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Attenuating persistent sodium current–induced atrial myopathy and fibrillation by preventing mitochondrial oxidative stress
Uma Mahesh R. Avula, Haikel Dridi, Bi-xing Chen, Qi Yuan, Alexander N. Katchman, Steven R. Reiken, Amar D. Desai, Samantha Parsons, Haajra Baksh, Elaine Ma, Parmanand Dasrat, Ruiping Ji, Yejun Lin, Christine Sison, W. Jonathan Lederer, Humberto C. Joca, Christopher W. Ward, Maura Greiser, Andrew R. Marks, Steven O. Marx, Elaine Y. Wan
Uma Mahesh R. Avula, Haikel Dridi, Bi-xing Chen, Qi Yuan, Alexander N. Katchman, Steven R. Reiken, Amar D. Desai, Samantha Parsons, Haajra Baksh, Elaine Ma, Parmanand Dasrat, Ruiping Ji, Yejun Lin, Christine Sison, W. Jonathan Lederer, Humberto C. Joca, Christopher W. Ward, Maura Greiser, Andrew R. Marks, Steven O. Marx, Elaine Y. Wan
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Research Article Cardiology

Attenuating persistent sodium current–induced atrial myopathy and fibrillation by preventing mitochondrial oxidative stress

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Abstract

Mechanistically driven therapies for atrial fibrillation (AF), the most common cardiac arrhythmia, are urgently needed, the development of which requires improved understanding of the cellular signaling pathways that facilitate the structural and electrophysiological remodeling that occurs in the atria. Similar to humans, increased persistent Na+ current leads to the development of an atrial myopathy and spontaneous and long-lasting episodes of AF in mice. How increased persistent Na+ current causes both structural and electrophysiological remodeling in the atria is unknown. We crossbred mice expressing human F1759A-NaV1.5 channels with mice expressing human mitochondrial catalase (mCAT). Increased expression of mCAT attenuated mitochondrial and cellular reactive oxygen species (ROS) and the structural remodeling that was induced by persistent F1759A-Na+ current. Despite the heterogeneously prolonged atrial action potential, which was unaffected by the reduction in ROS, the incidences of spontaneous AF, pacing-induced after-depolarizations, and AF were substantially reduced. Expression of mCAT markedly reduced persistent Na+ current–induced ryanodine receptor oxidation and dysfunction. In summary, increased persistent Na+ current in atrial cardiomyocytes, which is observed in patients with AF, induced atrial enlargement, fibrosis, mitochondrial dysmorphology, early after-depolarizations, and AF, all of which can be attenuated by resolving mitochondrial oxidative stress.

Authors

Uma Mahesh R. Avula, Haikel Dridi, Bi-xing Chen, Qi Yuan, Alexander N. Katchman, Steven R. Reiken, Amar D. Desai, Samantha Parsons, Haajra Baksh, Elaine Ma, Parmanand Dasrat, Ruiping Ji, Yejun Lin, Christine Sison, W. Jonathan Lederer, Humberto C. Joca, Christopher W. Ward, Maura Greiser, Andrew R. Marks, Steven O. Marx, Elaine Y. Wan

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Figure 1

Expression of mitochondrial catalase does not attenuate F1759A-induced Na+ current.

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Expression of mitochondrial catalase does not attenuate F1759A-induced N...
(A) The transgene system permitting expression of FLAG-F1759A-NaV1.5 when reverse tetracycline-controlled transactivator (rtTA) and doxycycline are present (Tet-ON). Top: rtTA-driven expression by the cardiac-specific α–myosin heavy chain (α-MHC) promoter. The 3 noncoding exons that make up the 5′-UTR of the α-MHC gene are depicted as boxes and the introns as lines. Bottom: cDNA for FLAG-F1759A-NaV1.5 ligated behind 7 tandem tetO sequences. (B, C, and G) Exemplary whole-cell Na+ current (INa) traces of atrial cardiomyocytes isolated from control nontransgenic, F1759A-NaV1.5, and F1759A-mCAT mice. Persistent INa was evaluated with a 190 ms depolarization from a holding potential of –110 mV to –30 mV in the absence (black) and presence (green) of ranolazine; 5 mM Na+ in the intracellular solution, and 100 mM Na+ in the extracellular solution. Inset: Peak INa and fraction of lidocaine-resistant current, whole-cell current traces were recorded with 5 mM Na+ in extracellular and intracellular solutions, in the absence (black) and presence (blue) of 3 mM lidocaine. (D) Intracellular Na+ concentration ([Na+]i) in nontransgenic (NTG) and F1759A-NaV1.5 in quiescent (0 Hz) and field-stimulated (1 Hz) atrial cardiomyocytes. Two-way repeated measures ANOVA, P = 0.016, Tukey’s multiple-comparison test: * P < 0.05, ** P = 0.01. n = 5 mice/group. (E) Mitochondria-directed catalase–driven expression by chicken actin/CMV promoter (28). (F) Anti-FLAG (upper) and anti-tubulin immunoblots (lower) of cardiac homogenates of F1759A-NaV1.5 and F1759A-mCAT mice. Representative of 3 experiments. See complete unedited blots in the supplemental material. (H) Peak INa density recorded with 5 mM external Na+. P = 0.46; 1-way ANOVA. (I) Capacitance-normalized peak INa resistance to 3 mM lidocaine. P = 0.86; t test. (J) Persistent INa normalized to peak current. One-way ANOVA, P < 0.001; ** P < 0.01; *** P < 0.001. Mean ± SEM.

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