Physiological Laboratory, University of Cambridge, Downing Street, Cambridge CB2 3EG, UK.
Cardiovasc Res. 2011 Mar 1;89(4):794-804. doi: 10.1093/cvr/cvq229. Epub 2010 Jul 9.
The experiments explored for atrial arrhythmogenesis and its possible physiological background in recently developed hetero-(RyR2(+/S)) and homozygotic (RyR2(S/S)) RyR2-P2328S murine models for catecholaminergic polymorphic ventricular tachycardia (VT) for the first time. They complement previous clinical and experimental reports describing increased ventricular arrhythmic tendencies associated with physical activity, stress, or catecholamine infusion, potentially leading to VT and ventricular fibrillation.
Atrial arrhythmogenic properties were compared at the whole animal, Langendorff-perfused heart, and single, isolated atrial myocyte levels using electrophysiological and confocal fluorescence microscopy methods. This demonstrated that: (i) electrocardiographic parameters in intact anaesthetized wild-type (WT), RyR2(+/S) and RyR2(S/S) mice were statistically indistinguishable both before and after addition of isoproterenol apart from increases in heart rates. (ii) Bipolar electrogram and monophasic action potential recordings showed significantly higher incidences of arrhythmogenesis in isolated perfused RyR2(S/S), but not RyR2(+/S), relative to WT hearts during either regular pacing or programmed electrical stimulation. The addition of isoproterenol increased such incidences in all three groups. (iii) However, there were no accompanying differences in cardiac anatomy or action potential durations at 90% repolarization and refractory periods. (iv) In contrast, episodes of diastolic Ca(2+) release were observed under confocal microscopy in isolated fluo-3-loaded RyR2(S/S), but not RyR2(+/S) or WT, atrial myocytes. The introduction of isoproterenol resulted in significant diastolic Ca(2+) release in all three groups.
These findings establish acute atrial arrhythmogenic properties in RyR2-P2328S hearts and correlate these with altered Ca(2+) homeostasis in an absence of repolarization abnormalities for the first time.
本实验首次在新近开发的儿茶酚胺多形性室性心动过速(VT)的杂合(RyR2(+/S)和纯合(RyR2(S/S)RyR2-P2328S 鼠模型中探索房性心律失常的发生机制及其可能的生理背景。这些模型补充了先前描述与体力活动、应激或儿茶酚胺输注相关的增加的室性心律失常倾向的临床和实验报告,这些因素可能导致 VT 和心室颤动。
使用电生理和共聚焦荧光显微镜方法,在整体动物、Langendorff 灌流心脏和单个分离的心房肌细胞水平上比较了房性心律失常的特性。结果表明:(i)在添加异丙肾上腺素前后,麻醉状态下的野生型(WT)、RyR2(+/S)和 RyR2(S/S)小鼠的心电图参数在统计学上无差异,除心率增加外。(ii)双极电图和单相动作电位记录显示,在正常起搏或程控电刺激期间,与 WT 心脏相比,分离的灌注 RyR2(S/S)心脏的心律失常发生率明显更高,但 RyR2(+/S)心脏则不然。在所有三组中,添加异丙肾上腺素均增加了这种发生率。(iii)然而,在 90%复极化和不应期时,心脏解剖结构或动作电位持续时间没有差异。(iv)相比之下,在共聚焦显微镜下观察到分离的 fluo-3 加载的 RyR2(S/S)心房肌细胞中存在舒张期 Ca2+释放。在所有三组中,添加异丙肾上腺素都会导致显著的舒张期 Ca2+释放。
这些发现确立了 RyR2-P2328S 心脏的急性房性心律失常特性,并首次将其与 Ca2+稳态的改变相关联,而没有复极化异常。