential role for PRD as a predictive biomarker for ischemia-related arrhythmias (no ventricular fibrillation versus ventricular fibrillation: 1.50±0.39 deg2 versus 3.18±0.53 deg2 [P<0.05]; no SCD versus SCD: 1.67±0.32 deg2 versus 3.91±0.63 deg2 [P<0.01]). CONCLUSIONS We demonstrate that ischemic heart failure leads to significant proarrhythmogenic autonomic remodeling. The concomitant elevation of PRD levels in pigs with ischemic heart failure and pigs with MI-related ventricular fibrillation/SCD suggests PRD as a biomarker for autonomic remodeling and as a potential predictive biomarker for ventricular arrhythmias/survival in the context of MI.
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Affiliation(s)
- Julia Bauer
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Julia Vlcek
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Valerie Pauly
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Nora Hesse
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Ruibing Xia
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Li Mo
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Aparna Sharma Chivukula
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Hannes Villgrater
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Marie Dressler
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Bianca Hildebrand
- Department of Medicine I University Hospital, LMU Munich Munich Germany
| | - Eckhard Wolf
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich Munich Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich Munich Germany
| | - Konstantinos D Rizas
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
| | - Axel Bauer
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- University Hospital for Internal Medicine III Medical University of Innsbruck Innsbruck Austria
| | - Stefan Kääb
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich Munich Germany
| | - Philipp Tomsits
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Dominik Schüttler
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
| | - Sebastian Clauss
- Department of Medicine I University Hospital, LMU Munich Munich Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance Munich Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine University Hospital, LMU Munich Munich Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich Munich Germany
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Zhang Z, Vlcek J, Pauly V, Hesse N, Bauer J, Chataut KR, Maderspacher F, Volz LS, Buchberger K, Xia R, Hildebrand B, Kääb S, Schüttler D, Tomsits P, Clauss S. Atrial fibrosis heterogeneity is a risk for atrial fibrillation in pigs with ischaemic heart failure. Eur J Clin Invest 2024; 54:e14137. [PMID: 38012826 DOI: 10.1111/eci.14137] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/02/2023] [Accepted: 11/18/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common arrhythmia and is associated with considerable morbidity and mortality. Ischaemic heart failure (IHF) remains one of the most common causes of AF in clinical practice. However, ischaemia-mediated mechanisms leading to AF are still incompletely understood, and thus, current treatment approaches are limited. To improve our understanding of the pathophysiology, we studied a porcine IHF model. METHODS In pigs, IHF was induced by balloon occlusion of the left anterior descending artery for 90 min. After 30 days of reperfusion, invasive haemodynamic measurements and electrophysiological studies were performed. Masson trichrome and immunofluorescence staining were conducted to assess interstitial fibrosis and myofibroblast activation in different heart regions. RESULTS After 30 days of reperfusion, heart failure with significantly reduced ejection fraction (left anterior obique 30°, 34.78 ± 3.29% [IHF] vs. 62.03 ± 2.36% [control], p < .001; anterior-posterior 0°, 29.16 ± 3.61% vs. 59.54 ± 1.09%, p < .01) was observed. These pigs showed a significantly higher susceptibility to AF (33.90% [IHF] vs. 12.98% [control], p < .05). Histological assessment revealed aggravated fibrosis in atrial appendages but not in atrial free walls in IHF pigs (11.13 ± 1.44% vs. 5.99 ± .86%, p < .01 [LAA], 8.28 ± .56% vs. 6.01 ± .35%, p < .01 [RAA]), which was paralleled by enhanced myofibroblast activation (12.09 ± .65% vs. 9.00 ± .94%, p < .05 [LAA], 14.37 ± .60% vs. 10.30 ± 1.41%, p < .05 [RAA]). Correlation analysis indicated that not fibrosis per se but its cross-regional heterogeneous distribution across the left atrium was associated with AF susceptibility (r = .6344, p < .01). CONCLUSION Our results suggest that left atrial cross-regional fibrosis difference rather than overall fibrosis level is associated with IHF-related AF susceptibility, presumably by establishing local conduction disturbances and heterogeneity.
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Affiliation(s)
- Zhihao Zhang
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Julia Vlcek
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Valerie Pauly
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Nora Hesse
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Julia Bauer
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Kavi Raj Chataut
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Florian Maderspacher
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Lina Sophie Volz
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Buchberger
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Ruibing Xia
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Bianca Hildebrand
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Stefan Kääb
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich, Munich, Germany
| | - Dominik Schüttler
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Philipp Tomsits
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Sebastian Clauss
- Department of Medicine I, Campus Grosshadern, University Hospital Munich, Ludwig-Maximilians University (LMU), Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich, Munich, Germany
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Villgrater HE, Xia R, Sharma Chivukula A, Tomsits P, Clauss S. Microdissection and Immunofluorescence Staining of Myocardial Sleeves in Murine Pulmonary Veins. J Vis Exp 2023. [PMID: 38078615 DOI: 10.3791/65836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Pulmonary veins (PVs) are the major source of ectopic beats in atrial arrhythmias and play a crucial role in the development and progression of atrial fibrillation (AF). PVs contain myocardial sleeves (MS) composed of cardiomyocytes. MS are implicated in the initiation and maintenance of AF, as they preserve similarities to the cardiac working myocardium, including the ability to generate ectopic electrical impulses. Rodents are widely used and may represent excellent animal models to study the pulmonary vein myocardium since cardiomyocytes are widely present all over the vessel wall. However, precise microdissection and preparation of murine PVs is challenging due to the small organ size and intricate anatomy. We demonstrate a microscopy-guided microdissection protocol for isolating the murine left atrium (LA) together with the PVs. Immunofluorescence staining using cardiac Troponin-T (cTNT) and connexin 43 (Cx43) antibodies is performed to visualize the LA and PVs in full length. Imaging at 10x and 40x magnification provides a comprehensive view of the PV structure as well as detailed insights into the myocardial architecture, particularly highlighting the presence of connexin 43 within the MS.
