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Relation between ventricular and myocyte function with tachycardia-induced cardiomyopathy
F G Spinale1, B M Fulbright, R Mukherjee
1Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston.
Insights
Chronic supraventricular tachycardia (SVT) leads to heart muscle cell dysfunction and structural changes, causing SVT cardiomyopathy. This study reveals primary defects in myocyte contractile performance and calcium responsiveness in SVT cardiomyopathy.
Area of Science:
- Cardiology
- Cell Biology
- Physiology
Background:
- Chronic supraventricular tachycardia (SVT) is known to cause left ventricular (LV) dilatation and dysfunction.
- Alterations in myocyte function and structure are suspected contributors to SVT-induced cardiomyopathy.
Purpose of the Study:
- To investigate LV function and isolated myocyte structure and function in pigs with pacing-induced SVT cardiomyopathy.
- To determine the cellular mechanisms underlying SVT cardiomyopathy.
Main Methods:
- Pacing-induced SVT cardiomyopathy in pigs (3 weeks at 240 bpm) compared to controls.
- Assessment of LV function via echocardiography and catheterization.
- Evaluation of isolated myocyte function using computer-assisted video microscopy, examining contractile performance in attached and unattached states, and calcium responsiveness.
Main Results:
- LV fractional shortening and peak +dP/dt were significantly reduced in SVT pigs.
- Isolated SVT myocytes exhibited significantly lower shortening extent and velocity in both attached and unattached states compared to controls.
- SVT myocytes showed blunted responsiveness to extracellular calcium and reduced myofibril volume.
Conclusions:
- SVT cardiomyopathy likely results from primary defects in isolated myocyte contractile performance.
- Reduced myocyte contractile function in SVT cardiomyopathy is associated with cytoarchitectural abnormalities and impaired calcium responsiveness.
Abstract:
Chronic supraventricular tachycardia (SVT) causes left ventricular (LV) dilatation and dysfunction. Changes in myocyte function and structure may be important factors in the development of SVT cardiomyopathy. Accordingly, LV function and isolated myocyte structure and function were examined in six pigs with pacing-induced SVT cardiomyopathy (3 weeks at 240 beats per minute) and six control pigs. LV function was examined by simultaneous echocardiography and catheterization, and isolated myocyte function was studied using computer-assisted video microscopy. Indexes of isolated myocyte contractile performance were examined in the unloaded, unattached state (31 control and 24 SVT cells) and after attachment to a basement membrane substrate (65 control and 45 SVT cells). LV fractional shortening and peak +dP/dt significantly decreased in SVT cells compared with control cells (12 +/- 2% versus 28 +/- 2%, and 842 +/- 61 versus 1,216 +/- 119 mm Hg/sec, respectively; p less than 0.05). Isolated myocyte percent shortening and normalized peak velocity of shortening of SVT myocytes adherent to a basement membrane were significantly lower than attached control myocytes (1.2 +/- 0.2% versus 4.3 +/- 0.3%, and 15 +/- 2 versus 37 +/- 5% resting cell length/sec, respectively; p less than 0.05). Similarly, in the unattached state, the extent and velocity of shortening of SVT myocytes were reduced by over 50% from control values. Contractile properties of attached and unattached cardiocytes were also examined in the presence of 2-8 mM extracellular Ca2+. For both attached and unattached SVT myocytes, responsiveness to increases in extracellular Ca2+ were significantly blunted from control values. Ultrastructural examination of SVT myocytes revealed that the percent volume of myofibrils within isolated myocytes was reduced from control values (46 +/- 7% versus 65 +/- 2%, p less than 0.05). In summary, SVT cardiomyopathy is probably due to a primary defect in isolated myocyte contractile performance. The reduced contractile function of SVT cardiomyopathic myocytes was associated with abnormalities in cytoarchitecture and Ca2+ responsiveness.