Local delivery of fluorescent dye for fiber-optics confocal microscopy of the living heart

Fiber-optics confocal microscopy (FCM) is an emerging imaging technology with various applications in basic research and clinical diagnosis. FCM allows for real-time in situ microscopy of tissue at sub-cellular scale. Recently FCM has been investigated for cardiac imaging, in particular, for discrimination of cardiac tissue during pediatric open-heart surgery. FCM relies on fluorescent dyes. The current clinical approach of dye delivery is based on systemic injection, which is associated with high dye consumption, and adverse clinical events. In this study, we investigated approaches for local dye delivery during FCM imaging based on dye carriers attached to the imaging probe. Using three-dimensional confocal microscopy, automated bench tests, and FCM imaging we quantitatively characterized dye release of carriers composed of open-pore foam only and foam loaded with agarose hydrogel. In addition, we compared local dye delivery with a model of systemic dye delivery in the isolated perfused rodent heart. We measured the signal-to-noise ratio (SNR) of images acquired in various regions of the heart. Our evaluations showed that foam-agarose dye carriers exhibited a prolonged dye release vs. foam-only carriers. Foam-agarose dye carriers allowed reliable imaging of 5–9 lines, which is comparable to 4–8 min of continuous dye release. Our study in the living heart revealed that the SNR of FCM images using local and systemic dye delivery is not different. However, we observed differences in the imaged tissue microstructure with the two approaches. Structural features characteristic of microvasculature were solely observed for systemic dye delivery. Our findings suggest that local dye delivery approach for FCM imaging constitutes an important alternative to systemic dye delivery. We suggest that the approach for local dye delivery will facilitate clinical translation of FCM, for instance, for FCM imaging during pediatric heart surgery

Modeling effects of L-type ca(2+) current and na(+)-ca(2+) exchanger on ca(2+) trigger flux in rabbit myocytes with realistic T-tubule geometries.

The transverse tubular system of rabbit ventricular myocytes consists of cell membrane invaginations (t-tubules) that are essential for efficient cardiac excitation-contraction coupling. In this study, we investigate how t-tubule micro-anatomy, L-type Ca(2+) channel (LCC) clustering, and allosteric activation of Na(+)/Ca(2+) exchanger by L-type Ca(2+) current affects intracellular Ca(2+) dynamics. Our model includes a realistic 3D geometry of a single t-tubule and its surrounding half-sarcomeres for rabbit ventricular myocytes. The effects of spatially distributed membrane ion-transporters (LCC, Na(+)/Ca(2+) exchanger, sarcolemmal Ca(2+) pump, and sarcolemmal Ca(2+) leak), and stationary and mobile Ca(2+) buffers (troponin C, ATP, calmodulin, and Fluo-3) are also considered. We used a coupled reaction-diffusion system to describe the spatio-temporal concentration profiles of free and buffered intracellular Ca(2+). We obtained parameters from voltage-clamp protocols of L-type Ca(2+) current and line-scan recordings of Ca(2+) concentration profiles in rabbit cells, in which the sarcoplasmic reticulum is disabled. Our model results agree with experimental measurements of global Ca(2+) transient in myocytes loaded with 50 μM Fluo-3. We found that local Ca(2+) concentrations within the cytosol and sub-sarcolemma, as well as the local trigger fluxes of Ca(2+) crossing the cell membrane, are sensitive to details of t-tubule micro-structure and membrane Ca(2+) flux distribution. The model additionally predicts that local Ca(2+) trigger fluxes are at least threefold to eightfold higher than the whole-cell Ca(2+) trigger flux. We found also that the activation of allosteric Ca(2+)-binding sites on the Na(+)/Ca(2+) exchanger could provide a mechanism for regulating global and local Ca(2+) trigger fluxes in vivo. Our studies indicate that improved structural and functional models could improve our understanding of the contributions of L-type and Na(+)/Ca(2+) exchanger fluxes to intracellular Ca(2+) dynamics

Extended Bidomain Modeling of Defibrillation: Quantifying Virtual Electrode Strengths in Fibrotic Myocardium