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Affiliation(s)
- Hannes E Villgrater
- University Hospital Munich, Department of Medicine I, Ludwig-Maximilians-University Munich (LMU); Walter Brendel Center of Experimental Medicine (WBex), LMU Munich; German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance (MHA)
| | - Ruibing Xia
- University Hospital Munich, Department of Medicine I, Ludwig-Maximilians-University Munich (LMU); Walter Brendel Center of Experimental Medicine (WBex), LMU Munich; German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance (MHA)
| | - Aparna Sharma Chivukula
- University Hospital Munich, Department of Medicine I, Ludwig-Maximilians-University Munich (LMU); Walter Brendel Center of Experimental Medicine (WBex), LMU Munich; German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance (MHA)
| | - Philipp Tomsits
- University Hospital Munich, Department of Medicine I, Ludwig-Maximilians-University Munich (LMU); Walter Brendel Center of Experimental Medicine (WBex), LMU Munich; German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance (MHA)
| | - Sebastian Clauss
- University Hospital Munich, Department of Medicine I, Ludwig-Maximilians-University Munich (LMU); Walter Brendel Center of Experimental Medicine (WBex), LMU Munich; German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance (MHA); Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich;
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Tomsits P, Volz L, Xia R, Chivukula A, Schüttler D, Clauß S. Medetomidine/midazolam/fentanyl narcosis alters cardiac autonomic tone leading to conduction disorders and arrhythmias in mice. Lab Anim (NY) 2023; 52:85-92. [PMID: 36959339 PMCID: PMC10063441 DOI: 10.1038/s41684-023-01141-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 02/15/2023] [Indexed: 03/25/2023]
Abstract
Arrhythmias are critical contributors to cardiovascular morbidity and mortality. Therapies are mainly symptomatic and often insufficient, emphasizing the need for basic research to unveil the mechanisms underlying arrhythmias and to enable better and ideally causal therapies. In translational approaches, mice are commonly used to study arrhythmia mechanisms in vivo. Experimental electrophysiology studies in mice are performed under anesthesia with medetomidine/midazolam/fentanyl (MMF) and isoflurane/fentanyl (IF) as commonly used regimens. Despite evidence of adverse effects of individual components on cardiac function, few data are available regarding the specific effects of these regimens on cardiac electrophysiology in mice. Here we present a study investigating the effects of MMF and IF narcosis on cardiac electrophysiology in vivo in C57BL/6N wild-type mice. Telemetry transmitters were implanted in a group of mice, which served as controls for baseline parameters without narcosis. In two other groups of mice, electrocardiogram and invasive electrophysiology studies were performed under narcosis (with either MMF or IF). Basic electrocardiogram parameters, heart rate variability parameters, sinus node and atrioventricular node function, and susceptibility to arrhythmias were assessed. Experimental data suggest a remarkable influence of MMF on cardiac electrophysiology compared with IF and awake animals. While IF only moderately reduced heart rate, MMF led to significant bradycardia, spontaneous arrhythmias, heart rate variability alterations as well as sinus and AV node dysfunction, and increased inducibility of ventricular arrhythmias. On the basis of these observed effects, we suggest avoiding MMF in mice, specifically when studying cardiac electrophysiology, but also whenever a regular heartbeat is required for reliable results, such as in heart failure or imaging research.
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Affiliation(s)
- Philipp Tomsits
- Medizinische Klinik und Poliklinik I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU), Munich, Germany.
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany.
| | - Lina Volz
- Medizinische Klinik und Poliklinik I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Ruibing Xia
- Medizinische Klinik und Poliklinik I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Aparna Chivukula
- Medizinische Klinik und Poliklinik I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Dominik Schüttler
- Medizinische Klinik und Poliklinik I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Sebastian Clauß
- Medizinische Klinik und Poliklinik I, University Hospital Munich, Campus Grosshadern and Innenstadt, Ludwig-Maximilians University Munich (LMU), Munich, Germany.
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Munich, Germany.
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich, Munich, Germany.
