Background—
We have previously linked hereditary progressive cardiac conduction defect (hereditary Lenègre’s disease) to a loss-of-function mutation in the gene encoding the main cardiac Na
+
channel,
SCN5A
. In the present study, we investigated heterozygous
Scn5a
-knockout mice (
Scn5a
+/−
mice) as a model for hereditary Lenègre’s disease.
Methods and Results—
In
Scn5a
+/−
mice, surface ECG recordings showed age-related lengthening of the P-wave and PR- and QRS-interval duration, coinciding with previous observations in patients with Lenègre’s disease. Old but not young
Scn5a
+/−
mice showed extensive fibrosis of their ventricular myocardium, a feature not seen in wild-type animals. In old
Scn5a
+/−
mice, fibrosis was accompanied by heterogeneous expression of connexin 43 and upregulation of hypertrophic markers, including β-MHC and skeletal α-actin. Global connexin 43 expression as assessed with Western blots was similar to wild-type mice. Decreased connexin 40 expression was seen in the atria. Using pangenomic microarrays and real-time PCR, we identified in
Scn5a
+/−
mice an age-related upregulation of genes encoding Atf3 and Egr1 transcription factors. Echocardiography and hemodynamic investigations demonstrated conserved cardiac function with aging and lack of ventricular hypertrophy.
Conclusions—
We conclude that
Scn5a
+/−
mice convincingly recapitulate the Lenègre’s disease phenotype, including progressive impairment with aging of atrial and ventricular conduction associated with myocardial rearrangements and fibrosis. Our work provides the first demonstration that a monogenic ion channel defect can progressively lead to myocardial structural anomalies.