Increased mechanically-induced ectopy in the hypertrophied heart

Left ventricular hypertrophy (LVH) predisposes patients to arrhythmias, but the mechanism of these arrhythmias is unclear. Here we show that hearts from spontaneously hypertensive rats (SHR) have a lower threshold for induction mechanically induced arrhythmias compared to age matched Wistar-Kyoto (WKY).

Recordings were made from isolated hearts from nine month old SHR (n = 18) and WKY (n = 17) rats. A water filled balloon in the left ventricle had its volume controlled by a servo-driven syringe. LVEDP was abruptly increased in increments until an ectopic beat was detected by an epicardial MAP electrode. Alternatively, LVEDP was abruptly reduced back to 5 mm Hg from an elevated pressure.

SHR hearts had a lower threshold for stretch induced ectopics (29.87 ± 2.79 mm Hg vs. 42.23 ± 2.33 mm Hg, p < 0.01) and for release induced ectopics (24.09 ± 1.40 vs. 37.23 ± 3.22, p < 0.01). Perfusion with 100 μM streptomycin increased threshold for stretch induced ectopics in both strains (from 49.4 ± 4.7 to 69.5 ± 6.9 mm Hg in WKY; p < 0.05 and from 21.2 ± 3.5 to 39.7 ± 9.0 mm Hg in SHR; p = 0.07). 100 μM streptomycin also increased threshold for release induced ectopics in SHR (from 23.5 ± 3.6 to 32.6 ± 4.9 mm Hg; p < 0.05) but not in WKY. Perfusion with 0.01 μM isoprenaline decreased the threshold for stretch induced ectopics in both strains (from 40.6 ± 5.0 to 22.6 ± 2.5 mm Hg in WKY; not significant at p < 0.05; p = 0.07 and from 31.0 ± 5.5 to 14.3 ± 2.5 mm Hg in SHR; p < 0.05).

Hearts from SHR are more susceptible to both stretch-induced and release-induced arrhythmia.