Effect of spironolactone on hyperthyroxine-induced atrial fibrillation and atrial remodeling in rabbits

AIM: To detect the effect of spironolactone on hyperthyroxine-induced atrial remodeling. METHODS: New Zealand rabbits were divided into control group (C), hyperthyroxine group (H) and spironolactone group (S). Thyroxin was given to the rabbits in group H and group S by intraperitoneal injection for 4 weeks, and then spironolactone was given in group S by gavage for 2 weeks. Atrial fibrillation (AF) was induced by "burst" stimulation after administration. The inducing rate of AF and atrial effective refractory period (AERP) were tested by intra-cardiac electrophysiologic instrument. The expression of AF-related Ca²⁺ channel (Cav1.2), K⁺ channels (Kv1.5 and Kv4.3) and connexins (Cx40 and Cx43) at mRNA and protein levels was detected by real-time PCR, immunohistochemistry and Western blot. RESULTS: Spironolactone reduced the inducing rate of AF. No significant difference of AERP between group H and group S was observed (CONCLUSION: Spironolactone attenuates the hyperthyroxine-induced atrial remodeling in rabbits, and reduces the susceptibility of the myocardium to AF.     

Influence of ischemia-reperfusion on apoptosis of sinoatrial node cells in rabbits in vivo

AIM:To study influence of ischemia-reperfusion(IR) on apoptosis and expression of apoptosis-related genes Fas-L, Bax and Bcl-2 of sinoatrial node(SAN) cells in rabbits in vivo. METHODS:Ninety healthy adult rabbits were divided randomly into control group, ischemia groups (I_{10 min}, I_{30 min}, I_{60 min} and I_{120 min}) and IR groups (I_{10 min}R_4h, I_{30 min}R_4h, I_{60 min}R_4hand I_{120 min}R_4h). IR injury model of SAN was established by occluding and loosening the start section of right coronary artery. The apoptosis of SAN cells was detected by TUNEL staining. The expression of Fas-L, Bax and Bcl-2 of SAN cells was detected by immunohistochemistry. RESULTS:①No obvious apoptosis of SAN cells was observed in control group, I_{10 min} and I_{30 min} groups. Apoptosis of different degrees in SAN cells were found in 68.3%(41/60) rabbits in I_{60 min}, I_{120 min} and 4 subgroups of IR. ②The highest expression of Fas-L and Bax was observed in I_{120 min} group and that of Bcl-2 was in I_{60 min} group. ③The highest expression of Fas-L and Bax was observed in I_{60 min}R_4h group. The peak level of Bcl-2 was observed in I_{30 min}R_4h group. ④The expression of Fas-L and Bax was significant higher in IR group than that in ischemic group at the same time point. CONCLUSION:Ischemia and IR induced apoptosis of SAN cells in rabbit in vivo. Fas-L、Bax、Bcl-2 may participate in the regulation of apoptosis and the injury during IR aggravates the apoptosis of SAN cells.     

Effects of the calpain system expression on atrial structural remodeling in canine with atrial fibrillation

AIM: To evaluate the influence of the calpain system mRNA and protein expression on the progress of atrial structural remodeling in fibrillating canine.METHODS: 17 dogs were randomly divided into 2 groups: normal control group (SR,n=6) and atrial fibrillation (AF,n=11) group.AF was induced by rapid pacing for 8 weeks and all dogs underwent transthoratic echocardiography before and after rapid pacing.The mRNA and protein expression of calpainⅠ,calpainⅡand calpastatin were assessed by real-time quantitative PCR and Western blotting,respectively.RESULTS: Compared with SR group,the left atrial diameters and the content of calcium in atrial myocardium increased significantly in AF group (P<0.05).There was no significant difference in mRNA expression of calpainⅠand calpainⅡ (P>0.05) between two groups.The expression of calpastatin mRNA was upregulated significantly in AF group (P<0.05).The levels of calpainⅠand calpainⅡprotein were significantly increased in AF group compared with SR group (P<0.05).The expression of calpastatin protein was significantly decreased in AF group (P<0.05).The calpainⅠand calpainⅡprotein levels were positively correlated with the left atrial diameter.The calpastatin protein level was negatively correlated with the left atrial diameter (P<0.05).CONCLUSION: The changes of the calpain system protein expression in AF result in the disturbance of calpain/calpastatin system and degradation of many proteins,which may play an important role in mechanism of atrial remodeling.     

