Trends in Cardiovascular Medicine
Volume 15, Issue 7 , Pages 259-264 , October 2005

Conduction Abnormalities in Nonischemic Dilated Cardiomyopathy: Basic Mechanisms and Arrhythmic Consequences

  • Fadi G. Akar
  • ,
  • Gordon F. Tomaselli

      Affiliations

    • Corresponding Author InformationAddress correspondence to: Gordon F. Tomaselli, MD, Professor and Vice Chair of Research, Department of Medicine, Division of Cardiology, Johns Hopkins University, 720 Rutland Ave, Ross844, Baltimore, MD 21205, USA. Tel.: (+1) 410-955-2776; fax: (+1) 410-502-2096

References 

  1. Ai X, Pogwizd SM. Connexin 43 downregulation and dephosphorylation in nonischemic heart failure is associated with enhanced colocalized protein phosphatase type 2A. Circ Res. 2005;96:54–63
  2. Akar FG, Rosenbaum DS. Transmural electrophysiological heterogeneities underlying arrhythmogenesis in heart failure. Circ Res. 2003;93:638–645
  3. Akar FG, Spragg DD, Tunin RS, et al. Mechanisms underlying conduction slowing and arrhythmogenesis in nonischemic dilated cardiomyopathy. Circ Res. 2004;95:717–725
  4. Allessie MA, Schalij MJ, Kirchhof CJ, et al. Experimental electrophysiology and arrhythmogenicity. Anisotropy and ventricular tachycardia. Eur Heart J. 1989;(10 Suppl E):2–8
  5. Cleland JG, Khand A, Clark A. The heart failure epidemic: Exactly how big is it?. Eur Heart J. 2001;22:623–626
  6. Eloff BC, Lerner DL, Yamada KA, et al. High resolution optical mapping reveals conduction slowing in connexin43 deficient mice. Cardiovasc Res. 2001;51:681–690
  7. Hall DG, Morley GE, Vaidya D, et al. Early onset heart failure in transgenic mice with dilated cardiomyopathy. Pediatr Res. 2000;48:36–42
  8. Hanna N, Cardin S, Leung TK, Nattel S. Differences in atrial versus ventricular remodeling in dogs with ventricular tachypacing-induced congestive heart failure. Cardiovasc Res. 2004;63:236–244
  9. Hombach V. Electrocardiogram of the failing heart. Card Electrophysiol Rev. 2002;6:209–214
  10. Kaab S, Nuss HB, Chiamvimonvat N, et al. Ionic mechanism of action potential prolongation in ventricular myocytes from dogs with pacing-induced heart failure. Circ Res. 1996;78:262–273
  11. Kleber AG. Conduction of the impulse in the ischemic myocardium—implications for malignant ventricular arrhythmias. Experientia. 1987;43:1056–1061
  12. Kucera JP, Kleber AG, Rohr S. Slow conduction in cardiac tissue: Insights from optical mapping at the cellular level. J Electrocardiol. 2001;(34 Suppl):57–64
  13. Kuryshev YA, Brittenham GM, Fujioka H. Decreased sodium and increased transient outward potassium currents in iron-loaded cardiac myocytes. Implications for the arrhythmogenesis of human siderotic heart disease. Circulation. 1999;100:675–683
  14. Lampe PD, Lau AF. The effects of connexin phosphorylation on gap junctional communication. Int J Biochem Cell Biol. 2004;36:1171–1186
  15. Lander P, Gomis P, Goyal R, et al. Analysis of abnormal intra-QRS potentials. Improved predictive value for arrhythmic events with the signal-averaged electrocardiogram. Circulation. 1997;95:1386–1393
  16. Laurita KR, Chuck ET, Yang T, et al. Optical mapping reveals conduction slowing and impulse block in iron-overload cardiomyopathy. J Lab Clin Med. 2003;142:83–89
  17. Mancini DM, Wong KL, Simson MB. Prognostic value of an abnormal signal-averaged electrocardiogram in patients with nonischemic congestive cardiomyopathy. Circulation. 1993;87:1083–1092
  18. Middlekauff HR, Stevenson WG, Woo MA, et al. Comparison of frequency of late potentials in idiopathic dilated cardiomyopathy and ischemic cardiomyopathy with advanced congestive heart failure and their usefulness in predicting sudden death. Am J Cardiol. 1990;66:1113–1117
