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Most cardiac arrhythmias at the whole heart level result from alteration of cell membrane ionic channels and intracellular calcium concentration ([Ca2+] i ) cycling with emerging spatiotemporal behavior through tissue-level coupling. For example, dynamically induced spatial dispersion of action potential duration, QT prolongation, and alternans are clinical markers for arrhythmia susceptibility in regular and heart-failure patients that originate due to changes of the transmembrane voltage (V m) and [Ca2+] i . We present an optical-mapping methodology that permits simultaneous measurements of the V m - [Ca2+] i signals using a single-camera without cross-talk, allowing quantitative characterization of favorable/adverse cell and tissue dynamical effects occurring from remodeling and/or drugs in heart failure. We demonstrate theoretically and experimentally in six different species the existence of a family of excitation wavelengths, we termed semasbestic, that give no change in signal for one dye, and thus can be used to record signals from another dye, guaranteeing zero cross-talk. [ABSTRACT FROM AUTHOR]

Cardiotoxicity of pharmaceutical drugs, industrial chemicals, and environmental toxicants can be severe, even life threatening, which necessitates a thorough evaluation of the human response to chemical compounds. Predicting risks for arrhythmia and sudden cardiac death accurately is critical for defining safety profiles. Currently available approaches have limitations including a focus on single select ion channels, the use of non-human species in vitro and in vivo, and limited direct physiological translation. We have advanced the robustness and reproducibility of in vitro platforms for assessing pro-arrhythmic cardiotoxicity using human induced pluripotent stem cell-derived cardiomyocytes and human cardiac fibroblasts in 3-dimensional microtissues. Using automated algorithms and statistical analyses of eight comprehensive evaluation metrics of cardiac action potentials, we demonstrate that tissue-engineered human cardiac microtissues respond appropriately to physiological stimuli and effectively differentiate between high-risk and low-risk compounds exhibiting blockade of the hERG channel (E4031 and ranolazine, respectively). Further, we show that the environmental endocrine disrupting chemical bisphenol-A (BPA) causes acute and sensitive disruption of human action potentials in the nanomolar range. Thus, this novel human 3D in vitro pro-arrhythmic risk assessment platform addresses critical needs in cardiotoxicity testing for both environmental and pharmaceutical compounds and can be leveraged to establish safe human exposure levels. [ABSTRACT FROM AUTHOR]

Background: Downregulated sodium currents in heart failure (HF) have been linked to increased arrhythmic risk. Reduced expression of the messenger RNA (mRNA)-stabilizing protein HuR (also known as ELAVL1) may be responsible for the downregulation of sodium channel gene SCN5A mRNA.Objective: The purpose of this article was to investigate whether HuR regulates SCN5A mRNA expression and whether manipulation of HuR benefits arrhythmia control in HF.Methods: Quantitative real-time reverse-transcriptase polymerase chain reaction was used to investigate the expression of SCN5A. Optical mapping of the intact heart was adopted to study the effects of HuR on the conduction velocity and action potential upstroke in mice with myocardial infarct and HF after injection of AAV9 viral particles carrying HuR.Results: HuR was associated with SCN5A mRNA in cardiomyocytes, and expression of HuR was downregulated in failing hearts. The association of HuR and SCN5A mRNA protected SCN5A mRNA from decay. Injection of AAV9 viral particles carrying HuR increased SCN5A expression in mouse heart tissues after MI. Optical mapping of the intact heart demonstrated that overexpression of HuR improved action potential upstroke and conduction velocity in the infarct border zone, which reduced the risk of reentrant arrhythmia after MI.Conclusion: Our data indicate that HuR is an important RNA-binding protein in maintaining SCN5A mRNA abundance in cardiomyocytes. Reduced expression of HuR may be at least partially responsible for the downregulation of SCN5A mRNA expression in ischemic HF. Overexpression of HuR may rescue decreased SCN5A expression and reduce arrhythmic risk in HF. Increasing mRNA stability to increase ion channel currents may correct a fundamental defect in HF and represent a new paradigm in antiarrhythmic therapy. [ABSTRACT FROM AUTHOR]

Background: Remodeling of cardiac repolarizing currents, such as the downregulation of slowly activating K+ channels (IKs), could underlie ventricular fibrillation (VF) in heart failure (HF). We evaluated the role of Iks remodeling in VF susceptibility using a tachypacing HF model of transgenic rabbits with Long QT Type 1 (LQT1) syndrome. Methods and Results: LQT1 and littermate control (LMC) rabbits underwent three weeks of tachypacing to induce cardiac myopathy (TICM). In vivo telemetry demonstrated steepening of the QT/RR slope in LQT1 with TICM (LQT1-TICM; pre: 0.26±0.04, post: 0.52±0.01, P<0.05). In vivo electrophysiology showed that LQT1-TICM had higher incidence of VF than LMC-TICM (6 of 11 vs. 3 of 11, respectively). Optical mapping revealed larger APD dispersion (16±4 vs. 38±6 ms, p<0.05) and steep APD restitution in LQT1-TICM compared to LQT1-sham (0.53±0.12 vs. 1.17±0.13, p<0.05). LQT1-TICM developed spatially discordant alternans (DA), which caused conduction block and higher-frequency VF (15±1 Hz in LQT1-TICM vs. 13±1 Hz in LMC-TICM, p<0.05). Ca2+ DA was highly dynamic and preceded voltage DA in LQT1-TICM. Ryanodine abolished DA in 5 out of 8 LQT1-TICM rabbits, demonstrating the importance of Ca2+ in complex DA formation. Computer simulations suggested that HF remodeling caused Ca2+-driven alternans, which was further potentiated in LQT1-TICM due to the lack of IKs. Conclusions: Compared with LMC-TICM, LQT1-TICM rabbits exhibit steepened APD restitution and complex DA modulated by Ca2+. Our results strongly support the contention that the downregulation of IKs in HF increases Ca2+ dependent alternans and thereby the risk of VF. [ABSTRACT FROM AUTHOR]

