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Arrhythmogenic Potential of Myocardial Edema: The Interstitial Osmolality Induces Spiral Waves and Multiple

Diana G Kiseleva1,2, Vitalii D Dzhabrailov3,4, Aleria A Aitova4,5

  • 1Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Petrovsky National Research Centre of Surgery, 119991 Moscow, Russia.

Biomedicines
|August 29, 2024
PubMed

Insights

Myocardial edema, induced by low osmolality, significantly slows calcium wave propagation in heart cells. This cellular edema can lead to dangerous arrhythmias like spiral waves and multiple wavelets, potentially causing fatal heart rhythms.

Area of Science:

  • Cardiology
  • Cellular Physiology
  • Biophysics

Background:

  • Myocardial edema exacerbates cardiovascular diseases and is linked to arrhythmias.
  • The impact of edema on cardiac calcium dynamics remains unstudied.
  • Edema can cause irreversible myocardial remodeling.

Purpose of the Study:

  • To investigate the effects of hypoosmolality-induced myocardial edema on calcium dynamics in cardiomyocytes.
  • To determine if altered calcium dynamics under edema conditions can precipitate arrhythmias.

Main Methods:

  • Optical mapping of intracellular calcium dynamics using Fluo-4 in neonatal rat cardiomyocyte monolayers.
  • Experimental manipulation of solution osmolality using varying NaCl concentrations (140 mM, 105 mM, 70 mM).
  • Analysis of calcium wave propagation speed and pattern under different osmotic conditions.

Main Results:

  • A significant decrease in calcium wave propagation speed was observed with decreasing osmolality.
  • Hypoosmotic conditions induced a transition from normal wavefronts to spiral waves and multiple wavelets.
  • Specific findings include spiral wave emergence at 0.75T and multiple wavelets at 0.5T, previously unrecorded in this model.

Conclusions:

  • Hypoosmolality, mimicking myocardial edema, disrupts normal calcium wave propagation in cardiomyocytes.
  • These disruptions can lead to the formation of complex reentrant arrhythmias, such as spiral waves and wave break.
  • The study suggests a novel cellular mechanism linking myocardial edema to potentially fatal ventricular arrhythmias.

Keywords:
cell swellingedemaexcitation waveletsmyocardial infarctionoptical mappingosmolalityre-entryspiral wavesventricular arrhythmiaventricular fibrillation

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