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Towards an integrated understanding of cardiac arrhythmogenesis − Growing roles of experimental pathology
- Source :
- Pathology International. 67:8-16
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- Cardiac arrhythmias have long been regarded as derangement of electrical impulse initiation and conduction within the heart. However, underlying mechanisms for arrhythmogenesis are not fully understood solely from the electrophysiological viewpoint. This review article discusses pathogenesis of arrhythmias from non-electrical aspects, which were elucidated by spatiotemporal imaging of functional molecules in combination with morphological analysis of living heart tissues. Intracellular Ca2+ ([Ca2+ ]i ) overload, caused by myocardial injury, provokes Ca2+ waves that could lead to abnormal excitations, i.e., triggered arrhythmias. Depressed Ca2+ release from the sarcoplasmic reticulum, caused by ischemia, heart failure, or T-tubular remodeling, results in spatiotemporally inhomogeneous [Ca2+ ]i dynamics that could disturb impulse conduction, leading to reentrant tachyarrhythmias. Impairment of the gap junction-mediated intercellular communications, which provokes derangement of impulse propagation of the myocardium, also leads to reentrant arrhythmias. Interpositions of non-cardiomyocytes, especially fibroblasts, in the myocardium could also contribute to arrhythmogenesis via heterocellular gap-junctional coupling with cardiomyocytes. Furthermore, alterations in myocardial histology, e.g., density and arrangements of myocytes in association with gap-junctional distributions, could constitute important pathologic bases of atrial fibrillation. Integration of these molecular, functional, and morphological features of the myocardium, unveiled by experimental pathological approaches, would pave a new way for understanding pathogenesis of cardiac arrhythmias.
- Subjects :
- 0301 basic medicine
Pathology
medicine.medical_specialty
Ischemia
Atrial fibrillation
General Medicine
030204 cardiovascular system & hematology
Biology
medicine.disease
Pathology and Forensic Medicine
Review article
Pathogenesis
03 medical and health sciences
Electrophysiology
030104 developmental biology
0302 clinical medicine
Heart failure
Internal medicine
cardiovascular system
medicine
Cardiology
Myocyte
Experimental pathology
cardiovascular diseases
Subjects
Details
- ISSN :
- 13205463
- Volume :
- 67
- Database :
- OpenAIRE
- Journal :
- Pathology International
- Accession number :
- edsair.doi...........941d1563400af9ce24c28390776ab08e