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High-resolution structure-function mapping of intact hearts reveals altered sympathetic control of infarct border zones
Ching Zhu, Pradeep S. Rajendran, Peter Hanna, Igor R. Efimov, Guy Salama, Charless C. Fowlkes, Kalyanam Shivkumar
Ching Zhu, Pradeep S. Rajendran, Peter Hanna, Igor R. Efimov, Guy Salama, Charless C. Fowlkes, Kalyanam Shivkumar
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Resource and Technical Advance Cardiology

High-resolution structure-function mapping of intact hearts reveals altered sympathetic control of infarct border zones

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Abstract

Remodeling of injured sympathetic nerves on the heart after myocardial infarction (MI) contributes to adverse outcomes such as sudden arrhythmic death, yet the underlying structural mechanisms are poorly understood. We sought to examine microstructural changes on the heart after MI and to directly link these changes with electrical dysfunction. We developed a high-resolution pipeline for anatomically precise alignment of electrical maps with structural myofiber and nerve-fiber maps created by customized computer vision algorithms. Using this integrative approach in a mouse model, we identified distinct structure-function correlates to objectively delineate the infarct border zone, a known source of arrhythmias after MI. During tyramine-induced sympathetic nerve activation, we demonstrated regional patterns of altered electrical conduction aligned directly with altered neuroeffector junction distribution, pointing to potential neural substrates for cardiac arrhythmia. This study establishes a synergistic framework for examining structure-function relationships after MI with microscopic precision that has potential to advance understanding of arrhythmogenic mechanisms.

Authors

Ching Zhu, Pradeep S. Rajendran, Peter Hanna, Igor R. Efimov, Guy Salama, Charless C. Fowlkes, Kalyanam Shivkumar

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Figure 5

Altered neuroeffector distribution underlies perturbed myocardial sympathetic control after chronic infarction.

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Altered neuroeffector distribution underlies perturbed myocardial sympat...
(A) Eighty percent of action potential duration (APD80) maps of representative sham heart at baseline and after infusion of 5 μM tyramine. (B) Change in APD80 (ΔAPD80) map of sham heart. (C) APD80 maps of representative MI heart at baseline and after infusion of 5 μM tyramine. Gray region denotes dense scar. (D) APD80 map of MI heart. (E–G) Representative action potentials at baseline (black) and after tyramine (magenta) in anatomically segmented regions of MI heart. (H) Comparison of regional, tyramine-mediated changes in APD80 between sham and MI hearts, with MI hearts showing significant regional variation in tyramine effect (Kruskal-Wallis, *P = 0.0132, n = 4 mice per group) while sham hearts showed no significant regional variation (Kruskal Wallis, P = 0.7463, n = 4 mice per group). (I) Plot of regional small-fiber prevalence in MI hearts versus tyramine-mediated APD change, with positive correlation in left ventricular (LV) base and right ventricular (RV) regions (Spearman’s r = 0.7381, P = 0.0458, n = 8 regions from 4 mice) but no correlation when border zone (BZ) is included (Spearman’s r = 0.021, P = 0.956, n = 12 regions from 4 mice). Scale bars: 1 mm (A–D).

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