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Title: Arrhythmogenic mechanisms in the isolated perfused hypokalaemic murine heart
Authors: Killeen, M. J.
Goddard, C. A.
Fraser, J. A.
Mahaut-Smith, Martin P.
Colledge, W. H.
Huang, CL-H.
Thomas, G.
Gurung, I. S.
Grace, A. A.
Killeen, M. J.
First Published: Jan-2007
Publisher: Wiley
Citation: Acta Physiologica, 2007, 189 (1), pp. 33-46
Abstract: Aim:  Hypokalaemia is associated with a lethal form of ventricular tachycardia (VT), torsade de pointes, through pathophysiological mechanisms requiring clarification. Methods:  Left ventricular endocardial and epicardial monophasic action potentials were compared in isolated mouse hearts paced from the right ventricular epicardium perfused with hypokalaemic (3 and 4 mm [K[superscript: +]]o) solutions. Corresponding K[superscript: +] currents were compared in whole-cell patch-clamped epicardial and endocardial myocytes. Results:  Hypokalaemia prolonged epicardial action potential durations (APD) from mean APD90s of 37.2 ± 1.7 ms (n = 7) to 58.4 ± 4.1 ms (n =7) and 66.7 ± 2.1 ms (n = 11) at 5.2, 4 and 3 mm [K[superscript: +]]o respectively. Endocardial APD90s correspondingly increased from 51.6 ± 1.9 ms (n = 7) to 62.8 ± 2.8 ms (n = 7) and 62.9 ± 5.9 ms (n = 11) giving reductions in endocardial–epicardial differences, ΔAPD90, from 14.4 ± 2.6 to 4.4 ± 5.0 and −3.4 ± 6.0 ms respectively. Early afterdepolarizations (EADs) occurred in epicardia in three of seven spontaneously beating hearts at 4 mm [K[superscript: +]]o with triggered beats followed by episodes of non-sustained VT in nine of 11 preparations at 3 mm. Programmed electrical stimulation never induced arrhythmic events in preparations perfused with normokalemic solutions yet induced VT in two of seven and nine of 11 preparations at 4 and 3 mm [K[superscript: +]]o respectively. Early outward K[superscript: +] current correspondingly fell from 73.46 ± 8.45 to 61.16±6.14 pA/pF in isolated epicardial but not endocardial myocytes (n = 9) (3 mm [K[superscript: +]]o). Conclusions:  Hypokalaemic mouse hearts recapitulate the clinical arrhythmogenic phenotype, demonstrating EADs and triggered beats that might initiate VT on the one hand and reduced transmural dispersion of repolarization reflected in ΔAPD90 suggesting arrhythmogenic substrate on the other.
DOI Link: 10.1111/j.1748-1716.2006.01643.x
ISSN: 1748-1708
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2007 The Authors Journal compilation © 2007 Scandinavian Physiological Society. Reuse of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation
Appears in Collections:Published Articles, Dept. of Cell Physiology and Pharmacology

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