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Journal of Applied Physiology
Article . 2012 . Peer-reviewed
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Nonlinearity between action potential alternans and restitution, which both predict ventricular arrhythmic properties inScn5a+/−and wild-type murine hearts

Authors: Matthews, Gareth D.K.; Guzadhur, Laila; Grace, Andrew; Huang, Christopher L.H.;

Nonlinearity between action potential alternans and restitution, which both predict ventricular arrhythmic properties inScn5a+/−and wild-type murine hearts

Abstract

Electrocardiographic QT- and T-wave alternans, presaging ventricular arrhythmia, reflects compromised adaptation of action potential (AP) duration (APD) to altered heart rate, classically attributed to incomplete Nav1.5 channel recovery prior to subsequent stimulation. The restitution hypothesis suggests a function whose slope directly relates to APD alternans magnitude, predicting a critical instability condition, potentially generating arrhythmia. The present experiments directly test for such correlations among arrhythmia, APD alternans and restitution. Mice haploinsufficient in the Scn5a, cardiac Na+channel gene ( Scn5a+/−), previously used to replicate Brugada syndrome, were used, owing to their established arrhythmic properties increased by flecainide and decreased by quinidine, particularly in right ventricular (RV) epicardium. Monophasic APs, obtained during pacing with progressively decrementing cycle lengths, were systematically compared at RV and left ventricular epicardial and endocardial recording sites in Langendorff-perfused Scn5a+/−and wild-type hearts before and following flecainide (10 μM) or quinidine (5 μM) application. The extent of alternans was assessed using a novel algorithm. Scn5a+/−hearts showed greater frequencies of arrhythmic endpoints with increased incidences of ventricular tachycardia, diminished by quinidine, and earlier onsets of ventricular fibrillation, particularly following flecainide challenge. These features correlated directly with increased refractory periods, specifically in the RV, and abnormal restitution and alternans properties in the RV epicardium. The latter variables were related by a unique, continuous higher-order function, rather than a linear relationship with an unstable threshold. These findings demonstrate a specific relationship between alternans and restitution, as well as confirming their capacity to predict arrhythmia, but implicate mechanisms additional to the voltage feedback suggested in the restitution hypothesis.

Country
United Kingdom
Keywords

Male, Mice, 129 Strain, Models, Cardiovascular, 610, Action Potentials, Arrhythmias, Cardiac, Heart, Mice, Transgenic, NAV1.5 Voltage-Gated Sodium Channel, Electrocardiography, Mice, Nonlinear Dynamics, Heart Rate, Predictive Value of Tests, Tachycardia, Ventricular, Animals, Female, Anti-Arrhythmia Agents

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
18
Average
Average
Average
bronze