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5
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Pauly V, Vlcek J, Zhang Z, Hesse N, Xia R, Bauer J, Loy S, Schneider S, Renner S, Wolf E, Kääb S, Schüttler D, Tomsits P, Clauss S. Effects of Sex on the Susceptibility for Atrial Fibrillation in Pigs with Ischemic Heart Failure. Cells 2023; 12:cells12070973. [PMID: 37048048 PMCID: PMC10093477 DOI: 10.3390/cells12070973] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Atrial fibrillation (AF) is the most prevalent arrhythmia, often caused by myocardial ischemia/infarction (MI). Men have a 1.5× higher prevalence of AF, whereas women show a higher risk for new onset AF after MI. However, the underlying mechanisms of how sex affects AF pathophysiology are largely unknown. In 72 pigs with/without ischemic heart failure (IHF) we investigated the impact of sex on ischemia-induced proarrhythmic atrial remodeling and the susceptibility for AF. Electrocardiogram (ECG) and electrophysiological studies were conducted to assess electrical remodeling; histological analyses were performed to assess atrial fibrosis in male and female pigs. IHF pigs of both sexes showed a significantly increased vulnerability for AF, but in male pigs more and longer episodes were observed. Unchanged conduction properties but enhanced left atrial fibrosis indicated structural rather than electrical remodeling underlying AF susceptibility. Sex differences were only observed in controls with female pigs showing an increased intrinsic heart rate, a prolonged QRS interval and a prolonged sinus node recovery time. In sum, susceptibility for AF is significantly increased both in male and female pigs with ischemic heart failure. Differences between males and females are moderate, including more and longer AF episodes in male pigs and sinus node dysfunction in female pigs.
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Affiliation(s)
- Valerie Pauly
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
| | - Julia Vlcek
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
| | - Zhihao Zhang
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
| | - Nora Hesse
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
| | - Ruibing Xia
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
| | - Julia Bauer
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
| | - Simone Loy
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
| | - Sarah Schneider
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
| | - Simone Renner
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich, Feodor-Lynen-Strasse 19, D-81377 Munich, Germany
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Strasse 25, D-81377 Munich, Germany
- Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstrasse 27, D-85764 Oberschleissheim, Germany
- German Center for Diabetes Research (DZD), Ingolstädter Landstrasse 1, D-85764 Neuherberg, Germany
| | - Eckhard Wolf
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich, Feodor-Lynen-Strasse 19, D-81377 Munich, Germany
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Strasse 25, D-81377 Munich, Germany
- Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstrasse 27, D-85764 Oberschleissheim, Germany
- German Center for Diabetes Research (DZD), Ingolstädter Landstrasse 1, D-85764 Neuherberg, Germany
- Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, Grosshadern Campus, LMU Munich, Feodor-Lynen-Stasse 25, D-81377 Munich, Germany
| | - Stefan Kääb
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich, Feodor-Lynen-Strasse 19, D-81377 Munich, Germany
| | - Dominik Schüttler
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
| | - Philipp Tomsits
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
| | - Sebastian Clauss
- Grosshadern Campus, Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, D-81377 Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, D-81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, LMU Munich, Marchioninistrasse 68, D-81377 Munich, Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICONLMU), LMU Munich, Feodor-Lynen-Strasse 19, D-81377 Munich, Germany
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6
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Rinné S, Oertli A, Nagel C, Tomsits P, Jenewein T, Kääb S, Kauferstein S, Loewe A, Beckmann BM, Decher N. Functional Characterization of a Spectrum of Novel Romano-Ward Syndrome KCNQ1 Variants. Int J Mol Sci 2023; 24:ijms24021350. [PMID: 36674868 PMCID: PMC9865342 DOI: 10.3390/ijms24021350] [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: 11/29/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/13/2023] Open
Abstract
The KCNQ1 gene encodes the α-subunit of the cardiac voltage-gated potassium (Kv) channel KCNQ1, also denoted as Kv7.1 or KvLQT1. The channel assembles with the ß-subunit KCNE1, also known as minK, to generate the slowly activating cardiac delayed rectifier current IKs, a key regulator of the heart rate dependent adaptation of the cardiac action potential duration (APD). Loss-of-function variants in KCNQ1 cause the congenital Long QT1 (LQT1) syndrome, characterized by delayed cardiac repolarization and a QT interval prolongation in the surface electrocardiogram (ECG). Autosomal dominant loss-of-function variants in KCNQ1 result in the LQT syndrome called Romano-Ward syndrome (RWS), while autosomal recessive variants affecting function, lead to Jervell and Lange-Nielsen syndrome (JLNS), associated with deafness. The aim of this study was the characterization of novel KCNQ1 variants identified in patients with RWS to widen the spectrum of known LQT1 variants, and improve the interpretation of the clinical relevance of variants in the KCNQ1 gene. We functionally characterized nine human KCNQ1 variants using the voltage-clamp technique in Xenopus laevis oocytes, from which we report seven novel variants. The functional data was taken as input to model surface ECGs, to subsequently compare the functional changes with the clinically observed QTc times, allowing a further interpretation of the severity of the different LQTS variants. We found that the electrophysiological properties of the variants correlate with the severity of the clinically diagnosed phenotype in most cases, however, not in all. Electrophysiological studies combined with in silico modelling approaches are valuable components for the interpretation of the pathogenicity of KCNQ1 variants, but assessing the clinical severity demands the consideration of other factors that are included, for example in the Schwartz score.
