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Unexpected impairment of INa underpins reentrant arrhythmias in a knock-in swine model of Timothy syndrome

Published inNature cardiovascular research, vol. 2, no. 12, p. 1291-1309
Publication date2023
First online date2023-12-11
Abstract

Timothy syndrome 1 (TS1) is a multi-organ form of long QT syndrome associated with life-threatening cardiac arrhythmias, the organ-level dynamics of which remain unclear. In this study, we developed and characterized a novel porcine model of TS1 carrying the causative p.Gly406Arg mutation inCACNA1C, known to impair CaV1.2 channel inactivation. Our model fully recapitulated the human disease with prolonged QT interval and arrhythmic mortality. Electroanatomical mapping revealed the presence of a functional substrate vulnerable to reentry, stemming from an unforeseen constitutional slowing of cardiac activation. This signature substrate of TS1 was reliably identified using the reentry vulnerability index, which, we further demonstrate, can be used as a benchmark for assessing treatment efficacy, as shown by testing of multiple clinical and preclinical anti-arrhythmic compounds. Notably, in vitro experiments showed that TS1 cardiomyocytes display Ca2+overload and decreased peak INacurrent, providing a rationale for the arrhythmogenic slowing of impulse propagation in vivo.

Keywords
  • Arrhythmias
  • Cardiovascular genetics
Affiliation entities Not a UNIGE publication
Citation (ISO format)
PORTA-SÁNCHEZ, Andreu et al. Unexpected impairment of INa underpins reentrant arrhythmias in a knock-in swine model of Timothy syndrome. In: Nature cardiovascular research, 2023, vol. 2, n° 12, p. 1291–1309. doi: 10.1038/s44161-023-00393-w
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Additional URL for this publicationhttps://www.nature.com/articles/s44161-023-00393-w
Journal ISSN2731-0590
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