Zhou Zihao, Yuan Jiamin, Zhu Didi, Chen Yanhong, Qian Zhiyong, Wang Yao, Ge Peibin, Wang Quanpeng, Hou Xiaofeng, Zou Jiangang
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University Nanjing, Jiangsu, China.
Department of Cardiology, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, China.
Am J Transl Res. 2020 Oct 15;12(10):6122-6135. eCollection 2020.
The incidence of ventricular arrhythmias (VAs) in chronic heart failure (CHF) exhibits a notable circadian rhythm, for which the underlying mechanism has not yet been well defined. Thus, we aimed to investigate the role of cardiac core circadian genes on circadian VAs in CHF. First, a guinea pig CHF model was created by transaortic constriction. Circadian oscillation of core clock genes was evaluated by RT-PCR and was found to be unaltered in CHF (P > 0.05). Using programmed electrical stimulation in Langendorff-perfused failing hearts, we discovered that the CHF group exhibited increased VAs with greater incidence at CT3 compared to CT15 upon isoproterenol (ISO) stimulation. Circadian VAs was blunted by a β1-AR-selective blocker rather than a β2-AR-selective blocker. Circadian oscillation of β1-AR was retained in CHF (P > 0.05) and a 4-h phase delay between β1-AR and CLOCK-BMAL1 was recorded. Therefore, when CLOCK-BMAL1 was overexpressed using adenovirus infection, an induced overexpression of β1-AR also ensued, which resulted in prolonged action potential duration (APD) and enhanced arrhythmic response to ISO stimulation in cardiomyocytes (P < 0.05). Finally, chromatin immunoprecipitation and luciferase assays confirmed that CLOCK-BMAL1 binds to the enhancer of β1-AR gene and upregulates β1-AR expression. Therefore, in this study, we discovered that CLOCK-BMAL1 regulates the expression of β1-AR on a transcriptional level and subsequently modulates circadian VAs in CHF.
慢性心力衰竭(CHF)患者室性心律失常(VAs)的发生率呈现出显著的昼夜节律,但其潜在机制尚未完全明确。因此,我们旨在研究心脏核心昼夜节律基因在CHF患者昼夜VAs中的作用。首先,通过经主动脉缩窄建立豚鼠CHF模型。通过RT-PCR评估核心生物钟基因的昼夜振荡,发现其在CHF中未发生改变(P>0.05)。在Langendorff灌注的衰竭心脏中使用程控电刺激,我们发现CHF组在异丙肾上腺素(ISO)刺激下,VAs增加,与CT15相比,CT3时的发生率更高。β1-肾上腺素能受体(β1-AR)选择性阻滞剂而非β2-AR选择性阻滞剂可减弱昼夜VAs。β1-AR的昼夜振荡在CHF中得以保留(P>0.05),并且记录到β1-AR与CLOCK-BMAL1之间存在4小时的相位延迟。因此,当使用腺病毒感染过表达CLOCK-BMAL1时,β1-AR也随之诱导性过表达,这导致心肌细胞动作电位时程(APD)延长,并增强了对ISO刺激的心律失常反应(P<0.05)。最后,染色质免疫沉淀和荧光素酶测定证实CLOCK-BMAL1与β1-AR基因的增强子结合并上调β1-AR表达。因此,在本研究中,我们发现CLOCK-BMAL1在转录水平上调节β1-AR的表达,进而调节CHF患者的昼夜VAs。
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