The initiation of polymorphic ventricular tachycardia in long QT syndrome type 2 (LQT2) has been associated with a characteristic ECG pattern of short-long RR intervals. We hypothesize that this characteristic pattern increases APD dispersion in LQT2, thereby promoting arrhythmia. We investigated APD dispersion and its dependence on two previous cycle lengths (CLs) in transgenic rabbit models of LQT2, LQT1, and their littermate controls (LMC) using random stimulation protocols. The results show that the short-long RR pattern was associated with a larger APD dispersion in LQT2 but not in LQT1 rabbits. The multivariate analyses of APD as a function of two previous CLs (APDn = C + α1CLn−1 + α2CLn−2) showed that α1 (APD restitution slope) is largest and heterogeneous in LQT2 but uniform in LQT1, enhancing APD dispersion under long CLn−1 in LQT2. The α2 (short-term memory) was negative in LQT2 while positive in LQT1, and the spatial pattern of α1 was inversely correlated to α2 in LQT2, which explains why a short-long combination causes a larger APD dispersion in LQT2 but not in LQT1 rabbits. In conclusion, short-long RR pattern increased APD dispersion only in LQT2 rabbits through heterogeneous APD restitution and the short-term memory, underscoring the genotype-specific triggering of arrhythmias in LQT syndrome. [ABSTRACT FROM AUTHOR]

Introduction: LQT5 is caused by mutations in KCNE1, an accessory subunit of slowly activating delayed rectifier K+ channel (IKs), and is associated with polymorphic ventricular tachycardia (pVT) and sudden cardiac arrest. Methods: Optical mapping of intact heart and single myocyte voltage clamp were used to investigate arrhythmia mechanism in LQT5 rabbit hearts. Results: LQT5 rabbits show slight prolongation of APDs as compared to littermate control (LMC) (179±12 vs. 165±10 ms at 350 ms pacing, p<0.05). APD restitution in LQT5 rabbits was non-monotonic and steeper at longer diastolic interval compared to LMC rabbits (τ=24±3 vs.16±2 ms), accompanying by APD alternans. Isoproterenol (ISO, 140 nM) alone did not induce pVT but the sudden acceleration of heart rate (HR) with S1S2S3S4 stimulation in the presence of ISO induced pVTs (n=9/11 in LQT5 vs. 0/5 LMC hearts (panel A). The mapping of pVT initiation showed that the sudden HR acceleration produced large APD oscillations (red line) and progressively increased APD dispersion of S2S3S4 beats (blue line, panel B), which is associated with triggered focal activity (stars, panel C) to form reentry. Patch clamp data showed that transient outward K+ current (Ito) in LQT5 myocytes is markedly altered with slow inactivation (τ=14 and 99 ms for double exponential curve fit) and slow recovery from inactivation kinetics (τ=217 and 3100 ms for Ito,f and Ito,s, respectively). These results suggest that in addition to IKs, KCNE1 mutation also modifies Ito thereby cause large APD oscillations and increase APD dispersion particularly during abrupt heart rate acceleration, resulting in pVTs in LQT5 rabbit. Conclusion: KCNE1 mutation in LQT5 affects multiple K+ channels including Ito, causing large APD variation and dispersion that trigger pVTs during sudden HR acceleration. [ABSTRACT FROM AUTHOR]

Abstract: Cardiac excitation waves that arise in heart tissues have long been an important research topic because they are related to various cardiac arrhythmia. Investigating their properties based on intact animal whole hearts is important but quite demanding and expensive. Subsequently, dissociated cardiac cell cultures have been used as an alternative. Here, we access the usefulness of cardiomyocyte cell line HL-1 in studying generic properties of cardiac waves. Spontaneous wave activities in confluent populations of HL-1 cells are monitored using a phase-contrast optical mapping system and a microelectrode array recording device. We find that high-density cultures of HL-1 cells can support well-defined reentries. Their conduction velocity and rotation period both increase over few days. The increasing trend of rotation period is opposite to the case of control experiments using primary cultures of mouse atrial cells. The progressive myolysis of HL-1 seems responsible for this difference. [Copyright &y& Elsevier]