Electroimmunology and cardiac arrhythmia

Grune, Jana; Yamazoe, Masahiro; Nahrendorf, Matthias

doi:10.1038/s41569-021-00520-9

Cited by 43 publications

(25 citation statements)

References 318 publications

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“…Not only inflammatory molecules but also inflammatory cells themselves interact directly with cardiomyocytes to alter their electrophysiological properties ( Grune et al, 2021 ). It has been known that cardiac fibroblasts express connexins and interact with cardiomyocytes via gap junctions ( Camelliti et al, 2004 ), and recently macrophages are also found to form gap junctions with cardiomyocytes ( Hulsmans et al, 2017 ).…”

Section: Atrial Inflammation Promotes Af Substrate Formationmentioning

confidence: 99%

Role of Inflammation in the Pathogenesis of Atrial Fibrillation

Ihara

Sasano

2022

Front. Physiol.

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Atrial fibrillation (AF) is one of the most common arrhythmias encountered in clinical practice. AF is a major risk factor for stroke, which is associated with high mortality and great disability and causes a significant burden on society. With the development of catheter ablation, AF has become a treatable disease, but its therapeutic outcome has been limited so far. In persistent and long-standing AF, the expanded AF substrate is difficult to treat only by ablation, and a better understanding of the mechanism of AF substrate formation will lead to the development of a new therapeutic strategy for AF. Inflammation is known to play an important role in the substrate formation of AF. Inflammation causes and accelerates the electrical and structural remodeling of the atria via pro-inflammatory cytokines and other inflammatory molecules, and enhances the AF substrate, leading to the maintenance of AF and further inflammation, which forms a vicious spiral, so-called “AF begets AF”. Breaking this vicious cycle is expected to be a key therapeutic intervention in AF. In this review, we will discuss the relationship between AF and inflammation, the inflammatory molecules included in the AF-related inflammatory process, and finally the potential of those molecules as a therapeutic target.

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Section: Atrial Inflammation Promotes Af Substrate Formationmentioning

confidence: 99%

Role of Inflammation in the Pathogenesis of Atrial Fibrillation

Ihara

Sasano

2022

Front. Physiol.

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“…Cx43 has low expression in the compact zone of the AV node but a higher expression in the lower nodal bundle, which may reflect a different density of gap junction-associated macrophages propagating electrical signals in separate areas of the cardiac conduction tissue. Whether other immune cells present in this area are also coupled with cardiomyocytes via C43-containing gap junctions has not yet been elucidated [ 56 , 57 ]. In addition, macrophage depletion triggers AV block, which demonstrates their indispensability to the process of electrical conduction in the AV node in a steady-state [ 56 ].…”

Section: The Role Of Macrophages In the Healthy Cardiovascular Systemmentioning

confidence: 99%

Multiple roles of cardiac macrophages in heart homeostasis and failure

2021

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Macrophages are essential components of the immune system and play a role in the normal functioning of the cardiovascular system. Depending on their origin and phenotype, cardiac macrophages perform various functions. In a steady-state, these cells play a beneficial role in maintaining cardiac homeostasis by defending the body from pathogens and eliminating apoptotic cells, participating in electrical conduction, vessel patrolling, and arterial tone regulation. However, macrophages also take part in adverse cardiac remodeling that could lead to the development and progression of heart failure (HF) in such HF comorbidities as hypertension, obesity, diabetes, and myocardial infarction. Nevertheless, studies on detailed mechanisms of cardiac macrophage function are still in progress, and could enable potential therapeutic applications of these cells. This review aims to present the latest reports on the origin, heterogeneity, and functions of cardiac macrophages in the healthy heart and in cardiovascular diseases leading to HF. The potential therapeutic use of macrophages is also briefly discussed.

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“…In the past, inflammation has been proved to be an important pathophysiological mechanism for the occurrence and development of arrhythmias ( Grune et al, 2021 ). The arrhythmogenic effects are mainly achieved through changes in electrophysiological properties, including ion channel disturbances, early and late afterdepolarization, as well as enhanced fibrosis and structural remodeling in cardiomyopathies ( Vonderlin et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Deep-Learning Model to Detect CRP Level from the Electrocardiogram

et al. 2022

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Background: C-reactive protein (CRP), as a non-specific inflammatory marker, is a predictor of the occurrence and prognosis of various arrhythmias. It is still unknown whether electrocardiographic features are altered in patients with inflammation.Objectives: To evaluate the performance of a deep learning model in detection of CRP levels from the ECG in patients with sinus rhythm.Methods: The study population came from an epidemiological survey of heart disease in Guangzhou. 12,315 ECGs of 11,480 patients with sinus rhythm were included. CRP > 5mg/L was defined as high CRP level. A convolutional neural network was trained and validated to detect CRP levels from 12 leads ECGs. The performance of the model was evaluated by calculating the area under the curve (AUC), accuracy, sensitivity, specificity, and balanced F Score (F1 score).Results: Overweight, smoking, hypertension and diabetes were more common in the High CRP group (p < 0.05). Although the ECG features were within the normal ranges in both groups, the high CRP group had faster heart rate, longer QTc interval and narrower QRS width. After training and validating the deep learning model, the AUC of the validation set was 0.86 (95% CI: 0.85–0.88) with sensitivity, specificity of 89.7 and 69.6%, while the AUC of the testing set was 0.85 (95% CI: 0.84–0.87) with sensitivity, specificity of 90.7 and 67.6%.Conclusion: An AI-enabled ECG algorithm was developed to detect CRP levels in patients with sinus rhythm. This study proved the existence of inflammation-related changes in cardiac electrophysiological signals and provided a noninvasive approach to screen patients with inflammatory status by detecting CRP levels.

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Electroimmunology and cardiac arrhythmia

Cited by 43 publications

References 318 publications

Role of Inflammation in the Pathogenesis of Atrial Fibrillation

Role of Inflammation in the Pathogenesis of Atrial Fibrillation

Multiple roles of cardiac macrophages in heart homeostasis and failure

Development and Validation of a Deep-Learning Model to Detect CRP Level from the Electrocardiogram

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