  19. Morley GE, Vaidya D, Jalife J. Characterization of conduction in the ventricles of normal and heterozygous Cx43 knockout mice using optical mapping. J Cardiovasc Electrophysiol. 2000;11:375–377
  20. Peters NS, Wit AL. Myocardial architecture and ventricular arrhythmogenesis. Circulation. 1998;97:1746–1754
  21. Peters NS, Coromilas J, Severs NJ, Wit AL. Disturbed connexin43 gap junction distribution correlates with the location of reentrant circuits in the epicardial border zone of healing canine infarcts that cause ventricular tachycardia. Circulation. 1997;95:988–996
  22. Poelzing S, Rosenbaum DS. Altered connexin43 expression produces arrhythmia substrate in heart failure. Am J Physiol Heart Circ Physiol. 2004;287:H1762–H1770
  23. Pu J, Boyden PA. Alterations of Na+ currents in myocytes from epicardial border zone of the infarcted heart. A possible ionic mechanism for reduced excitability and postrepolarization refractoriness. Circ Res. 1997;81:110–119
  24. Qin D, Zhang ZH, Caref EB, et al. Cellular and ionic basis of arrhythmias in postinfarction remodeled ventricular myocardium. Circ Res. 1996;79:461–473
  25. Sabbah HN, Stein PD, Kono T, et al. A canine model of chronic heart failure produced by multiple sequential coronary microembolizations. Am J Physiol. 1991;260:H1379–H1384
  26. Sabbah HN, Sharov VG, Lesch M, Goldstein S. Progression of heart failure: A role for interstitial fibrosis. Mol Cell Biochem. 1995;147:29–34
  27. Shaw RM, Rudy Y. Electrophysiologic effects of acute myocardial ischemia. A mechanistic investigation of action potential conduction and conduction failure. Circ Res. 1997;80:124–138
  28. Spach MS, Dolber PC, Heidlage JF. Influence of the passive anisotropic properties on directional differences in propagation following modification of the sodium conductance in human atrial muscle. A model of reentry based on anisotropic discontinuous propagation. Circ Res. 1988;62:811–832
  29. Stevenson WG, Sweeney MO. Arrhythmias and sudden death in heart failure. Jpn Circ J. 1997;61:727–740
  30. Thomas SP, Kucera JP, Bircher-Lehmann L, et al. Impulse propagation in synthetic strands of neonatal cardiac myocytes with genetically reduced levels of connexin43. Circ Res. 2003;92:1209–1216
  31. Tomaselli GF, Zipes DP. What causes sudden death in heart failure?. Circ Res. 2004;95:754–763
  32. Tomaselli GF, Beuckelmann DJ, et al. Sudden cardiac death in heart failure. The role of abnormal repolarization. Circulation. 1994;90:2534–2539
  33. Weigerinck RF, Belterman CN, Opthof T, et al. Increased cell size in rabbits with heart failure increases myocardial conduction velocity and paradoxically increases QRS duration. Heart Rhythm. 2005;2(Supplement):139–140(abstract)
  34. Wit AL, Rosen MR. Pathophysiologic mechanisms of cardiac arrhythmias. Am Heart J. 1983;106:798–811
  35. Wit AL, Dillon SM, Coromilas J, et al. Anisotropic reentry in the epicardial border zone of myocardial infarcts. Ann N Y Acad Sci. 1990;591:86–108
  36. Yamada KA, Rogers JG, Sundset R, et al. Up-regulation of connexin45 in heart failure. J Cardiovasc Electrophysiol. 2003;14:1205–1212
  37. Zicha S, Maltsev VA, Nattel S, et al. Post-transcriptional alterations in the expression of cardiac Na+ channel subunits in chronic heart failure. J Mol Cell Cardiol. 2004;37:91–100

PII: S1050-1738(05)00127-1

doi: 10.1016/j.tcm.2005.08.002

Trends in Cardiovascular Medicine
Volume 15, Issue 7 , Pages 259-264 , October 2005