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Affiliation(s)
- Susanne Rinné
- Institute of Physiology and Pathophysiology, Vegetative Physiology, University of Marburg, 35037 Marburg, Germany
| | - Annemarie Oertli
- Institute of Physiology and Pathophysiology, Vegetative Physiology, University of Marburg, 35037 Marburg, Germany
| | - Claudia Nagel
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany
| | - Philipp Tomsits
- Department of Medicine I, University Hospital, LMU Munich, 80802 Munich, Germany
- Deutsches Zentrum für Herz-Kreislauferkrankungen (DZHK), Partner Site Munich, 80636 Munich, Germany
- Member of the European Reference Network for Rare, Low Prevalance and Complex Diseases of the Heart (ERN GUARD-Heart), 81377 Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Marchioninistrasse 27, 81377 Munich, Germany
| | - Tina Jenewein
- Institute of Legal Medicine, Goethe University, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Institute for Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg-Hessen, Goethe University Frankfurt, 60528 Frankfurt, Germany
| | - Stefan Kääb
- Department of Medicine I, University Hospital, LMU Munich, 80802 Munich, Germany
- Deutsches Zentrum für Herz-Kreislauferkrankungen (DZHK), Partner Site Munich, 80636 Munich, Germany
- Member of the European Reference Network for Rare, Low Prevalance and Complex Diseases of the Heart (ERN GUARD-Heart), 81377 Munich, Germany
| | - Silke Kauferstein
- Institute of Legal Medicine, Goethe University, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Deutsches Zentrum für Herz-Kreislauferkrankungen (DZHK), Partner Site Frankfurt, 60596 Frankfurt, Germany
| | - Axel Loewe
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany
| | - Britt Maria Beckmann
- Department of Medicine I, University Hospital, LMU Munich, 80802 Munich, Germany
- Institute of Legal Medicine, Goethe University, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Niels Decher
- Institute of Physiology and Pathophysiology, Vegetative Physiology, University of Marburg, 35037 Marburg, Germany
- Correspondence: ; Tel.: +49-(0)6421-28-62148
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7
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Xia R, Tomsits P, Loy S, Zhang Z, Pauly V, Schüttler D, Clauss S. Cardiac Macrophages and Their Effects on Arrhythmogenesis. Front Physiol 2022; 13:900094. [PMID: 35812333 PMCID: PMC9257039 DOI: 10.3389/fphys.2022.900094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
Abstract
Cardiac electrophysiology is a complex system established by a plethora of inward and outward ion currents in cardiomyocytes generating and conducting electrical signals in the heart. However, not only cardiomyocytes but also other cell types can modulate the heart rhythm. Recently, cardiac macrophages were demonstrated as important players in both electrophysiology and arrhythmogenesis. Cardiac macrophages are a heterogeneous group of immune cells including resident macrophages derived from embryonic and fetal precursors and recruited macrophages derived from circulating monocytes from the bone marrow. Recent studies suggest antiarrhythmic as well as proarrhythmic effects of cardiac macrophages. The proposed mechanisms of how cardiac macrophages affect electrophysiology vary and include both direct and indirect interactions with other cardiac cells. In this review, we provide an overview of the different subsets of macrophages in the heart and their possible interactions with cardiomyocytes under both physiologic conditions and heart disease. Furthermore, we elucidate similarities and differences between human, murine and porcine cardiac macrophages, thus providing detailed information for researchers investigating cardiac macrophages in important animal species for electrophysiologic research. Finally, we discuss the pros and cons of mice and pigs to investigate the role of cardiac macrophages in arrhythmogenesis from a translational perspective.
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Affiliation(s)
- Ruibing Xia
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
| | - Philipp Tomsits
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
| | - Simone Loy
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
| | - Zhihao Zhang
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
| | - Valerie Pauly
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
| | - Dominik Schüttler
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
| | - Sebastian Clauss
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
- *Correspondence: Sebastian Clauss,
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8
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Tomsits P, Sharma Chivukula A, Raj Chataut K, Simahendra A, Weckbach LT, Brunner S, Clauss S. Real-Time Electrocardiogram Monitoring during Treadmill Training in Mice. J Vis Exp 2022. [DOI: 10.3791/63873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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9
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Tomsits P, Schüttler D, Volz LS, Chivukula AS, Xia R, Villgrater HE, Mo L, Schneider S, Clauss S. PO-630-08 INFLUENCE OF TWO NARCOSIS REGIMENS ON CARDIAC ELECTROPHYSIOLOGY IN MICE. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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10
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Clauss S, Tomsits P, Vlcek J, Pauly V, Hesse N, Xia R, Loy S, Volz LS, Villgrater HE, KOTTU LAKSHME, Renner S, Kaab S, Wolf E, Schüttler D. PO-630-07 INVESTIGATION OF DIABETES-INDUCED ATRIAL REMODELING IN A PRECLINICAL LARGE ANIMAL MODEL. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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11
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Schüttler D, Tomsits P, Bleyer C, Vlcek J, Pauly V, Hesse N, Sinner M, Merkus D, Hamers J, Kääb S, Clauss S. A practical guide to setting up pig models for cardiovascular catheterization, electrophysiological assessment and heart disease research. Lab Anim (NY) 2022; 51:46-67. [PMID: 35087256 DOI: 10.1038/s41684-021-00909-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 12/15/2021] [Indexed: 01/09/2023]
Abstract
Over the past years, the use of large animals has become increasingly interesting in translational research, to bridge the gap between basic research in rodents and targeted therapies in humans. Pigs are highly valued in cardiovascular research because of their anatomical, hemodynamic and electrophysiological features, which closely resemble those of humans. For studying these aspects in swine, cardiac catheterization techniques are essential procedures. Although cardiac catheterization seems to be comparatively easy in pigs as human equipment can be used to perform the procedure, there are some pitfalls. Here we provide a detailed protocol to guide the reader through different aspects of cardiac catheterization in pigs. We suggest an approach for safe intubation and extubation, provide tips for perioperative and postoperative management of the animals and guide the reader through different experimental steps, including sheath insertion. We also describe the procedures for basic electrophysiological assessment of conduction properties and atrial fibrillation induction, hemodynamic assessment via pressure-volume loops, right heart and left heart catheterization and the development of a myocardial infarction model by balloon occlusion. This protocol was developed in Landrace pigs and can be adapted to other pig breeds or other large animal species. This protocol requires approximately six and a half working hours in total and should be performed by researchers with previous experience in large animal experimentation and in the presence of a veterinarian.
