Electrophysiologic effects of the IK1 inhibitor PA-6 are modulated by extracellular potassium in isolated guinea pig hearts

The pentamidine analog PA‐6 was developed as a specific inward rectifier potassium current (I(K) (1)) antagonist, because established inhibitors either lack specificity or have side effects that prohibit their use in vivo. We previously demonstrated that BaCl(2), an established I(K) (1) inhibitor, could prolong action potential duration (APD) and increase cardiac conduction velocity (CV). However, few studies have addressed whether targeted I(K) (1) inhibition similarly affects ventricular electrophysiology. The aim of this study was to determine the effects of PA‐6 on cardiac repolarization and conduction in Langendorff‐perfused guinea pig hearts. PA‐6 (200 nm) or vehicle was perfused into ex‐vivo guinea pig hearts for 60 min. Hearts were optically mapped with di‐4‐ANEPPS to quantify CV and APD at 90% repolarization (APD (90)). Ventricular APD (90) was significantly prolonged in hearts treated with PA‐6 (115 ± 2% of baseline; P < 0.05), but not vehicle (105 ± 2% of baseline). PA‐6 slightly, but significantly, increased transverse CV by 7%. PA‐6 significantly prolonged APD (90) during hypokalemia (2 mmol/L [K+](o)), although to a lesser degree than observed at 4.56 mmol/L [K+](o). In contrast, the effect of PA‐6 on CV was more pronounced during hypokalemia, where transverse CV with PA‐6 (24 ± 2 cm/sec) was significantly faster than with vehicle (13 ± 3 cm/sec, P < 0.05). These results show that under normokalemic conditions, PA‐6 significantly prolonged APD (90), whereas its effect on CV was modest. During hypokalemia, PA‐6 prolonged APD (90) to a lesser degree, but profoundly increased CV. Thus, in intact guinea pig hearts, the electrophysiologic effects of the I(K) (1) inhibitor, PA‐6, are [K+](o)‐dependent

A Novel Frequency Analysis Method for Assessing Kir2.1 and Nav1.5 Currents

Voltage clamping is an important tool for measuring individual currents from an electrically active cell. However, it is difficult to isolate individual currents without pharmacological or voltage inhibition. Herein, we present a technique that involves inserting a noise function into a standard voltage step protocol, which allows one to characterize the unique frequency response of an ion channel at different step potentials. Specifically, we compute the fast Fourier transform for a family of current traces at different step potentials for the inward rectifying potassium channel, Kir2.1, and the channel encoding the cardiac fast sodium current, Nav1.5. Each individual frequency magnitude, as a function of voltage step, is correlated to the peak current produced by each channel. The correlation coefficient vs. frequency relationship reveals that these two channels are associated with some unique frequencies with high absolute correlation. The individual IV relationship can then be recreated using only the unique frequencies with magnitudes of high absolute correlation. Thus, this study demonstrates that ion channels may exhibit unique frequency responses

Cable properties and propagation velocity in a long single chain of simulated myocardial cells

