Tse Gary, Yeo Jie Ming, Tse Vivian, Kwan Joseph, Sun Bing
Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, P.R. China.
Faculty of Medicine, Imperial College London, London SW7 2AZ, UK.
Mol Med Rep. 2016 Nov;14(5):4069-4074. doi: 10.3892/mmr.2016.5738. Epub 2016 Sep 13.
In the current study, arrhythmogenic effects of the gap junction inhibitor heptanol (0.05 mM) were examined in Langendorff-perfused mouse hearts. Monophasic action potential recordings were obtained from the left ventricular epicardium during right ventricular pacing. Regular activity was observed both prior and subsequent to application of heptanol in all of the 12 hearts studied during 8 Hz pacing. By contrast, induced ventricular tachycardia (VT) was observed after heptanol treatment in 6/12 hearts using a S1S2 protocol (Fisher's exact test; P<0.05). The arrhythmogenic effects of heptanol were associated with increased activation latencies from 13.2±0.6 to 19.4±1.3 msec (analysis of variance; P<0.001) and reduced conduction velocities (CVs) from 0.23±0.01 to 0.16±0.01 msec (analysis of variance; P<0.001) in an absence of alterations in action potential durations (ADPs) at x=90% (38.0±1.0 vs. 38.3±1.8 msec), 70% (16.8±1.0 vs. 19.5±0.9 msec), 50% (9.2±0.8 vs. 10.1±0.6 msec) or 30% (4.8±0.5 vs. 6.3±0.6 msec) repolarization (APDx) or in effective refractory period (ERPs) (39.6±1.9 vs. 40.6±3.0 msec) (all P>0.05). Consequently, excitation wavelengths (λ; CV x ERP) were reduced from 9.1±0.6 to 6.5±0.6 mm (P<0.01), however critical intervals for re‑excitation (APD90 ‑ ERP) were unaltered (‑1.1±2.4 vs. ‑2.3±1.8 msec; P>0.05). Together, these observations demonstrate for the first time, to the best of our knowledge, that inhibition of gap junctions alone using a low heptanol concentration (0.05 mM) was able to reduce CV, which alone was sufficient to permit the induction of VT using premature stimulation by reducing λ, which therefore appears central in the determination of arrhythmic tendency.
在本研究中,我们在Langendorff灌注的小鼠心脏中检测了缝隙连接抑制剂庚醇(0.05 mM)的致心律失常作用。在右心室起搏期间,从左心室心外膜记录单相动作电位。在8 Hz起搏的所有12颗研究心脏中,在应用庚醇之前和之后均观察到规则活动。相比之下,在使用S1S2方案的12颗心脏中,有6颗在庚醇处理后诱发出室性心动过速(VT)(Fisher精确检验;P<0.05)。庚醇的致心律失常作用与激活延迟从13.2±0.6毫秒增加到19.4±1.3毫秒(方差分析;P<0.001)以及传导速度(CV)从0.23±0.01毫秒降低到0.16±0.01毫秒(方差分析;P<0.001)相关,而动作电位持续时间(ADP)在复极化x=90%(38.0±1.0对38.3±1.8毫秒)、70%(16.8±1.0对19.5±0.9毫秒)、50%(9.2±0.8对10.1±0.6毫秒)或30%(4.8±0.5对6.3±0.6毫秒)时未改变,有效不应期(ERP)也未改变(39.6±1.9对40.6±3.0毫秒)(所有P>0.05)。因此,兴奋波长(λ;CV×ERP)从9.1±0.6毫米降低到6.5±0.6毫米(P<0.01),然而再兴奋的临界间期(APD90 - ERP)未改变(-1.1±2.4对-2.3±1.8毫秒;P>0.05)。据我们所知,这些观察结果首次表明,单独使用低浓度庚醇(0.05 mM)抑制缝隙连接能够降低CV,这本身就足以通过降低λ使用过早刺激诱发出VT,因此λ似乎在心律失常倾向的决定中起核心作用。