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Affiliation(s)
- Dominik Schüttler
- Medizinische Klinik und Poliklinik I, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany
| | - Philipp Tomsits
- Medizinische Klinik und Poliklinik I, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany
| | - Christina Bleyer
- Medizinische Klinik und Poliklinik I, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany
| | - Julia Vlcek
- Medizinische Klinik und Poliklinik I, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany
| | - Valerie Pauly
- Medizinische Klinik und Poliklinik I, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany
| | - Nora Hesse
- Medizinische Klinik und Poliklinik I, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany
| | - Moritz Sinner
- Medizinische Klinik und Poliklinik I, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Daphne Merkus
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany.,Division of Experimental Cardiology, Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jules Hamers
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany
| | - Stefan Kääb
- Medizinische Klinik und Poliklinik I, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Sebastian Clauss
- Medizinische Klinik und Poliklinik I, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany. .,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany. .,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, LMU Hospital, Ludwig-Maximilians-Universität Munich (LMU), Munich, Germany.
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12
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Affiliation(s)
- Funsho E Fakuade
- Institute of Pharmacology and Toxicology, University Medical Center, Robert-Koch-Str. 40, D-37075 Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Germany
| | - Philipp Tomsits
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University (LMU), Marchioninistraße 15, 81377 Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Germany.,Walter Brendel Center of Experimental Medicine, Ludwig-Maximilians University (LMU), Marchioninistraße 27, 81377 Munich, Germany
| | - Niels Voigt
- Institute of Pharmacology and Toxicology, University Medical Center, Robert-Koch-Str. 40, D-37075 Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Germany.,Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), University of Göttingen, Germany
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13
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Tomsits P, Clauss S, Kääb S. Genetic insight into sick sinus syndrome. Is there a pill for it or how far are we on the translational road to personalized medicine? Eur Heart J 2021; 42:1972-1975. [PMID: 33860310 DOI: 10.1093/eurheartj/ehab209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Philipp Tomsits
- University Hospital Munich, Ludwig-Maximilians University Munich (LMU), Department of Medicine I, Campus Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Marchioninistrasse 27, D-81377 Munich, Germany
| | - Sebastian Clauss
- University Hospital Munich, Ludwig-Maximilians University Munich (LMU), Department of Medicine I, Campus Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany.,Institute of Surgical Research at the Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Marchioninistrasse 27, D-81377 Munich, Germany
| | - Stefan Kääb
- University Hospital Munich, Ludwig-Maximilians University Munich (LMU), Department of Medicine I, Campus Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance, Munich, Germany
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14
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Tomsits P, Chataut KR, Chivukula AS, Mo L, Xia R, Schüttler D, Clauss S. Analyzing Long-Term Electrocardiography Recordings to Detect Arrhythmias in Mice. J Vis Exp 2021. [PMID: 34096914 DOI: 10.3791/62386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Arrhythmias are common, affecting millions of patients worldwide. Current treatment strategies are associated with significant side effects and remain ineffective in many patients. To improve patient care, novel and innovative therapeutic concepts causally targeting arrhythmia mechanisms are needed. To study the complex pathophysiology of arrhythmias, suitable animal models are necessary, and mice have been proven to be ideal model species to evaluate the genetic impact on arrhythmias, to investigate fundamental molecular and cellular mechanisms, and to identify potential therapeutic targets. Implantable telemetry devices are among the most powerful tools available to study electrophysiology in mice, allowing continuous ECG recording over a period of several months in freely moving, awake mice. However, due to the huge number of data points (>1 million QRS complexes per day), analysis of telemetry data remains challenging. This article describes a step-by-step approach to analyze ECGs and to detect arrhythmias in long-term telemetry recordings using the software, Ponemah, with its analysis modules, ECG Pro and Data Insights, developed by Data Sciences International (DSI). To analyze basic ECG parameters, such as heart rate, P wave duration, PR interval, QRS interval, or QT duration, an automated attribute analysis was performed using Ponemah to identify P, Q, and T waves within individually adjusted windows around detected R waves. Results were then manually reviewed, allowing adjustment of individual annotations. The output from the attribute-based analysis and the pattern recognition analysis was then used by the Data Insights module to detect arrhythmias. This module allows an automatic screening for individually defined arrhythmias within the recording, followed by a manual review of suspected arrhythmia episodes. The article briefly discusses challenges in recording and detecting ECG signals, suggests strategies to improve data quality, and provides representative recordings of arrhythmias detected in mice using the approach described above.