Effects of atorvastatin on atrial electrical remodeling in a rabbit model of chronic atrial fibrillation

AIM: To evaluate the effects of atorvastatin (ATO) on atrial electrical remodeling in a rabbit mo-del of chronic atrial fibrillation (AF) produced by 3 weeks of rapid atrial pacing (RAP). METHODS: The sternotomy was performed and the pacing and testing electrodes were fixed to the left atria of 24 New Zealand white rabbits. The animals were randomly divided into 3 groups. The rabbits in model group and ATO group were subjected to RAP for 3 weeks, and then were treated with placebo and ATO (2.5 mg·kg^-1·d^-1), respectively. The rabbits in sham group did not receive RAP and drugs. Electrophysiological examination was performed to test heart rate, P-wave duration, atrial effective refractory period (AERP) and AF inducibility. The protein expression levels of Cav1.2, Kv4.3 and myeloperoxidase (MPO) were detected by Western blot. RESULTS: Sustained AF was induced in 5 and 4 rabbilts in model group and atorvastatin group and no rabbits in sham group was found. After 3 weeks of RAP, compared with sham group, heart rate and P-wave duration were increased and AERP was shortened in model group and ATO group (P<0.05). Compared with model group, AERP was increased in ATO group (P<0.05), while heart rate and P-wave duration had no difference between these 2 groups. Compared with sham group, the protein levels of Cav1.2 and Kv4.3 were decreased, and protein level of MPO was increased in model group and ATO group (P<0.05). Compared with model group, Cav1.2 was increased and MPO was decreased in ATO group (P<0.05), while Kv4.3 had no difference between these 2 groups. CONCLUSION: Atorvastatin suppresses the down-regulation of atrial Cav1.2 protein level and the shortening of AERP, thus preventing atrial electrical remodeling in a rabbit model of chronic AF. The effect of atrovastatin on reducing atrial MPO level may be the potential mechanism.     

Effects of spironolactone on atrial structural remodeling in rabbit model of chronic atrial fibrillation

AIM: To evaluate the effects and potential mechanism of spironolactone (SP) on atrial structural remodeling in rabbit model of chronic atrial fibrillation (AF). METHODS: The sternotomy was performed and the pacing electrodes were fixed to the left atria of New Zealand white rabbits. The animals were randomly divided into 3 groups. The rabbits were subjected to rapid atrial pacing (RAP) for 3 weeks in RAP group (intragastric administration with placebo) and RAP+SP group (intragastric administration with spironolactone at 20 mg·kg^-1·d^-1), respectively. The rabbits in sham group did not receive RAP and drugs. Before and after RAP, the structure and function of the atria were evaluated and AF inducibility was tested. After RAP, the atrial fibrosis was evaluated, and the expression levels of collagen I, collagen Ⅲ, matrix metalloproteinase (MMP)-2 and MMP-9 were determined. RESULTS: After 3 weeks of RAP, compared with sham group, obvious left atrial enlargement and dysfunction were observed in RAP group and RAP+SP group, but those had no significant differences in these 2 groups. Sustained AF was induced in 7, 5, and 0 rabbits in RAP group, RAP+SP group, and sham group, respectively. Compared with sham group, atrial interstitial fibrosis and the protein expression levels of collagen Ⅰ, collagen Ⅲ, MMP-2 and MMP-9 were all significantly increased in RAP group and RAP+SP group(P<0.05). Compared with RAP group, the the above indexes were all decreased in RAP+SP group(P<0.05). CONCLUSION: Spironolactone suppresses the atrial interstitial fibrosis and collagen expression, thus preventing atrial structural remodeling in rabbit model of chronic AF. The effect of spironolactone on reducing atrial MMP-2 and MMP-9 levels may be the potential mechanism.     

