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2015 ; 12
(11
): 2316-24
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Electrophysiologic consequences of KATP gain of function in the heart: Conduction
abnormalities in Cantu syndrome
#MMPMID26142302
Levin MD
; Zhang H
; Uchida K
; Grange DK
; Singh GK
; Nichols CG
Heart Rhythm
2015[Nov]; 12
(11
): 2316-24
PMID26142302
show ga
BACKGROUND: Gain-of-function (GOF) mutations in the KATP channel subunits Kir6.1
and SUR2 cause Cantu syndrome (CS), a disease characterized by multiple
cardiovascular abnormalities. OBJECTIVE: The purpose of this study was to better
determine the electrophysiologic consequences of such GOF mutations in the heart.
METHODS: We generated transgenic mice (Kir6.1-GOF) expressing ATP-insensitive
Kir6.1[G343D] subunits under ?-myosin heavy chain (?-MHC) promoter control, to
target gene expression specifically in cardiomyocytes, and performed patch-clamp
experiments on isolated ventricular myocytes and invasive electrophysiology on
anesthetized mice. RESULTS: In Kir6.1-GOF ventricular myocytes, KATP channels
showed decreased ATP sensitivity but no significant change in current density.
Ambulatory ECG recordings on Kir6.1-GOF mice revealed AV nodal conduction
abnormalities and junctional rhythm. Invasive electrophysiologic analyses
revealed slowing of conduction and conduction failure through the AV node but no
increase in susceptibility to atrial or ventricular ectopic activity. Surface
ECGs recorded from CS patients also demonstrated first-degree AV block and
fascicular block. CONCLUSION: The primary electrophysiologic consequence of
cardiac KATP GOF is on the conduction system, particularly the AV node, resulting
in conduction abnormalities in CS patients who carry KATP GOF mutations.