Defibrillation is a well-established therapy for atrial and ventricular arrhythmia. Here, we shed light on defibrillation in the fibrotic heart. Using the extended bidomain model of electrical conduction in cardiac tissue, we assessed the influence of fibrosis on the strength of virtual electrodes caused by extracellular electrical current. We created one-dimensional models of rabbit ventricular tissue with a central patch of fibrosis. The fibrosis was incorporated by altering volume fractions for extracellular, myocyte and fibroblast domains. In our prior work, we calculated these volume fractions from microscopic images at the infarct border zone of rabbit hearts. An average and a large degree of fibrosis were modeled. We simulated defibrillation by application of an extracellular current for a short duration (5 ms). We explored the effects of myocyte-fibroblast coupling, intra-fibroblast conductivity and patch length on the strength of the virtual electrodes present at the borders of the normal and fibrotic tissue. We discriminated between effects on myocyte and fibroblast membranes at both borders of the patch. Similarly, we studied defibrillation in two-dimensional models of fibrotic tissue. Square and disk-like patches of fibrotic tissue were embedded in control tissue. We quantified the influence of the geometry and fibrosis composition on virtual electrode strength. We compared the results obtained with a square and disk shape of the fibrotic patch with results from the one-dimensional simulations. Both, one- and two-dimensional simulations indicate that extracellular current application causes virtual electrodes at boundaries of fibrotic patches. A higher degree of fibrosis and larger patch size were associated with an increased strength of the virtual electrodes. Also, patch geometry affected the strength of the virtual electrodes. Our simulations suggest that increased fibroblast-myocyte coupling and intra-fibroblast conductivity reduce virtual electrode strength. However, experimental data to constrain these modeling parameters are limited and thus pinpointing the magnitude of the reduction will require further understanding of electrical coupling of fibroblasts in native cardiac tissues. We propose that the findings from our computational studies are important for development of patient-specific protocols for internal defibrillators

Extended bidomain modeling of defibrillation: quantifying virtual electrode strengths in fibrotic myocardium

Defibrillation is a well-established therapy for atrial and ventricular arrhythmia. Here, we shed light on defibrillation in the fibrotic heart. Using the extended bidomain model of electrical conduction in cardiac tissue, we assessed the influence of fibrosis on the strength of virtual electrodes caused by extracellular electrical current. We created one-dimensional models of rabbit ventricular tissue with a central patch of fibrosis. The fibrosis was incorporated by altering volume fractions for extracellular, myocyte and fibroblast domains. In our prior work, we calculated these volume fractions from microscopic images at the infarct border zone of rabbit hearts. An average and a large degree of fibrosis were modeled. We simulated defibrillation by application of an extracellular current for a short duration (5 ms). We explored the effects of myocyte-fibroblast coupling, intra-fibroblast conductivity and patch length on the strength of the virtual electrodes present at the borders of the normal and fibrotic tissue. We discriminated between effects on myocyte and fibroblast membranes at both borders of the patch. Similarly, we studied defibrillation in two-dimensional models of fibrotic tissue. Square and disk-like patches of fibrotic tissue were embedded in control tissue. We quantified the influence of the geometry and fibrosis composition on virtual electrode strength. We compared the results obtained with a square and disk shape of the fibrotic patch with results from the one-dimensional simulations. Both, one- and two-dimensional simulations indicate that extracellular current application causes virtual electrodes at boundaries of fibrotic patches. A higher degree of fibrosis and larger patch size were associated with an increased strength of the virtual electrodes. Also, patch geometry affected the strength of the virtual electrodes. Our simulations suggest that increased fibroblast-myocyte coupling and intra-fibroblast conductivity reduce virtual electrode strength. However, experimental data to constrain these modeling parameters are limited and thus pinpointing the magnitude of the reduction will require further understanding of electrical coupling of fibroblasts in native cardiac tissues. We propose that the findings from our computational studies are important for development of patient-specific protocols for internal defibrillators