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Affiliation(s)
- Philipp Tomsits
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA); Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU);
| | - Kavi Raj Chataut
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA)
| | - Aparna Sharma Chivukula
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA)
| | - Li Mo
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA)
| | - Ruibing Xia
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA)
| | - Dominik Schüttler
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA); Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU)
| | - Sebastian Clauss
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA); Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU)
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15
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Tomsits P, Schüttler D, Kääb S, Clauss S, Voigt N. Isolation of High Quality Murine Atrial and Ventricular Myocytes for Simultaneous Measurements of Ca2+ Transients and L-Type Calcium Current. J Vis Exp 2020. [PMID: 33226029 DOI: 10.3791/61964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Mouse models play a crucial role in arrhythmia research and allow studying key mechanisms of arrhythmogenesis including altered ion channel function and calcium handling. For this purpose, atrial or ventricular cardiomyocytes of high quality are necessary to perform patch-clamp measurements or to explore calcium handling abnormalities. However, the limited yield of high-quality cardiomyocytes obtained by current isolation protocols does not allow both measurements in the same mouse. This article describes a method to isolate high-quality murine atrial and ventricular myocytes via retrograde enzyme-based Langendorff perfusion, for subsequent simultaneous measurements of calcium transients and L-type calcium current from one animal. Mouse hearts are obtained, and the aorta is rapidly cannulated to remove blood. Hearts are then initially perfused with a calcium-free solution (37 °C) to dissociate the tissue at the level of intercalated discs and afterwards with an enzyme solution containing little calcium to disrupt extracellular matrix (37 °C). The digested heart is subsequently dissected into atria and ventricles. Tissue samples are chopped into small pieces and dissolved by carefully pipetting up and down. The enzymatic digestion is stopped, and cells are stepwise reintroduced to physiologic calcium concentrations. After loading with a fluorescent Ca2+-indicator, isolated cardiomyocytes are prepared for simultaneous measurement of calcium currents and transients. Additionally, isolation pitfalls are discussed and patch-clamp protocols and representative traces of L-type calcium currents with simultaneous calcium transient measurements in atrial and ventricular murine myocytes isolated as described above are provided.
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Affiliation(s)
- Philipp Tomsits
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); Partner Site Munich, Munich Heart Alliance (MHA), DZHK (German Centre for Cardiovascular Research); Walter Brendel Center of Experimental Medicine, Ludwig-Maximilians University Munich (LMU);
| | - Dominik Schüttler
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); Partner Site Munich, Munich Heart Alliance (MHA), DZHK (German Centre for Cardiovascular Research); Walter Brendel Center of Experimental Medicine, Ludwig-Maximilians University Munich (LMU)
| | - Stefan Kääb
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); Partner Site Munich, Munich Heart Alliance (MHA), DZHK (German Centre for Cardiovascular Research)
| | - Sebastian Clauss
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU); Partner Site Munich, Munich Heart Alliance (MHA), DZHK (German Centre for Cardiovascular Research); Walter Brendel Center of Experimental Medicine, Ludwig-Maximilians University Munich (LMU)
| | - Niels Voigt
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen; Partner Site Göttingen, DZHK (German Centre for Cardiovascular Research); Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), University of Göttingen
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16
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Abstract
Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in humans and is a significant source of morbidity and mortality. Despite its prevalence, our mechanistic understanding is incomplete, the therapeutic options have limited efficacy, and are often fraught with risks. A better biological understanding of AF is needed to spearhead novel therapeutic avenues. Although "natural" AF is nearly nonexistent in most species, animal models have contributed significantly to our understanding of AF and some therapeutic options. However, the impediments of animal models are also apparent and stem largely from the differences in basic physiology as well as the complexities underlying human AF; these preclude the creation of a "perfect" animal model and have obviated the translation of animal findings. Herein, we review the vast array of AF models available, spanning the mouse heart (weighing 1/1000th of a human heart) to the horse heart (10× heavier than the human heart). We attempt to highlight the features of each model that bring value to our understanding of AF but also the shortcomings and pitfalls. Finally, we borrowed the concept of a SWOT analysis from the business community (which stands for strengths, weaknesses, opportunities, and threats) and applied this introspective type of analysis to animal models for AF. We identify unmet needs and stress that is in the context of rapidly advancing technologies, these present opportunities for the future use of animal models.
