Ventricular arrhythmias in acute myocardial ischaemia—Focus on the ageing and sex

Oknińska, Marta; Mączewski, Michał; Mackiewicz, Urszula

doi:10.1016/j.arr.2022.101722

Cited by 10 publications

(10 citation statements)

References 213 publications

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“…158 Uma recente revisão sobre arritmias ventriculares na isquemia miocárdica aguda, com foco no papel da idade e do sexo, concluiu que há falta de entendimento d o s m e c a n i s m o s r e s p o n s á v e i s p e l a s d i f e r e n ç a s sexo-dependentes na susceptibilidade para arritmias ventriculares malignas durante a isquemia aguda. 159 Esse dado, associado à baixa representatividade das mulheres em ensaios clínicos, contribui para a falta de evidências científicas suficientes para desenvolver métodos sexodependentes de prevenção de morte súbita cardíaca. A despeito da pobreza de dados em relação aos mecanismos de arritmias em mulheres, indica-se que parâmetros que promovem as arritmias ventriculares, como fibrose, hipertrofia cardíaca, anormalidades na sinalização de cálcio e alterações eletrofisiológicas, apresentam-se de forma diferente no que diz respeito a idade e sexo, ressaltando-se a necessidade de pesquisas adicionais.…”

Section: Arritmias Ventriculares: Morte Súbita Prevenção E Tratamentounclassified

Posicionamento sobre Doença Isquêmica do Coração – A Mulher no Centro do Cuidado – 2023

Oliveira¹,

Almeida²,

Rassi³

et al. 2023

Arquivos Brasileiros De Cardiologia

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Section: Arritmias Ventriculares: Morte Súbita Prevenção E Tratamentounclassified

Posicionamento sobre Doença Isquêmica do Coração – A Mulher no Centro do Cuidado – 2023

Oliveira¹,

Almeida²,

Rassi³

et al. 2023

Arquivos Brasileiros De Cardiologia

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“…The main triggers of re-entry are ventricular premature beats (PVBs), the formation of which is promoted by prolongation of the action potential (AP) and disturbances in intracellular calcium signaling due to changes in the expression and posttranslational modifications (phosphorylation, oxidation and nitrosylation) of ion channels and calcium transporters, respectively. PVBs lead to VT/VF especially in the presence of structural changes in the myocardium due to fibrosis and loss and hypertrophy of cardiomyocytes, leading to changes in the pathway and rate of impulse propagation 8 , 9 . However, the development of arrhythmia substrates in the heart and the underlying mechanisms are inadequately understood, especially in the elderly individuals and women.…”

Section: Introductionmentioning

confidence: 99%

“…However, the development of arrhythmia substrates in the heart and the underlying mechanisms are inadequately understood, especially in the elderly individuals and women. This is because the overwhelming majority of basic animal model studies devoted to identifying arrhythmia mechanisms have been conducted on male individuals, mostly at a young age, as highlighted by an extensive literature review recently published by our group 9 .…”

Section: Introductionmentioning

confidence: 99%

Sex- and age-dependent susceptibility to ventricular arrhythmias in the rat heart ex vivo

