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Apelin increases atrial conduction velocity, refractoriness, and prevents inducibility of atrial fibrillation
Young M. Kim, … , Peter H. Backx, Euan A. Ashley
Young M. Kim, … , Peter H. Backx, Euan A. Ashley
Published September 3, 2020
Citation Information: JCI Insight. 2020;5(17):e126525. https://doi.org/10.1172/jci.insight.126525.
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Research Article Cardiology

Apelin increases atrial conduction velocity, refractoriness, and prevents inducibility of atrial fibrillation

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Abstract

Previous studies have shown an association between elevated atrial NADPH-dependent oxidative stress and decreased plasma apelin in patients with atrial fibrillation (AF), though the basis for this relationship is unclear. In the current study, RT-PCR and immunofluorescence studies of human right atrial appendages (RAAs) showed expression of the apelin receptor, APJ, and reduced apelin content in the atria, but not in plasma, of patients with AF versus normal sinus rhythm. Disruption of the apelin gene in mice increased (2.4-fold) NADPH-stimulated superoxide levels and slowed atrial conduction velocities in optical mapping of a Langendorff-perfused isolated heart model, suggesting that apelin levels may influence AF vulnerability. Indeed, in mice with increased AF vulnerability (induced by chronic intense exercise), apelin administration reduced the incidence and duration of induced atrial arrhythmias in association with prolonged atrial refractory periods. Moreover, apelin decreased AF induction in isolated atria from exercised mice while accelerating conduction velocity and increasing action potential durations. At the cellular level, these changes were associated with increased atrial cardiomyocyte sodium currents. These findings support the conclusion that reduced atrial apelin is maladaptive in fibrillating human atrial myocardium and that increasing apelin bioavailability may be a worthwhile therapeutic strategy for treating and preventing AF.

Authors

Young M. Kim, Robert Lakin, Hao Zhang, Jack Liu, Ayaaz Sachedina, Maneesh Singh, Emily Wilson, Marco Perez, Subodh Verma, Thomas Quertermous, Jeffrey Olgin, Peter H. Backx, Euan A. Ashley

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Figure 3

Direct functional effects of PYRapelin13 on atrial electrophysiology.

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Direct functional effects of PYRapelin13 on atrial electrophysiology.
(A...
(A) Representative murine atrial activation isochrones (ms) at baseline and following PYRapelin13 administration (20 nM) in isolated (denervated) atria paced at 90 ms intervals from the right atrial appendage (RAA) (scale bar: 200 μm). (B) Conduction velocities calculated from the left atrial appendage (LAA) of 90 ms paced atria were increased (***P < 0.0007, 2-tailed Student’s paired t test comparing before and after PYRapelin13 administration) following PYRapelin13 administration in both exercised and sedentary control mice. (C) Representative tracings and I–V relationships of INa from isolated murine left atrial (LA) myocytes before (baseline) and after PYRapelin13 (10 nM) infusion. (D) Whole-cell voltage-clamp steady-state sodium channel activation curves were determined from single-cell recordings from sedentary CD1 mice (8–10 weeks old) of cardiac sodium current (INa) in freshly isolated murine LA myocytes before and after treatment with PYRapelin13 (10 nM) infusion and saline (control). In contrast to saline infusion, apelin reversibly induced a hyperpolarized voltage shift (P = 0.041) in the steady-state activation curve from –40.68 ± 2.03 mV to –46.58 ± 1.69 mV. (E) I–V relationship of INa from LA myocytes before and after saline revealed no change in maximal conductance. By contrast, PYRapelin13 (10 nM) infusion increased (P = 0.006) maximum conductance from 0.34 ± 0.02 pS/pF to 0.41 ± 0.02 pS/pF. Data are presented as mean ± SEM. For sodium channel measures, n = 7 myocytes/3 mouse isolated atria per group. Representative data are the result of experiments being repeated 6 times.

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