Vascular endothelial growth factor promotes atrial arrhythmias by inducing acute intercalated disk remodeling
Abstract Atrial fibrillation (AF) is the most common arrhythmia and is associated with inflammation. AF patients have elevated levels of inflammatory cytokines known to promote vascular leak, such as vascular endothelial growth factor A (VEGF). However, the contribution of vascular leak and conseque...
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doaj-339058eefeee476198027db5f79e00fe2020-12-08T13:02:08ZengNature Publishing GroupScientific Reports2045-23222020-11-0110111410.1038/s41598-020-77562-5Vascular endothelial growth factor promotes atrial arrhythmias by inducing acute intercalated disk remodelingLouisa Mezache0Heather L. Struckman1Amara Greer-Short2Stephen Baine3Sándor Györke4Przemysław B. Radwański5Thomas J. Hund6Rengasayee Veeraraghavan7Department of Biomedical Engineering, College of Engineering, The Ohio State UniversityDepartment of Biomedical Engineering, College of Engineering, The Ohio State UniversityThe Frick Center for Heart Failure and Arrhythmia, Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical CenterThe Frick Center for Heart Failure and Arrhythmia, Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical CenterThe Frick Center for Heart Failure and Arrhythmia, Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical CenterThe Frick Center for Heart Failure and Arrhythmia, Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical CenterDepartment of Biomedical Engineering, College of Engineering, The Ohio State UniversityDepartment of Biomedical Engineering, College of Engineering, The Ohio State UniversityAbstract Atrial fibrillation (AF) is the most common arrhythmia and is associated with inflammation. AF patients have elevated levels of inflammatory cytokines known to promote vascular leak, such as vascular endothelial growth factor A (VEGF). However, the contribution of vascular leak and consequent cardiac edema to the genesis of atrial arrhythmias remains unknown. Previous work suggests that interstitial edema in the heart can acutely promote ventricular arrhythmias by disrupting ventricular myocyte intercalated disk (ID) nanodomains rich in cardiac sodium channels (NaV1.5) and slowing cardiac conduction. Interestingly, similar disruption of ID nanodomains has been identified in atrial samples from AF patients. Therefore, we tested the hypothesis that VEGF-induced vascular leak can acutely increase atrial arrhythmia susceptibility by disrupting ID nanodomains and slowing atrial conduction. Treatment of murine hearts with VEGF (30–60 min, at clinically relevant levels) prolonged the electrocardiographic P wave and increased susceptibility to burst pacing-induced atrial arrhythmias. Optical voltage mapping revealed slower atrial conduction following VEGF treatment (10 ± 0.4 cm/s vs. 21 ± 1 cm/s at baseline, p < 0.05). Transmission electron microscopy revealed increased intermembrane spacing at ID sites adjacent to gap junctions (GJs; 64 ± 9 nm versus 17 ± 1 nm in controls, p < 0.05), as well as sites next to mechanical junctions (MJs; 63 ± 4 nm versus 27 ± 2 nm in controls, p < 0.05) in VEGF–treated hearts relative to controls. Importantly, super-resolution microscopy and quantitative image analysis revealed reorganization of NaV1.5 away from dense clusters localized near GJs and MJs to a more diffuse distribution throughout the ID. Taken together, these data suggest that VEGF can acutely predispose otherwise normal hearts to atrial arrhythmias by dynamically disrupting NaV1.5-rich ID nanodomains and slowing atrial conduction. These data highlight inflammation-induced vascular leak as a potential factor in the development and progression of AF.https://doi.org/10.1038/s41598-020-77562-5 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Louisa Mezache Heather L. Struckman Amara Greer-Short Stephen Baine Sándor Györke Przemysław B. Radwański Thomas J. Hund Rengasayee Veeraraghavan |
spellingShingle |
Louisa Mezache Heather L. Struckman Amara Greer-Short Stephen Baine Sándor Györke Przemysław B. Radwański Thomas J. Hund Rengasayee Veeraraghavan Vascular endothelial growth factor promotes atrial arrhythmias by inducing acute intercalated disk remodeling Scientific Reports |
author_facet |
Louisa Mezache Heather L. Struckman Amara Greer-Short Stephen Baine Sándor Györke Przemysław B. Radwański Thomas J. Hund Rengasayee Veeraraghavan |
author_sort |
Louisa Mezache |
title |
Vascular endothelial growth factor promotes atrial arrhythmias by inducing acute intercalated disk remodeling |
title_short |
Vascular endothelial growth factor promotes atrial arrhythmias by inducing acute intercalated disk remodeling |
title_full |
Vascular endothelial growth factor promotes atrial arrhythmias by inducing acute intercalated disk remodeling |
title_fullStr |
Vascular endothelial growth factor promotes atrial arrhythmias by inducing acute intercalated disk remodeling |
title_full_unstemmed |
Vascular endothelial growth factor promotes atrial arrhythmias by inducing acute intercalated disk remodeling |
title_sort |
vascular endothelial growth factor promotes atrial arrhythmias by inducing acute intercalated disk remodeling |
publisher |
Nature Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2020-11-01 |
description |
Abstract Atrial fibrillation (AF) is the most common arrhythmia and is associated with inflammation. AF patients have elevated levels of inflammatory cytokines known to promote vascular leak, such as vascular endothelial growth factor A (VEGF). However, the contribution of vascular leak and consequent cardiac edema to the genesis of atrial arrhythmias remains unknown. Previous work suggests that interstitial edema in the heart can acutely promote ventricular arrhythmias by disrupting ventricular myocyte intercalated disk (ID) nanodomains rich in cardiac sodium channels (NaV1.5) and slowing cardiac conduction. Interestingly, similar disruption of ID nanodomains has been identified in atrial samples from AF patients. Therefore, we tested the hypothesis that VEGF-induced vascular leak can acutely increase atrial arrhythmia susceptibility by disrupting ID nanodomains and slowing atrial conduction. Treatment of murine hearts with VEGF (30–60 min, at clinically relevant levels) prolonged the electrocardiographic P wave and increased susceptibility to burst pacing-induced atrial arrhythmias. Optical voltage mapping revealed slower atrial conduction following VEGF treatment (10 ± 0.4 cm/s vs. 21 ± 1 cm/s at baseline, p < 0.05). Transmission electron microscopy revealed increased intermembrane spacing at ID sites adjacent to gap junctions (GJs; 64 ± 9 nm versus 17 ± 1 nm in controls, p < 0.05), as well as sites next to mechanical junctions (MJs; 63 ± 4 nm versus 27 ± 2 nm in controls, p < 0.05) in VEGF–treated hearts relative to controls. Importantly, super-resolution microscopy and quantitative image analysis revealed reorganization of NaV1.5 away from dense clusters localized near GJs and MJs to a more diffuse distribution throughout the ID. Taken together, these data suggest that VEGF can acutely predispose otherwise normal hearts to atrial arrhythmias by dynamically disrupting NaV1.5-rich ID nanodomains and slowing atrial conduction. These data highlight inflammation-induced vascular leak as a potential factor in the development and progression of AF. |
url |
https://doi.org/10.1038/s41598-020-77562-5 |
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