Effects of simulated ischemia/reperfusion on spontaneous action potentials in primary cultured sinoatrial node cells and the influence of pinacidil

AIM: To study the effects of ischemia/reperfusion (I/R) on primary cultured sinoatrial node (SAN) cells and the influence of pinacidil (a K_ATP channel activator). METHODS: The SAN cells were isolated from newborn rats and purified. The 48 h cultured cells were cultivated in following mediums: simulated reperfusion solution as normal control, simulated ischemia/reperfusion solution (I/R), Pinacidil+I/R (P+I/R), 5-HD+P+I/R and 5-HD+I/R. Spontaneous action potentials were recorded by ruptured-patch whole-cell technique in current clamp (I=0) and the maximum diastolic potential (MDP), upstroke velocity (UV), action potential overshoot (APO), interbeat interval (IBI) and action potential durations at 50% repolarization (APD₅₀) were measured. RESULTS: Compared with control group, simulated ischemia/reperfusion shorten APD₅₀, reduced UV, MDP and APO. Exposed to pinacidil, MDP of cells in I/R groups was hyperpolarized; IBI, UV and APO were increased; APD₅₀ was shorten. 5-HD couldn't block the effects of pinacdil on APD₅₀, IBI and MDP, but reversed its actions on increasing UV and APO. CONCLUSIONS: Pinacidil made changes of AP in I/R group by opening different K_ATP channels of SAN cells. The role of this changes on protection in SAN cells during ischemia/reperfusion requires further investigation.     

Relationship between fibrosis and remodeling of gap junction in atrium of patients with atrial fibrillation

AIM: To examine fibrosis and remodeling of gap junction in atrial myocardium of patients with or without atrial fibrillation and to investigate the relationship between them. METHODS: Right atrial appendage (RAA) samples were collected from 44 patients with rheumatic heart disease during heart operation, 28 of which were clinically diagnosed as atrial fibrillation (AF), the left remained sinus rhythm (SR). Fibrosis and remodeling of connexin 43 were examined by polarization microscope and microscopy respectively, and analyzed with an image analyzer. Meanwhile, intercalated disc was counted under transmission electron microscope. The collagen volume fraction of type I (CVF-I) and the volume fraction of Cx43 (Cx43VF) were studied between groups of atrial fibrillation and sinus rhythm. The relationship between CVF-I and fraction of remodeled intercalated disc was studied as well. RESULTS: (1) Polarization microscope demonstrated that CVF-I collagen increased (P<0.01) in atrial fibrillation group. (2) The ratio of remodeled of intercalated disc in patients with AF was higher (P<0.01) than that in SR group whereas the number of intercalated disc was not different (P>0.05) between the two groups. (3) Cx43VF decreased (P<0.01) in the AF patients compared to those with SR. (4) A positive correlation between fibrosis and the remodeling of intercalated disc (r=0.96, P<0.01) was observed. The CVF-I was negatively correlated with the Cx43VF (r=-0.98, P<0.01). CONCLUSION: These results suggest that both fibrosis of atrial muscle and remodeling of intercalated disc are involved in the pathogenesis of human atrial fibrillation. Fibrosis of atrial muscle may play an important role in the process of atrial fibrillation by interfering with remodeling of intercalated disc and thereby involves in the remodeling of connexins.     

Effects of cardiac remodeling on atrial arrhythmogenesis in aged rabbit left atrium

