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1Leon H. Charney Division of Cardiology, Department of Medicine and Departments of 2Cell Biology, 3Pediatric Cardiology and 4Physiology & Neuroscience and Pharmacology, New York University School of Medicine; and 5Department of Pharmacology, Columbia University College of Physicians and Surgeons, New York, New York; 6Department of Cardiology, Shandong Provincial Hospital, Jinan, Shandong, China; and 7Department of Cardiology, St Mary's Hospital, Imperial College London, United Kingdom
Submitted 5 June 2008 ; accepted in final form 26 August 2008
Gap junction redistribution and reduced expression, a phenomenon termed gap junction remodeling (GJR), is often seen in diseased hearts and may predispose toward arrhythmias. We have recently shown that short-term pacing in the mouse is associated with changes in connexin43 (Cx43) expression and localization but not with increased inducibility into sustained arrhythmias. We hypothesized that short-term pacing, if imposed on murine hearts with decreased Cx43 abundance, could serve as a model for evaluating the electrophysiological effects of GJR. We paced wild-type (normal Cx43 abundance) and heterozygous Cx43 knockout (Cx43+/–; 66% mean reduction in Cx43) mice for 6 h at 10–15% above their average sinus rate. We investigated the electrophysiological effects of pacing on the whole animal using programmed electrical stimulation and in isolated ventricular myocytes with patch-clamp studies. Cx43+/– myocytes had significantly shorter action potential durations (APD) and increased steady-state (Iss) and inward rectifier (IK1) potassium currents compared with those of wild-type littermate cells. In Cx43+/– hearts, pacing resulted in a significant prolongation of ventricular effective refractory period and APD and significant diminution of Iss compared with unpaced Cx43+/– hearts. However, these changes were not seen in paced wild-type mice. These data suggest that Cx43 abundance plays a critical role in regulating currents involved in myocardial repolarization and their response to pacing. Our study may aid in understanding how dyssynchronous activation of diseased, Cx43-deficient myocardial tissue can lead to electrophysiological changes, which may contribute to the worsened prognosis often associated with pacing in the failing heart.
ventricular myocytes; gap junction
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