Document Detail


Developmental basis for electrophysiological heterogeneity in the ventricular and outflow tract myocardium as a substrate for life-threatening ventricular arrhythmias.
MedLine Citation:
PMID:  19118284     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Reentry is the main mechanism of life-threatening ventricular arrhythmias, including ventricular fibrillation and tachycardia. Its occurrence depends on the simultaneous presence of an arrhythmogenic substrate (a preexisting condition) and a "trigger," and is favored by electrophysiological heterogeneities. In the adult heart, electrophysiological heterogeneities of the ventricle exist along the apicobasal, left-right, and transmural axes. Also, conduction is preferentially slowed in the right ventricular outflow tract, especially during pharmacological sodium channel blockade. We propose that the origin of electrophysiological heterogeneities of the adult heart lies in early heart development. The heart is formed from several progenitor regions: the first heart field predominantly forms the left ventricle, whereas the second heart field forms the right ventricle and outflow tract. Furthermore, the embryonic outflow tract consists of slowly conducting tissue until it is incorporated into the ventricles and develops rapidly conducting properties. The subepicardial myocytes and subendocardial myocytes run distinctive gene programs from their formation onwards. This review discusses the hypothesis that electrophysiological heterogeneities in the adult heart result from persisting patterns in gene expression and function along the craniocaudal and epicardial-endocardial axes of the developing heart. Understanding the developmental origins of electrophysiological heterogeneity contributing to ventricular arrhythmias may give rise to new therapies.
Authors:
Bastiaan J D Boukens; Vincent M Christoffels; Ruben Coronel; Antoon F M Moorman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Circulation research     Volume:  104     ISSN:  1524-4571     ISO Abbreviation:  Circ. Res.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-01     Completed Date:  2009-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0047103     Medline TA:  Circ Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  19-31     Citation Subset:  IM    
Affiliation:
Heart Failure Research Center, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Action Potentials
Animals
Aorta / embryology,  physiopathology*
Arrhythmogenic Right Ventricular Dysplasia / genetics,  physiopathology
Brugada Syndrome / genetics,  physiopathology
Connexins / biosynthesis,  genetics
Fetal Heart / metabolism*
Gap Junctions / physiology
Gene Expression Regulation, Developmental*
Genetic Heterogeneity
Heart Conduction System / embryology*,  physiopathology
Heart Ventricles / embryology,  physiopathology*
Humans
Ion Channels / biosynthesis,  genetics
Mammals
Myocytes, Cardiac / classification,  metabolism*
Neural Crest / cytology
Phenotype
Pulmonary Artery / embryology,  physiopathology*
Tachycardia, Ventricular / embryology*,  genetics,  physiopathology
Transcription, Genetic
Ventricular Fibrillation / embryology*,  genetics,  physiopathology
Chemical
Reg. No./Substance:
0/Connexins; 0/Ion Channels

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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