Atrial Myocyte NLRP3/CaMKII Nexus Forms a Substrate for Postoperative Atrial Fibrillation

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Jordi Heijman - , University of Duisburg-Essen, Maastricht University (Author)
  • Azinwi Phina Muna - , University of Duisburg-Essen (Author)
  • Tina Veleva - , University of Duisburg-Essen (Author)
  • Cristina E. Molina - , University of Duisburg-Essen, University of Hamburg (Author)
  • Henry Sutanto - , Maastricht University (Author)
  • Marcel Tekook - , University of Duisburg-Essen (Author)
  • Qiongling Wang - , Baylor College of Medicine (Author)
  • Issam H. Abu-Taha - , University of Duisburg-Essen (Author)
  • Marcel Gorka - , University of Duisburg-Essen (Author)
  • Stephan Künzel - , Institute of Pharmacology and Toxicology, University of Duisburg-Essen (Author)
  • Ali El-Armouche - , Institute of Pharmacology and Toxicology (Author)
  • Hermann Reichenspurner - , University of Hamburg (Author)
  • Markus Kamler - , University of Duisburg-Essen (Author)
  • Viacheslav Nikolaev - , University of Hamburg (Author)
  • Ursula Ravens - , University Medical Center Freiburg, Medical Faculty Carl Gustav Carus (Author)
  • Na Li - , Baylor College of Medicine (Author)
  • Stanley Nattel - , University of Montreal, Université de Bordeaux (Author)
  • Xander H.T. Wehrens - , Baylor College of Medicine (Author)
  • Dobromir Dobrev - , University of Duisburg-Essen (Author)

Abstract

Rationale: Postoperative atrial fibrillation (POAF) is a common and troublesome complication of cardiac surgery. POAF is generally believed to occur when postoperative triggers act on a preexisting vulnerable substrate, but the underlying cellular and molecular mechanisms are largely unknown. Objective: To identify cellular POAF mechanisms in right atrial samples from patients without a history of atrial fibrillation undergoing open-heart surgery. Methods and Results: Multicellular action potentials, membrane ion-currents (perforated patch-clamp), or simultaneous membrane-current (ruptured patch-clamp) and [Ca2+]i-recordings in atrial cardiomyocytes, along with protein-expression levels in tissue homogenates or cardiomyocytes, were assessed in 265 atrial samples from patients without or with POAF. No indices of electrical, profibrotic, or connexin remodeling were noted in POAF, but Ca2+-transient amplitude was smaller, although spontaneous sarcoplasmic reticulum (SR) Ca2+-release events and L-type Ca2+-current alternans occurred more frequently. CaMKII (Ca2+/calmodulin-dependent protein kinase-II) protein-expression, CaMKII-dependent phosphorylation of the cardiac RyR2 (ryanodine-receptor channel type-2), and RyR2 single-channel open-probability were significantly increased in POAF. SR Ca2+-content was unchanged in POAF despite greater SR Ca2+-leak, with a trend towards increased SR Ca2+-ATPase activity. Patients with POAF also showed stronger expression of activated components of the NLRP3 (NACHT, LRR, and PYD domains-containing protein-3)-inflammasome system in atrial whole-tissue homogenates and cardiomyocytes. Acute application of interleukin-1β caused NLRP3-signaling activation and CaMKII-dependent RyR2/phospholamban hyperphosphorylation in an immortalized mouse atrial cardiomyocyte cell-line (HL-1-cardiomyocytes) and enhanced spontaneous SR Ca2+-release events in both POAF cardiomyocytes and HL-1-cardiomyocytes. Computational modeling showed that RyR2 dysfunction and increased SR Ca2+-uptake are sufficient to reproduce the Ca2+-handling phenotype and indicated an increased risk of proarrhythmic delayed afterdepolarizations in POAF subjects in response to interleukin-1β. Conclusions: Preexisting Ca2+-handling abnormalities and activation of NLRP3-inflammasome/CaMKII signaling are evident in atrial cardiomyocytes from patients who subsequently develop POAF. These molecular substrates sensitize cardiomyocytes to spontaneous Ca2+-releases and arrhythmogenic afterdepolarizations, particularly upon exposure to inflammatory mediators. Our data reveal a potential cellular and molecular substrate for this important clinical problem.

Details

Original languageEnglish
Pages (from-to)1036-1055
Number of pages20
JournalCirculation research
Volume127
Issue number8
Publication statusPublished - 25 Sept 2020
Peer-reviewedYes

External IDs

PubMed 32762493
ORCID /0000-0003-2514-9429/work/151437837

Keywords

Keywords

  • action potentials, atrial fibrillation, calcium, CaMKII, interleukin, NLRP3, sarcoplasmic reticulum