AIM: To investigate the effects of myocardial remodeling of aged left atrium (LA) on atrial arrhythmogenesis in rabbits.METHODS: The male New Zealand rabbits were divided into young LA and aged LA groups. By observing the changes of monophasic action potential (MAP) and burst-pacing in LA of the rabbits in vivo, the main cardioelectrophysiological parameters such as resting membrane potential (RMP), action potential amplitude (APA), ma-ximum rise veloctiy of action potential (dv/dt_max), plateau potential and action potential duration at 30%, 50% and 90% (APD₃₀, APD₅₀ and APD₉₀), as well as the inducibility and duration of atrial arrhythmias were recorded. L-type calcium current (I_Ca,L) was analyzed via whole-cell patch-clamp technique in enzymatically dissociated single rabbit LA myocytes. The myocardial collagen content was quantified after Masson staining, and the ultrastructure of the LA cells was observed under scanning electron microscope. The expression of Cav1.2 in LA tissue of the 2 groups was detected by Western blot.RESULTS: Compared with young LA group, dv/dt_max and plateau potential were significantly decreased, APD₃₀ and APD₅₀ were shortened, and APD₉₀ was notably prolongated in aged LA group (P<0.01). The inducibility or duration of atrial arrhythmias was severely increased or prolongated in aged LA group (P<0.01). With voltage clamp model, the density of I_Ca,L in aged LA group was significantly decreased, and current-voltage curve was notably moved upward compared with young LA group. When the clamp potential was +20 mV, the density of I_Ca,L was notably modified from (11.72±1.39) pA/pF in young LA group to (6.08±0.98) pA/pF in aged LA group (P<0.01). Compared with young LA group, the protein level of collagen was significantly increased (P<0.01), and the arrange of atrial myocytes was irregular in LA of rabbits in aged LA group. The atrial myocytes of the LA wall in aged LA group exhibited abnormal ultrastructural alterations, such as karyopyknosis, irregular and swelling mitochondria with the presence of vacuoles, and mild and severe sarcomere degeneration. Compared with those in LA tissues of young rabbits, the expression levels of Cav1.2 in the LA tissues of aged rabbits were severely reduced (P<0.01), and had a significant positive correlation with the reduction of I_Ca,L (r=0.83, P<0.01).CONCLUSION: The pathophysiological characteristics of aged LA are significantly altered, and might contribute to vulnerability and susceptibility of occurrence of atrial fibillation in aged rabbits. The mechanisms might completely attribute to the notable reduction of I_Ca,L, abnormal alterations of ultrastructures and obvious decrease in the expression of Cav1.2 in the aged LA of aged rabbits.     

Over-expressed calreticulin interacts with integrin-α5 and calcineurin system to induce atrial remodeling in patients with atrial fibrillation and valvular disease

AIM: To determine whether calreticulin over-expression contributes to atrial fibrosis in the patients with atrial fibrillation (AF) and valvular heart disease (VHD).METHODS: Right and left atrial specimens were obtained from 78 patients undergoing valve replacement surgery. The patients were divided into sinus rhythm (SR) group, paroxysmal AF (PaAF) group and persistent AF (PeAF, AF lasting >6 months) group. The protein expression of calreticulin, integrin-α5, and transforming growth factor-β1 (TGF-β1) was measured. Immunoprecipitation was also performed to determine whether calreticulin interacted with either calcineurin B or integrin-α5. RESULTS: The protein expression of calreticulin, integrin-α5 and TGF-β1 was increased in AF groups, especially in the left atrium of the patients with mitral valve disease as compared with SR group. Calreticulin interacted with both calcineurin B and integrin-α5. The expression level of integrin-α5 was significantly correlated with the expression level of TGF-β1, while the expression level of calreticulin was correlated with that of integrin-α5 and TGF-β1. Under similar classification of the cardiac function, the expression level of calreticulin in PeAF group was higher than that in SR group. CONCLUSION: The expression of calreticulin, integrin-α5, and TGF-β1 is increased in the atrial tissues of the AF patients and is related to the AF type, suggesting that calreticulin is involved in atrial remodeling in AF and VHD patients.     

Cx43 is involved in electrical remodeling of atrial myocytes through regulating L-type calcium current

AIM: To investigate whether the association of connexin 43(Cx43) and L-type calcium channel involved in the pathogenesis of atrial fibrillation (AF). METHODS: The biochemical assays and whole-cell patch-clamp technique were used to study the expression of Cx43 in human atrial tissue. The co-localization of Cx43 and L -type calcium channel, and the regulation of L-type calcium current in atrial myocytes were investigated. RESULTS: The expression of Cx43 at mRNA and protein levels was decreased in human atrial tissues of AF patients. In cultured atrium-derived myocytes (HL-1 cells), knockdown of Cx43 significantly inhibited the mRNA expression of L-type calcium channel α1c subunit, as well as L-type calcium current. Co-localization of Cx43 with L-type calcium channel α1c subunit in mouse atrial myocytes was observed. CONCLUSION: The decrease in Cx43 is involved in the pathogenesis of AF, probably through reducing the L-type calcium current in atrial myoctyes by co-localization with L-type calcium channel, thus representing the potential pathogenesis in atrial fibrillation.     