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Affiliation(s)
- Dominik Schüttler
- From the Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Germany (D.S., S.K., P.T., S.C.).,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Germany (D.S., S.K., P.T., S.C.).,Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Germany (D.S., P.T., S.C.)
| | - Aneesh Bapat
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston (A.B., K.L., W.J.H.).,Cardiac Arrhythmia Service, Division of Cardiology, Massachusetts General Hospital, Boston (A.B., W.J.H.)
| | - Stefan Kääb
- From the Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Germany (D.S., S.K., P.T., S.C.).,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Germany (D.S., S.K., P.T., S.C.)
| | - Kichang Lee
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston (A.B., K.L., W.J.H.)
| | - Philipp Tomsits
- From the Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Germany (D.S., S.K., P.T., S.C.).,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Germany (D.S., S.K., P.T., S.C.).,Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Germany (D.S., P.T., S.C.)
| | - Sebastian Clauss
- From the Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Germany (D.S., S.K., P.T., S.C.).,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Germany (D.S., S.K., P.T., S.C.).,Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Germany (D.S., P.T., S.C.)
| | - William J Hucker
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston (A.B., K.L., W.J.H.).,Cardiac Arrhythmia Service, Division of Cardiology, Massachusetts General Hospital, Boston (A.B., W.J.H.)
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17
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Tomsits P, Clauss S, Kääb S. Genetic Burden of Birthweight on Atrial Fibrillation: Translational Challenges in Genetic Atrial Fibrillation Studies. Circ Genom Precis Med 2020; 13:e002987. [PMID: 32543993 DOI: 10.1161/circgen.120.002987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Philipp Tomsits
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich (LMU) (P.T., S.C., S.K.).,German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance (P.T., S.C., S.K.)
| | - Sebastian Clauss
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich (LMU) (P.T., S.C., S.K.).,German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance (P.T., S.C., S.K.)
| | - Stefan Kääb
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich (LMU) (P.T., S.C., S.K.).,German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance (P.T., S.C., S.K.)
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18
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Clauss S, Schüttler D, Bleyer C, Vlcek J, Shakarami M, Tomsits P, Schneider S, Maderspacher F, Chataut K, Trebo A, Wang C, Kleeberger J, Xia R, Baloch E, Hildebrand B, Massberg S, Wakili R, Kääb S. Characterization of a porcine model of atrial arrhythmogenicity in the context of ischaemic heart failure. PLoS One 2020; 15:e0232374. [PMID: 32365085 PMCID: PMC7197782 DOI: 10.1371/journal.pone.0232374] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/13/2020] [Indexed: 11/18/2022] Open
Abstract
Atrial fibrillation (AF) is a major healthcare challenge contributing to high morbidity and mortality. Treatment options are still limited, mainly due to insufficient understanding of the underlying pathophysiology. Further research and the development of reliable animal models resembling the human disease phenotype is therefore necessary to develop novel, innovative and ideally causal therapies. Since ischaemic heart failure (IHF) is a major cause for AF in patients we investigated AF in the context of IHF in a close-to-human porcine ischaemia-reperfusion model. Myocardial infarction (AMI) was induced in propofol/fentanyl/midazolam-anaesthetized pigs by occluding the left anterior descending artery for 90 minutes to model ischaemia with reperfusion. After 30 days ejection fraction (EF) was significantly reduced and haemodynamic parameters (pulmonary capillary wedge pressure (PCWP), right atrial pressure (RAP), left ventricular enddiastolic pressure (LVEDP)) were significantly elevated compared to age/weight matched control pigs without AMI, demonstrating an IHF phenotype. Electrophysiological properties (sinus node recovery time (SNRT), atrial/AV nodal refractory periods (AERP, AVERP)) did not differ between groups. Atrial burst pacing at 1200 bpm, however, revealed a significantly higher inducibility of atrial arrhythmia episodes including AF in IHF pigs (3/15 vs. 10/16, p = 0.029). Histological analysis showed pronounced left atrial and left ventricular fibrosis demonstrating a structural substrate underlying the increased arrhythmogenicity. Consequently, selective ventricular infarction via LAD occlusion causes haemodynamic alterations inducing structural atrial remodeling which results in increased atrial fibrosis as the arrhythmogenic atrial substrate in pigs with IHF.
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Affiliation(s)
- Sebastian Clauss
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- * E-mail:
| | - Dominik Schüttler
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Munich, Germany
| | - Christina Bleyer
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Munich, Germany
| | - Julia Vlcek
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Munich, Germany
| | - Mehdi Shakarami
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Munich, Germany
| | - Philipp Tomsits
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Sarah Schneider
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Florian Maderspacher
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Kavi Chataut
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Anna Trebo
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Christine Wang
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Jan Kleeberger
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Ruibing Xia
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Elisabeth Baloch
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
| | - Bianca Hildebrand
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
| | - Steffen Massberg
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Munich, Germany
| | - Reza Wakili
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
- Universitätsklinikum Essen, Westdeutsches Herz- und Gefäßzentrum Essen, Essen, Germany
| | - Stefan Kääb
- Department of Medicine I, University Hospital Munich, Campus Großhadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
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19
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Clauss S, Bleyer C, Schüttler D, Tomsits P, Renner S, Klymiuk N, Wakili R, Massberg S, Wolf E, Kääb S. Animal models of arrhythmia: classic electrophysiology to genetically modified large animals. Nat Rev Cardiol 2020; 16:457-475. [PMID: 30894679 DOI: 10.1038/s41569-019-0179-0] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Arrhythmias are common and contribute substantially to cardiovascular morbidity and mortality. The underlying pathophysiology of arrhythmias is complex and remains incompletely understood, which explains why mostly only symptomatic therapy is available. The evaluation of the complex interplay between various cell types in the heart, including cardiomyocytes from the conduction system and the working myocardium, fibroblasts and cardiac immune cells, remains a major challenge in arrhythmia research because it can be investigated only in vivo. Various animal species have been used, and several disease models have been developed to study arrhythmias. Although every species is useful and might be ideal to study a specific hypothesis, we suggest a practical trio of animal models for future use: mice for genetic investigations, mechanistic evaluations or early studies to identify potential drug targets; rabbits for studies on ion channel function, repolarization or re-entrant arrhythmias; and pigs for preclinical translational studies to validate previous findings. In this Review, we provide a comprehensive overview of different models and currently used species for arrhythmia research, discuss their advantages and disadvantages and provide guidance for researchers who are considering performing in vivo studies.
