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Modulating cardiac conduction during metabolic ischemia with perfusate sodium and calcium in guinea pig hearts.

Authors :
George SA
Hoeker G
Calhoun PJ
Entz M 2nd
Raisch TB
King DR
Khan M
Baker C
Gourdie RG
Smyth JW
Nielsen MS
Poelzing S
Source :
American journal of physiology. Heart and circulatory physiology [Am J Physiol Heart Circ Physiol] 2019 Apr 01; Vol. 316 (4), pp. H849-H861. Date of Electronic Publication: 2019 Feb 01.
Publication Year :
2019

Abstract

We previously demonstrated that altering extracellular sodium (Na <subscript>o</subscript> ) and calcium (Ca <subscript>o</subscript> ) can modulate a form of electrical communication between cardiomyocytes termed "ephaptic coupling" (EpC), especially during loss of gap junction coupling. We hypothesized that altering Na <subscript>o</subscript> and Ca <subscript>o</subscript> modulates conduction velocity (CV) and arrhythmic burden during ischemia. Electrophysiology was quantified by optically mapping Langendorff-perfused guinea pig ventricles with modified Na <subscript>o</subscript> (147 or 155 mM) and Ca <subscript>o</subscript> (1.25 or 2.0 mM) during 30 min of simulated metabolic ischemia (pH 6.5, anoxia, aglycemia). Gap junction-adjacent perinexal width ( W <subscript>P</subscript> ), a candidate cardiac ephapse, and connexin (Cx)43 protein expression and Cx43 phosphorylation at S368 were quantified by transmission electron microscopy and Western immunoblot analysis, respectively. Metabolic ischemia slowed CV in hearts perfused with 147 mM Na <subscript>o</subscript> and 2.0 mM Ca <subscript>o</subscript> ; however, theoretically increasing EpC with 155 mM Na <subscript>o</subscript> was arrhythmogenic, and CV could not be measured. Reducing Ca <subscript>o</subscript> to 1.25 mM expanded W <subscript>P</subscript> , as expected during ischemia, consistent with reduced EpC, but attenuated CV slowing while delaying arrhythmia onset. These results were further supported by osmotically reducing W <subscript>P</subscript> with albumin, which exacerbated CV slowing and increased early arrhythmias during ischemia, whereas mannitol expanded W <subscript>P</subscript> , permitted conduction, and delayed the onset of arrhythmias. Cx43 expression patterns during the various interventions insufficiently correlated with observed CV changes and arrhythmic burden. In conclusion, decreasing perfusate calcium during metabolic ischemia enhances perinexal expansion, attenuates conduction slowing, and delays arrhythmias. Thus, perinexal expansion may be cardioprotective during metabolic ischemia. NEW & NOTEWORTHY This study demonstrates, for the first time, that modulating perfusate ion composition can alter cardiac electrophysiology during simulated metabolic ischemia.

Details

Language :
English
ISSN :
1522-1539
Volume :
316
Issue :
4
Database :
MEDLINE
Journal :
American journal of physiology. Heart and circulatory physiology
Publication Type :
Academic Journal
Accession number :
30707595
Full Text :
https://doi.org/10.1152/ajpheart.00083.2018