Effects of serum from patients with atrial fibrillation on chemotaxis of cardiac fibroblasts

AIM: To investigate the effects of the serum from the patients with atrial fibrillation (AF) on the chemotaxis of rat cardiac fibroblasts.METHODS: Cardiac fibroblasts were isolated from the ventricles of neonatal Sprague-Dawley rats and primarily cultured with digestion and differential adhesion. The cells in 3 to 4 passages were used for Transwell chamber assay to determine the chemotatic effects of the sera.RESULTS: Compared with control group, the cells that migrated through the polycarbonate membrane were obviously increased in AF group. The strongest chemotaxis was induced by the serum from the patients with persistent atrial fibrillation(pers-AF).The number of migrated cells in non-AF atrial arrhythmia(AA) group was higher than that in paroxysmal atrial fibrillation(paro-AF) group, and that in control group was the lowest. The results of multiple Logistic regression analysis showed that the migrated cells were related to AF and left atrial diameter.CONCLUSION: The chemotactic effect of AF serum is obviously higher than that of control serum. The differences of AF sera among groups show that myocardial fibrosis is a chronic, insidious and delayed process. The migration and infiltration of cardiac fibroblasts indirectly reflect the presence, severity and extent of the myocardial damage. The changes of migrated cells precede the changes of left atrial diameter, indicating that the cause of fibrosis is more important, and the positive correlation between AF and left atrial diameter may not be the direct causality.     

Expression of MPO,MMP-2 and MMP-9 in atrial myocardium of rabbit atrial fibrillation model

ATM: To investigate the expression of myeloperoxidase (MPO), matrix metalloproteinase (MMP)-2 and MMP-9 in the atrial myocardium, and their potential effects on atrial structural remodeling in a rabbit atrial fibrillation (AF) model. METHODS: The sternotomy was performed and the pacing electrode was fixed to the left atria of 20 New Zealand white rabbits. The animals were randomly divided into 2 groups:rapid atrial pacing (RAP) group and sham group. The rabbits in RAP group were subjected to RAP for 3 weeks. The structure and function of the atria and ventricle were analyzed by echocardiography. Atrial burst stimulation was performed to test AF inducibility. The atrial fibrosis was evaluated by Masson trichrome-staining. The mRNA and protein levels of MPO, MMP-2 and MMP-9 were detected by RT-qPCR and Western blot. RESULTS: After 3 weeks of RAP, obvious left atrial enlargement and dysfunction were observed, but almost no change of left ventricular diameter and function was found in RAP group compared with sham group. AF inducibility, atrial interstitial fibrosis and the mRNA and protein levels of MPO, MMP-2 and MMP-9 were all significantly increased in RAP group compared with sham group. CONCLUSION: Obvious atrial structural remodeling is found in the rabbit AF model induced by sustained RAP, and the up-regulation of MPO, MMP-2 and MMP-9 may be the potential molecular mechanism of atrial structural remodeling.     

Non-contact mapping and frequency analysis of vagal-mediated atrial fibrillation

AIM: To explore the mechanism of the initiation and maintenance of vagal-mediated atrial fibrillation (AF) by non-contact mapping and frequency analysis of vagal-mediated atrial fibrillation in canine.METHODS: Atrial effective refractory period (AERP) and dispersion of AERP were measured in 8 canine during baseline and bilateral cervical vagal nerve stimulation (CVNS). Left atrium (LA) and right atrium (RA) electrical activity of AF was assessed by non-contact mapping and frequency analysis.RESULTS: Compared with baseline, CVNS attenuated left and right AERP, but only increased the dispersion of left AERP. During CVNS, AF was easily induced and maintained, repetitive organized activations rotated around a preferential route were only found in the LA, and dominant frequencies (DFs) from LA were higher than those of the RA ［(12.5±1.5)Hz vs (9.3±1.2)Hz, P<0.01］. After the cessation of CVNS, DFs of AF decreased in the LA and RA ［(9.2±0.5)Hz vs (8.5±0.6)Hz, P>0.05］, and AF was spontaneously terminated.CONCLUSION: The change of electrophysiological character, difference of activation pattern, and frequency gradient between the LA and RA suggest that the initiation and maintenance of vagal-mediated AF dependent on the LA.     

