BS59 Mechanisms underlying atrial dysfunction in heart failure: role of the mitochondrial permeability transition pore

S. Khan, G. Galli, K. Dibb
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Abstract

IntroductionHeart Failure (HF) carries significant mortality and morbidity, especially due to comorbidities such as Atrial Fibrillation (AF). Previous work illustrates that mitochondrial dysfunction underpins the pathophysiology of both HF and AF, including decreased Adenosine TriPhosphate (ATP) production, Ca2+ mishandling, oxidative stress and elevated apoptosis. In addition to these problems, recent work suggests the Mitochondrial Permeability Transition Pore (MPTP) in ventricular cardiomyocytes may become sensitised to Ca2+ during HF, leading to increased apoptosis. Nevertheless, the role of mitochondrial dysfunction has not been investigated in the atria. In this study, we investigated the role of Ca2+ sensitivity of the MPTP and mitochondrial aerobic capacity in atrial muscle of the failing heart.MethodsRight atrial appendage and right ventricular free wall were dissected from 15 sheep representing an ovine model of tachycardia-induced HF. The tissue was subsequently homogenized and differentially centrifuged, yielding isolated mitochondria. Respiratory function was measured using a respirometer, with the electron transport system (ETS) selectively probed through addition of various substrates stimulating differing ETS complexes. A Calcium Retention Capacity (CRC) assay determined MPTP Ca2+ sensitivity, which involved Ca2+ titrations onto isolated mitochondria containing a Ca2+-sensitive fluorescent dye. An increase in fluorescence marked MPTP opening.ResultsAerobic capacity was not affected by HF, but an increase in ventricular leak respiration was statistically significant (p=0.0140). HF reduced atrial mitochondrial efficiency by 68% (p=0.0063) but did not affect maximal mitochondrial respiration. There was no significant effect of HF or tissue-type on MPTP Ca2+ sensitivity and mitochondrial Ca2+ buffering capacity.ConclusionOur data suggests HF affects atrial and ventricular mitochondrial respiratory function asymmetrically, with HF affecting atrial mitochondrial efficiency and ventricular leak respiration. The COVID-19 pandemic hindered this research project;however, it provides rationale on the unequal effect of HF on mitochondrial function across the atria and ventricle. Future research should therefore consider incorporating atrial samples when assessing potential HF therapies.Conflict of InterestNil
心衰心房功能障碍的机制:线粒体通透性过渡孔的作用
心力衰竭(HF)具有显著的死亡率和发病率,特别是由于合并症,如心房颤动(AF)。先前的研究表明,线粒体功能障碍支持心衰和房颤的病理生理,包括三磷酸腺苷(ATP)产生减少、Ca2+处理不当、氧化应激和细胞凋亡升高。除了这些问题外,最近的研究表明,心衰期间心室心肌细胞的线粒体通透性过渡孔(MPTP)可能对Ca2+敏感,导致细胞凋亡增加。然而,线粒体功能障碍在心房中的作用尚未被研究。在这项研究中,我们研究了Ca2+敏感性的MPTP和线粒体有氧能力在衰竭心脏心房肌中的作用。方法取15只羊的右心房附件和右心室游离壁,建立绵羊心动过速性心衰模型。随后将组织匀浆并差速离心,得到分离的线粒体。使用呼吸计测量呼吸功能,通过添加各种底物刺激不同的ETS复合物,选择性地探测电子传递系统(ETS)。钙保留容量(CRC)测定确定MPTP Ca2+的敏感性,其中包括Ca2+滴定到含有Ca2+敏感荧光染料的分离线粒体。荧光增加表明MPTP打开。结果HF对有氧能力无明显影响,但室性漏呼吸增加有统计学意义(p=0.0140)。HF使心房线粒体效率降低68% (p=0.0063),但不影响最大线粒体呼吸。HF或组织类型对MPTP Ca2+敏感性和线粒体Ca2+缓冲能力没有显著影响。结论心衰对心房和心室线粒体呼吸功能的影响是不对称的,心衰影响心房线粒体效率和心室漏呼吸。COVID-19大流行阻碍了本研究项目,然而,它为HF对心房和心室线粒体功能的不均匀影响提供了理论依据。因此,未来的研究在评估潜在的心衰治疗方法时应考虑纳入心房样本。利益冲突无
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