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Affiliation(s)
- Sebastian Clauss
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany. .,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.
| | - Christina Bleyer
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Dominik Schüttler
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Philipp Tomsits
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Simone Renner
- Institute of Molecular Animal Breeding and Biotechnology, Ludwig-Maximilians University Munich (LMU), Munich, Germany.,DZD (German Centre for Diabetes Research), Neuherberg, Germany
| | - Nikolai Klymiuk
- Institute of Molecular Animal Breeding and Biotechnology, Ludwig-Maximilians University Munich (LMU), Munich, Germany
| | - Reza Wakili
- Universitätsklinikum Essen, Westdeutsches Herz- und Gefäßzentrum Essen, Essen, Germany
| | - Steffen Massberg
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Eckhard Wolf
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany.,Institute of Molecular Animal Breeding and Biotechnology, Ludwig-Maximilians University Munich (LMU), Munich, Germany.,DZD (German Centre for Diabetes Research), Neuherberg, Germany
| | - Stefan Kääb
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
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20
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Glinge C, Clauss S, Boddum K, Jabbari R, Jabbari J, Risgaard B, Tomsits P, Hildebrand B, Kääb S, Wakili R, Jespersen T, Tfelt-Hansen J. Stability of Circulating Blood-Based MicroRNAs - Pre-Analytic Methodological Considerations. PLoS One 2017; 12:e0167969. [PMID: 28151938 PMCID: PMC5289450 DOI: 10.1371/journal.pone.0167969] [Citation(s) in RCA: 218] [Impact Index Per Article: 31.1] [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: 05/17/2016] [Accepted: 11/23/2016] [Indexed: 12/11/2022] Open
Abstract
Background and aim The potential of microRNAs (miRNA) as non-invasive diagnostic, prognostic, and predictive biomarkers, as well as therapeutic targets, has recently been recognized. Previous studies have highlighted the importance of consistency in the methodology used, but to our knowledge, no study has described the methodology of sample preparation and storage systematically with respect to miRNAs as blood biomarkers. The aim of this study was to investigate the stability of miRNAs in blood under various relevant clinical and research conditions: different collection tubes, storage at different temperatures, physical disturbance, as well as serial freeze-thaw cycles. Methods Blood samples were collected from 12 healthy donors into different collection tubes containing anticoagulants, including EDTA, citrate and lithium-heparin, as well as into serum collection tubes. MiRNA stability was evaluated by measuring expression changes of miR-1, miR-21 and miR-29b at different conditions: varying processing time of whole blood (up to 72 hours (h)), long-term storage (9 months at -80°C), physical disturbance (1 and 8 h), as well as in a series of freeze/thaw cycles (1 and 4 times). Results Different collection tubes revealed comparable concentrations of miR-1, miR-21 and miR-29b. Tubes with lithium-heparin were found unsuitable for miRNA quantification. MiRNA levels were stable for at least 24 h at room temperature in whole blood, while separated fractions did show alterations within 24 h. There were significant changes in the miR-21 and miR-29b levels after 72 h incubation of whole blood at room temperature (p<0.01 for both). Both miR-1 and miR-21 showed decreased levels after physical disturbance for 8 h in separated plasma and miR-1 in serum whole blood, while after 1 h of disturbance no changes were observed. Storage of samples at -80°C extended the miRNA stability remarkably, however, miRNA levels in long-term stored (9 months) whole blood samples were significantly changed, which is in contrast to the plasma samples, where miR-21 or miR-29b levels were found to be stable. Repetitive (n = 4) freeze-thaw cycles resulted in a significant reduction of miRNA concentration both in plasma and serum samples. Conclusion This study highlights the importance of proper and systematic sample collection and preparation when measuring circulating miRNAs, e.g., in context of clinical trials. We demonstrated that the type of collection tubes, preparation, handling and storage of samples should be standardized to avoid confounding variables influencing the results.
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Affiliation(s)
- Charlotte Glinge
- Department of Cardiology, the Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- * E-mail:
| | - Sebastian Clauss
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, United States of America
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Kim Boddum
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Reza Jabbari
- Department of Cardiology, the Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Javad Jabbari
- Department of Cardiology, the Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Bjarke Risgaard
- Department of Cardiology, the Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Philipp Tomsits
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Bianca Hildebrand
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
| | - Stefan Kääb
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Reza Wakili
- Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Thomas Jespersen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Tfelt-Hansen
- Department of Cardiology, the Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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