Activation of extracellular-signal regulated kinase and protein phosphatases in human atria during atrial fibrillation

AIM: The purpose of this study was to determine whether the signal transduction systems were activated at the molecular atrial tissue level in patients with atrial fibrillation (AF) and whether atrial expression of extracellular-signal regulated kinase (ERK) and protein phosphatases is altered. METHODS: Atrial tissue sample of 30 patients undergoing cardiac surgery were examined. 20 patients had AF, 10 patients had no history of AF. The mRNA expression of calcineurin B and MKP-1 were detected by semi-quantitative RT-PCR. ERK1 and phospho-ERK1 were analyzed at the protein level by Western blot. RESULTS: Western blot analysis showed that atrial fibrillation did not induce significant change in ERK1 expression level in the left atrium. In contrast , phospho-ERK1 content was increased in the patients with AF in comparison with those who had sinus rhythm (SR). The mRNA expression of calcineurin B and MKP-1 in the patients with AF were significantly higher than that in patients with SR. CONCLUSION: The activation of extracellular-signal regulated kinase and protein phosphatases may have correlation with the initiation or maintenance of atrial fibrillation.     

Effect of fluvastatin on left ventricular remodeling after myocardial infarction in rats

AIM: To clarify the protective effect of long-term administration of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor fluvastatin on ventricular remodeling after myocardial infarction (MI) in rats and its mechanisms. METHODS: Myocardial infarction were established by ligated left coronary anterior artery in SD rats, 24 hours after the operation, the survival rats were treated by gavage fluvastatin (20 mg·kg^-1·d^-1) or distilled water for 8 weeks. Doppler echocardiography, homodynamic and cardiac histomorphometry were used to assess the ventricular remodeling and cardiac function. The plasma levels of total cholesterol (Tch), creatinine (Cr), glutamic-oxal (o) acetic transaminase (AST), lipid peroxidation (LPO), glutathione perioxidase (GSH-PX), nitrogen monoxide (NO₂^-/NO₃^-) were detected. RESULTS: The Tch, Cr and AST were not significant difference in groups. Left ventricular end-diastole pressure, right relative weight, left ventricular posterior wall thickness, collagen volume fraction and the lung weight were decreased in AMI+fluvastatin group compared to AMI group (P＜0.05, P<0.01); The levels of LPO, NO₂^-+NO₃^- in plasma and LPO in myocardium decreased, but plasma GSH-PX level increased in AMI+fluvastatin group (P＜0.05). CONCLUSION: Fluvastatin ameliorates the ventricular structural remodeling in a rat model of infarction, and delays the development of heart failure. The anti-oxidation mechanism of fluvastatin may take part in this process.     

Effect of atrial natriuretic peptide on acute lung injury induced by lipopolysaccharide

AIM: To investigate effect of atrial natriuretic peptide (ANP) on acute lung injury (ALI) induced by lipopolysaccharide (LPS) in rat. METHODS: Mean arterial blood pressure (MAP) was recorded with model 6280 physiology intelligentialize grapher, nitric oxide (NO) and endothelin (ET) concentrations in plasma were measured after lipopolysaccharide (LPS) or following LPS ,ANP was injected into vein in rats. After experiment,lung water as well as pulmonary histopathological changes was measured and observed, respectively. RESULTS: Administration of LPS elicited a persistence decrease in MAP (8.1 kPa±2.6 kPa,at 4 h,P<0.01 vs control); NO and ET concentration in plasma was evident higher than that in control group, respectively (P<0.01); Wet-dry ratio of lung was higher than that in control group (5.15±0.43,at 4 h) (P<0.05); Alveolus detelectasis was observed and pulmonary mesenchyme was thicker than that in control group. No erythrocyte and leukocytes in alveolus,which show an interstitial pulmonary edema, was observed in LPS+ANP group, ANP maintained MAP at higher levels (13.35 kPa±2.93 kPa, at 4 h, P<0.05 vs LPS) after an transient decline when LPS was injected; NO and ET concentration of plasma had all significantly decrease, respectively (P<0.05 vs LPS, at 4 h); Wet-dry ratio of lung was lower than LPS group (4.57±0.35, P<0.05). Compared with control group the ratio was not evident difference (P>0.05); The histopathological of lung displayed markedly improved. CONCLUSION: ANP attenuates ALI induced by LPS in the rat. The effect of ANP may be via decreasing secretion of ET,NO and regulation arterial blood pressure.