Oknińska,

Duda,

Czarnowska

et al. 2024

Sci Rep

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The incidence of life-threatening ventricular arrhythmias, the most common cause of sudden cardiac death (SCD), depends largely on the arrhythmic substrate that develops in the myocardium during the aging process. There is a large deficit of comparative studies on the development of this substrate in both sexes, with a particular paucity of studies in females. To identify the substrates of arrhythmia, fibrosis, cardiomyocyte hypertrophy, mitochondrial density, oxidative stress, antioxidant defense and intracellular Ca2+ signaling in isolated cardiomyocytes were measured in the hearts of 3- and 24-month-old female and male rats. Arrhythmia susceptibility was assessed in ex vivo perfused hearts after exposure to isoproterenol (ISO) and hydrogen peroxide (H2O2). The number of ventricular premature beats (PVBs), ventricular tachycardia (VT) and ventricular fibrillation (VF) episodes, as well as intrinsic heart rate, QRS and QT duration, were measured in ECG signals recorded from the surfaces of the beating hearts. After ISO administration, VT/VFs were formed only in the hearts of males, mainly older ones. In contrast, H2O2 led to VT/VF formation in the hearts of rats of both sexes but much more frequently in older males. We identified several components of the arrhythmia substrate that develop in the myocardium during the aging process, including high spontaneous ryanodine receptor activity in cardiomyocytes, fibrosis of varying severity in different layers of the myocardium (nonheterogenic fibrosis), and high levels of oxidative stress as measured by nitrated tyrosine levels. All of these elements appeared at a much greater intensity in male individuals during the aging process. On the other hand, in aging females, antioxidant defense at the level of H2O2 detoxification, measured as glutathione peroxidase expression, was weaker than that in males of the same age. We showed that sex has a significant effect on the development of an arrhythmic substrate during aging. This substrate determines the incidence of life-threatening ventricular arrhythmias in the presence of additional stimuli with proarrhythmic potential, such as catecholamine stimulation or oxidative stress, which are constant elements in the pathomechanism of most cardiovascular diseases.

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“…[1,2] VAs are a common complication in the early stages of acute myocardial infarction (AMI), with more than 10% myocardial infarction (MI) patients suffering from VAs. [3,4] The causes of VAs after MI are multifactorial and include inflammation, fibrosis, gap junction dephosphorylation, sympathetic nerve overactivation, and changes in ionic current. However, there is a lack of effective approaches for preventing VAs in the clinic.…”

Section: Introductionmentioning

confidence: 99%

Muscone attenuates susceptibility to ventricular arrhythmia by inhibiting NLRP3 inflammasome activation in rats after myocardial infarction

Yang

Wei

et al. 2023

J Biochem & Molecular Tox

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Fibrosis and abnormal expression of connexin 43 (Cx43) in the ventricle play vital roles in ventricular arrhythmias (VAs) after myocardial infarction (MI). Muscone, an active monomer of heart‐protecting musk pill, has various biological activities, but its effect on susceptibility to VAs in rats with MI has not been determined. In the present study, we investigated the effects of muscone on ventricular inflammation, fibrosis, Cx43 expression, and the occurrence of VAs after MI. An MI model was established by ligating the proximal left anterior descending coronary artery. Then, the MI model rats were administered muscone (2 mg/kg/day) or vehicle (saline)via intragastric injection for 14 days. Cardiac function was evaluated by echocardiography, and an in vivo electrophysiological study was performed on Day 14. Cardiac inflammation, fibrosis, and Cx43 expression were determined by histochemical analysis and western blot analysis. Our results indicated that muscone treatment significantly improved cardiac function and inhibited ventricular inflammation, fibrosis, and nucleotide‐binding oligomerization domain, leucine‐rich repeat, and pyrin domain containing 3 (NLRP3) inflammasome activation. Electrocardiogrphy and electrophysiology studies showed that muscone shortened the QRS interval, QT interval, QTc interval, and action potential duration; prolonged the effective refractory period; and reduced susceptibility to VAs in rats after MI. Furthermore, Cx43 expression in the BZ was increased by muscone treatment, and this change was coupled by inhibition of the NLRP3/IL‐1β/p38 MAPK pathway. Taken together, our results demonstrated that muscone reduces susceptibility to VA, mainly by decreasing ventricular inflammation and fibrosis, and attenuates abnormal Cx43 expression by inhibiting NLRP3 inflammasome activation after myocardial infarction in rats.

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Ventricular arrhythmias in acute myocardial ischaemia—Focus on the ageing and sex

Cited by 10 publications

References 213 publications

Posicionamento sobre Doença Isquêmica do Coração – A Mulher no Centro do Cuidado – 2023

Posicionamento sobre Doença Isquêmica do Coração – A Mulher no Centro do Cuidado – 2023

Sex- and age-dependent susceptibility to ventricular arrhythmias in the rat heart ex vivo

Muscone attenuates susceptibility to ventricular arrhythmia by inhibiting NLRP3 inflammasome activation in rats after myocardial infarction

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