<p>Abstract</p> <p>Background</p> <p>Propagation of simulated action potentials (APs) was previously studied in short single chains and in two-dimensional sheets of myocardial cells <abbrgrp><abbr bid="B1">1</abbr><abbr bid="B2">2</abbr><abbr bid="B3">3</abbr></abbrgrp>. The present study was undertaken to examine propagation in a long single chain of cells of various lengths, and with varying numbers of gap-junction (g-j) channels, and to compare propagation velocity with the cable properties such as the length constant (<it>λ</it>).</p> <p>Methods and Results</p> <p>Simulations were carried out using the PSpice program as previously described. When the electric field (EF) mechanism was dominant (0, 1, and 10 gj-channels), the longer the chain length, the faster the overall velocity (<it>θ</it>_ov). There seems to be no simple explanation for this phenomenon. In contrast, when the local-circuit current mechanism was dominant (100 gj-channels or more), <it>θ</it>_ovwas slightly slowed with lengthening of the chain. Increasing the number of gj-channels produced an increase in <it>θ</it>_ovand caused the firing order to become more uniform. The end-effect was more pronounced at longer chain lengths and at greater number of gj-channels.</p> <p>When there were no or only few gj-channels (namely, 0, 10, or 30), the voltage change (ΔV_m) in the two contiguous cells (#50 & #52) to the cell injected with current (#51) was nearly zero, i.e., there was a sharp discontinuity in voltage between the adjacent cells. When there were many gj-channels (e.g., 300, 1000, 3000), there was an exponential decay of voltage on either side of the injected cell, with the length constant (<it>λ</it>) increasing at higher numbers of gj-channels. The effect of increasing the number of gj-channels on increasing <it>λ </it>was relatively small compared to the larger effect on <it>θ</it>_ov. <it>θ</it>_ovbecame very non-physiological at 300 gj-channels or higher.</p> <p>Conclusion</p> <p>Thus, when there were only 0, 1, or 10 gj-channels, <it>θ</it>_ovincreased with increase in chain length, whereas at 100 gj-channels or higher, <it>θ</it>_ovdid not increase with chain length. When there were only 0, 10, or 30 gj-channels, there was a very sharp decrease in ΔV_min the two contiguous cells on either side of the injected cell, whereas at 300, 1000, or 3000 gj-channels, the voltage decay was exponential along the length of the chain. The effect of increasing the number of gj-channels on spread of current was relatively small compared to the large effect on <it>θ</it>_ov.</p

Electrophysiological and Structural Remodeling in Heart Failure Modulate Arrhythmogenesis. 1D Simulation Study

Background: Heart failure is a final common pathway or descriptor for various cardiac pathologies. It is associated with sudden cardiac death, which is frequently caused by ventricular arrhythmias. Electrophysiological remodeling, intercellular uncoupling, fibrosis and autonomic imbalance have been identified as major arrhythmogenic factors in heart failure etiology and progression. Objective: In this study we investigate in silico the role of electrophysiological and structural heart failure remodeling on the modulation of key elements of the arrhythmogenic substrate, i.e., electrophysiological gradients and abnormal impulse propagation. Methods: Two different mathematical models of the human ventricular action potential were used to formulate models of the failing ventricular myocyte. This provided the basis for simulations of the electrical activity within a transmural ventricular strand. Our main goal was to elucidate the roles of electrophysiological and structural remodeling in setting the stage for malignant life-threatening arrhythmias. Results: Simulation results illustrate how the presence of M cells and heterogeneous electrophysiological remodeling in the human failing ventricle modulate the dispersion of action potential duration and repolarization time. Specifically, selective heterogeneous remodeling of expression levels for the Na+ /Ca2+ exchanger and SERCA pump decrease these heterogeneities. In contrast, fibroblast proliferation and cellular uncoupling both strongly increase repolarization heterogeneities. Conduction velocity and the safety factor for conduction are also reduced by the progressive structural remodeling during heart failure. Conclusion: An extensive literature now establishes that in human ventricle, as heart failure progresses, gradients for repolarization are changed significantly by protein specific electrophysiological remodeling (either homogeneous or heterogeneous). Our simulations illustrate and provide new insights into this. Furthermore, enhanced fibrosis in failing hearts, as well as reduced intercellular coupling, combine to increase electrophysiological gradients and reduce electrical propagation. In combination these changes set the stage for arrhythmias.This work was partially supported by (i) the "VI Plan Nacional de Investigacion Cientifica, Desarrollo e Innovacion Tecnologica" from the Ministerio de Economia y Competitividad of Spain (grant number TIN2012-37546-C03-01) and the European Commission (European Regional Development Funds - ERDF - FEDER), (ii) the Direccion General de Politica Cientifica de la Generalitat Valenciana (grant number GV/2013/119), and (iii) Programa Prometeo (PROMETEO/2012/030) de la Conselleria d'Educacio Formacio I Ocupacio, Generalitat Valenciana. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Gómez García, JF.; Cardona, K.; Romero Pérez, L.; Ferrero De Loma-Osorio, JM.; Trénor Gomis, BA. (2014). Electrophysiological and Structural Remodeling in Heart Failure Modulate Arrhythmogenesis. 1D Simulation Study. PLoS ONE. 9(9). https://doi.org/10.1371/journal.pone.0106602S9