A Large-scale 3D Micromechanical Computational Myocardium Model

The right ventricle (RV) of the heart experiences substantial adaptions in structure and mechanical properties under pulmonary arterial hypertension (PAH). Developing computational models of RV myocardium can provide crucial insight into the factors influencing the onset, progression, and potential reversibility of post-PAH remodeling. However, knowledge of the mechanical interactions between myocardial constituents like myofibers and extracellular matrix (ECM) collagen, previously shown to be essential for capturing tissue behavior, remains incomplete, necessitating a micromechanical framework to link tissue-scale mechanical behavior to myocardial microanatomy. We developed a micromechanical finite element (FE) model leveraging high-fidelity imaging of myocardial microstructure to elucidate micro-scale myofiber-collagen interactions and their contribution to bulk tissue properties. We generated a 1.1-million tetrahedral mesh from a confocal microscopy dataset of a 204x204x40 μm myocardium sample. The material behaviors of the myofiber and ECM were modeled with hyperelastic, anisotropic, nearly incompressible constitutive forms derived from previous structurally-based models. The FE model was used to simulate physiologically informed equibiaxial and non-equibiaxial planar biaxial deformations, and the material parameters were fitted to the total stress-strain response of our previously developed tissue- scale model. Simulations were performed on the Stampede2 supercomputer at the Texas Advanced Computing Center using the finite element solver FEniCS, parallelized over 68 processors. We then employed a multiscale homogenization technique to predict tissue-level (5x5x0.7-mm) biaxial behavior from the localized micromechanical response via emulation of the tissue-scale histological structure and experimental biaxial deformation protocols. Recapitulation of the myocardial microanatomy successfully reproduced the tissue-level results in all deformation modes, suggesting that the micro-scale arrangement of myofibers and ECM is a primary mechanism driving myofiber-collagen coupling at the bulk tissue level. This work establishes the feasibility of incorporating microanatomy into high-fidelity supercomputer-based modeling of myocardium to investigate post-PAH remodeling of the cardiac microstructure and identify mechanical attributes critical to heart disease therapies

Sensitivity and Specificity of Cardiac Tissue Discrimination Using Fiber-Optics Confocal Microscopy

Disturbances of the cardiac conduction system constitute a major risk after surgical repair of complex cases of congenital heart disease. Intraoperative identification of the conduction system may reduce the incidence of these disturbances. We previously developed an approach to identify cardiac tissue types using fiber-optics confocal microscopy and extracellular fluorophores. Here, we applied this approach to investigate sensitivity and specificity of human and automated classification in discriminating images of atrial working myocardium and specialized tissue of the conduction system. Two-dimensional image sequences from atrial working myocardium and nodal tissue of isolated perfused rodent hearts were acquired using a fiber-optics confocal microscope (Leica FCM1000). We compared two methods for local application of extracellular fluorophores: topical via pipette and with a dye carrier. Eight blinded examiners evaluated 162 randomly selected images of atrial working myocardium (n = 81) and nodal tissue (n = 81). In addition, we evaluated the images using automated classification. Blinded examiners achieved a sensitivity and specificity of 99.2±0.3% and 98.0±0.7%, respectively, with the dye carrier method of dye application. Sensitivity and specificity was similar for dye application via a pipette (99.2±0.3% and 94.0±2.4%, respectively). Sensitivity and specificity for automated methods of tissue discrimination were similarly high. Human and automated classification achieved high sensitivity and specificity in discriminating atrial working myocardium and nodal tissue. We suggest that our findings facilitate clinical translation of fiber-optics confocal microscopy as an intraoperative imaging modality to reduce the incidence of conduction disturbances during surgical correction of congenital heart disease

Modification of hERG1 channel gating by Cd2+

Each of the four subunits in a voltage-gated potassium channel has a voltage sensor domain (VSD) that is formed by four transmembrane helical segments (S1–S4). In response to changes in membrane potential, intramembrane displacement of basic residues in S4 produces a gating current. As S4 moves through the membrane, its basic residues also form sequential electrostatic interactions with acidic residues in immobile regions of the S2 and S3 segments. Transition metal cations interact with these same acidic residues and modify channel gating. In human ether-á-go-go–related gene type 1 (hERG1) channels, Cd2+ coordinated by D456 and D460 in S2 and D509 in S3 induces a positive shift in the voltage dependence of activation of ionic currents. Here, we characterize the effects of Cd2+ on hERG1 gating currents in Xenopus oocytes using the cut-open Vaseline gap technique. Cd2+ shifted the half-point (V1/2) for the voltage dependence of the OFF gating charge–voltage (QOFF-V) relationship with an EC50 of 171 µM; at 0.3 mM, V1/2 was shifted by +50 mV. Cd2+ also induced an as of yet unrecognized small outward current (ICd-out) upon repolarization in a concentration- and voltage-dependent manner. We propose that Cd2+ and Arg residues in the S4 segment compete for interaction with acidic residues in S2 and S3 segments, and that the initial inward movement of S4 associated with membrane repolarization displaces Cd2+ in an outward direction to produce ICd-out. Co2+, Zn2+, and La3+ at concentrations that caused ∼+35-mV shifts in the QOFF-V relationship did not induce a current similar to ICd-out, suggesting that the binding site for these cations or their competition with basic residues in S4 differs from Cd2+. New Markov models of hERG1 channels were developed that describe gating currents as a noncooperative two-phase process of the VSD and can account for changes in these currents caused by extracellular Cd2+