Acetylcholine as an age-dependent non-neuronal source in the heart
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Updated: Jun 12, 2026

Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System
Published on: May 22, 2018
Obaida R Rana1, Patrick Schauerte, Rahel Kluttig
1Department of Cardiology, RWTH Aachen University, Aachen, 52074, Germany. orana@ukaachen.de
Insights
Adult cardiomyocytes synthesize, transport, and excrete acetylcholine (ACh), a process down-regulated in older rats. This cardiac acetylcholine (ACh) pathway may influence heart cell communication and function.
Area of Science:
- Cardiovascular Physiology
- Cellular Biology
- Neurochemistry
Background:
- Acetylcholine (ACh) is known for its cardiovascular effects and anti-inflammatory roles.
- Neuronal cells were previously considered the sole source of ACh in the heart.
- The role of cardiomyocytes in ACh synthesis and function remained unexplored.
Purpose of the Study:
- To investigate whether cardiomyocytes can synthesize, transport, and excrete acetylcholine (ACh).
- To examine age-dependent changes in cardiomyocyte ACh handling in a rat model.
Main Methods:
- Real-time PCR, Western blot, and immunofluorescence to assess enzyme and transporter expression.
- High-performance liquid chromatography (HPLC) to quantify ACh excretion.
- Use of a choline acetyltransferase (ChAT) inhibitor (Bromo-acetylcholine) to confirm synthesis pathway.
Main Results:
- Adult cardiomyocytes express choline acetyltransferase (ChAT), choline transporter-1 (CHT-1), and vesicular acetylcholine transporter (VAChT).
- ChAT expression and ACh excretion are significantly reduced in aged cardiomyocytes.
- Bromo-acetylcholine treatment confirmed ChAT's role in cardiomyocyte ACh synthesis.
Conclusions:
- Adult cardiomyocytes, but not neonatal ones, synthesize, transport, and excrete ACh in the rat heart.
- Aging leads to a significant downregulation of ChAT expression and ACh excretion in cardiomyocytes.
- This discovery opens new avenues for understanding cardiomyocyte communication and cardiac pathophysiology.
Abstract:
In the heart, acetylcholine (ACh) slows pacemaker activity, depresses contractility and slows conduction in the atrioventricular node. Beside these cardiovascular effects, ACh has also been associated with an anti-inflammatory and anti-apoptotic pathway. There is no evidence for ACh synthesis and excretion in other cell types than neuronal cells in the heart. Therefore, this study investigates whether cardiomyocytes are able to synthesize, transport and excrete ACh in the heart. We chose a rat model of different aged rats (neonatal, 6-8 week = young, 20-24 month = old). By real-time PCR, Western blot and immunofluorescence experiments we could demonstrate that adult, but not neonatal cardiomyocytes, express the choline acetyltransferase (ChAT). The expression level of ChAT is down-regulated in old cardiomyocytes. Furthermore, we found that young and old cardiomyocytes express the ACh transport proteins choline transporter-1 (CHT-1) and the vesicular acetylcholine transporter (VAChT). The amount of ACh excretion detected by high performance liquid chromatography (HPLC) is significantly down-regulated in old cardiomyocytes. Bromo-acetylcholine (BrACh), a specific ChAT inhibitor, significantly decreased ACh concentrations in cardiomyocyte supernatants demonstrating that ChAT is the main ACh synthesizing enzyme in cardiomyocytes. In conclusion, we could demonstrate that adult, but not neonatal, cardiomyocytes are able to synthesize, transport and excrete ACh in the rat heart. The expression level of ChAT and the ACh excretion amount are significantly down-regulated in old cardiomyocytes. This finding may provide new physiological/pathological aspects in the communication between cardiomyocytes and other cell types in the myocardium, e.g. fibrocytes, neurocytes or endothelial cells.
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