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Updated: Feb 12, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Functional Characterization of Novel Atrial Fibrillation-Linked GJA5 (Cx40) Mutants
Mahmoud Noureldin1, Honghong Chen2, Donglin Bai3
1Department of Physiology and Pharmacology, University of Western Ontario, London, ON, N6A 5C1 Canada. mnourel@uwo.ca.
Insights
Four new connexin 40 (Cx40) mutations were found in atrial fibrillation (AF) patients. The Q236H mutation significantly reduced gap junction function, potentially contributing to AF development.
Area of Science:
- Cardiovascular Research
- Molecular Biology
- Genetics
Background:
- Atrial fibrillation (AF) is a prevalent cardiac arrhythmia.
- Connexin 40 (Cx40) mutations are implicated in cardiac arrhythmias.
- Four novel heterozygous Cx40 mutations (K107R, L223M, Q236H, I257L) were identified in AF patients.
Purpose of the Study:
- To investigate the functional consequences of novel Cx40 mutations.
- To assess the cellular localization and gap junction (GJ) function of Cx40 mutants.
- To determine if Cx40 mutations contribute to AF pathogenesis.
Main Methods:
- Expression of GFP-tagged and untagged Cx40 mutants in connexin-deficient cells.
- Analysis of Cx40 mutant localization at cell-cell junctions.
- Measurement of GJ coupling conductance (Gj) and transjunctional voltage-dependent gating (Vj gating).
Main Results:
- All four Cx40 mutants localized to cell-cell junctions, similar to wildtype Cx40.
- The Cx40 Q236H mutant, but not others, significantly reduced GJ coupling conductance (Gj).
- Co-expression of Cx40 Q236H with Cx43 also decreased Gj.
- Altered Vj gating properties were observed for GJs formed by Cx40 Q236H.
Conclusions:
- The Cx40 Q236H mutation impairs GJ function and alters gating properties.
- Reduced GJ function and altered gating associated with Cx40 Q236H may promote AF.
- These findings highlight the role of Cx40 mutations in AF pathophysiology.
Abstract:
Atrial fibrillation (AF) is the most common form of cardiac arrhythmia. Recently, four novel heterozygous Cx40 mutations-K107R, L223M, Q236H, and I257L-were identified in 4 of 310 unrelated AF patients and a followup genetic analysis of the mutant carriers' families showed that the mutants were present in all the affected members. To study possible alterations associated with these Cx40 mutants, including their cellular localization and gap junction (GJ) function, we expressed GFP-tagged and untagged mutants in connexin-deficient model cells. All four Cx40 mutants showed clustered localization at cell-cell junctions similar to that observed of wildtype Cx40. However, cell pairs expressing Cx40 Q236H, but not the other individual mutants, displayed a significantly lower GJ coupling conductance (Gj) than wildtype Cx40. Similarly, co-expression of Cx40 Q236H with Cx43 resulted in a significantly lower Gj. Transjunctional voltage-dependent gating (Vj gating) properties were also altered in the GJs formed by Q236H. Reduced GJ function and altered Vj gating may play a role in promoting the Q236H carriers to AF.
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