Gap junction heterogeneity as mechanism for electrophysiologically distinct properties across the ventricular wall

Gap junctions are critical to maintaining synchronized impulse propagation and repolarization. Heterogeneous expression of the principal ventricular gap junction protein connexin43 (Cx43) is associated with action potential duration (APD) dispersion across the anterior ventricular wall. Little is known about Cx43 expression patterns and their disparate impact on regional electrophysiology throughout the heart. We aimed to determine whether the anterior and posterior regions of the heart are electrophysiologically distinct. Multisegment, high-resolution optical mapping was performed in canine wedge preparations harvested separately from the anterior left ventricle (aLV; n = 8) and posterior left ventricle (pLV; n = 8). Transmural APD dispersion was significantly greater on the aLV than the pLV (45 ± 13 vs. 26 ± 8.0 ms; P < 0.05). Conduction velocity dispersion was also significantly higher (P < 0.05) across the aLV (39 ± 7%) than the pLV (16 ± 3%). Carbenoxolone perfusion significantly enhanced APD and conduction velocity dispersion on the aLV (by 1.53-fold and 1.36-fold, respectively), but not the pLV (by 1.27-fold and 1.2-fold, respectively), and produced a 4.2-fold increase in susceptibility to inducible arrhythmias in the aLV. Confocal immunofluorescence microscopy revealed significantly (P < 0.05) greater transmural dispersion of Cx43 expression on the aLV (44 ± 10%) compared with the pLV wall (8.3 ± 0.7%), suggesting that regional expression of Cx43 expression patterns may account for regional electrophysiological differences. Computer simulations affirmed that localized uncoupling at the epicardial-midmyocardial interface is sufficient to produce APD gradients observed on the aLV. These data demonstrate that the aLV and pLV differ importantly with respect to their electrophysiological properties and Cx43 expression patterns. Furthermore, local underexpression of Cx43 is closely associated with transmural electrophysiological heterogeneity on the aLV. Therefore, regional and transmural heterogeneous Cx43 expression patterns may be an important mechanism underlying arrhythmia susceptibility, particularly in disease states where gap junction expression is altered

Intercalated Disk Extracellular Nanodomain Expansion in Patients With Atrial Fibrillation

Aims: Atrial fibrillation (AF) is the most common sustained arrhythmia. Previous evidence in animal models suggests that the gap junction (GJ) adjacent nanodomain – perinexus – is a site capable of independent intercellular communication via ephaptic transmission. Perinexal expansion is associated with slowed conduction and increased ventricular arrhythmias in animal models, but has not been studied in human tissue. The purpose of this study was to characterize the perinexus in humans and determine if perinexal expansion associates with AF.Methods: Atrial appendages from 39 patients (pts) undergoing cardiac surgery were fixed for immunofluorescence and transmission electron microscopy (TEM). Intercalated disk distribution of the cardiac sodium channel Nav1.5, its β1 subunit, and connexin43 (C×43) was determined by confocal immunofluorescence. Perinexal width (Wp) from TEM was manually segmented by two blinded observers using ImageJ software.Results: Nav1.5, β1, and C×43 are co-adjacent within intercalated disks of human atria, consistent with perinexal protein distributions in ventricular tissue of other species. TEM revealed that the GJ adjacent intermembrane separation in an individual perinexus does not change at distances greater than 30 nm from the GJ edge. Importantly, Wp is significantly wider in patients with a history of AF than in patients with no history of AF by approximately 3 nm, and Wp correlates with age (R = 0.7, p &lt; 0.05).Conclusion: Human atrial myocytes have voltage-gated sodium channels in a dynamic intercellular cleft adjacent to GJs that is consistent with previous descriptions of the perinexus. Further, perinexal width is greater in patients with AF undergoing cardiac surgery than in those without