Key result
Cardiac macrophages regulate physiologic electrical conduction in the healthy heart and contribute to proarrhythmic electrical, structural, and autonomic remodeling in the diseased heart.
Why the study?
Cardiac macrophages have recently been demonstrated as important players in electrophysiology and arrhythmogenesis, with proposed antiarrhythmic and proarrhythmic mechanisms involving diverse subsets and direct or indirect interactions with cardiomyocytes.
This review highlights the emerging role of cardiac macrophages in modulating cardiac electrophysiology and their potential involvement in arrhythmogenesis.
Macrophage modulation should not yet change arrhythmia management; leaves open targeted therapies as a hypothesis-generating research priority.
Cardiac electrophysiology is a complex system established by a plethora of inward and outward ion currents in cardiomyocytes generating and conducting electrical signals in the heart. However, not only cardiomyocytes but also other cell types can modulate the heart rhythm. Recently, cardiac macrophages were demonstrated as important players in both electrophysiology and arrhythmogenesis. Cardiac macrophages are a heterogeneous group of immune cells including resident macrophages derived from embryonic and fetal precursors and recruited macrophages derived from circulating monocytes from the bone marrow. Recent studies suggest antiarrhythmic as well as proarrhythmic effects of cardiac macrophages. The proposed mechanisms of how cardiac macrophages affect electrophysiology vary and include both direct and indirect interactions with other cardiac cells. In this review, we provide an overview of the different subsets of macrophages in the heart and their possible interactions with cardiomyocytes under both physiologic conditions and heart disease. Furthermore, we elucidate similarities and differences between human, murine and porcine cardiac macrophages, thus providing detailed information for researchers investigating cardiac macrophages in important animal species for electrophysiologic research. Finally, we discuss the pros and cons of mice and pigs to investigate the role of cardiac macrophages in arrhythmogenesis from a translational perspective.
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Xia et al. (2022) conducted a review in Arrhythmia. Cardiac macrophages was evaluated. Cardiac macrophages regulate physiologic electrical conduction in the healthy heart and contribute to proarrhythmic electrical, structural, and autonomic remodeling in the diseased heart.
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