Key result
GIRK channel blockade prolongs QT interval ~48% and increases ventricular arrhythmias in heart failure mice.
Why the study?
Ventricular arrhythmia causing sudden cardiac death is the leading mode of death in patients with heart failure, but the mechanisms that prevent ventricular arrhythmias in heart failure are not well characterized.
Does GIRK channel blockade with tertiapin-Q induce QT prolongation and arrhythmias in a mouse model of heart failure?
Does GIRK channel blockade with tertiapin-Q induce QT prolongation and arrhythmias in a mouse model of heart failure?
Absolute Event Rate: 99.8% vs 67.4%
p-value: p=<0.05
Constitutive GIRK channel activity in failing ventricular myocytes protects against QT prolongation and ventricular arrhythmias, suggesting a novel compensatory anti-arrhythmic mechanism in heart failure.
GIRK blockade may promote arrhythmias in failing hearts; hypothesis-generating for compensatory mechanism, needs translational confirmation.
Ventricular arrhythmia causing sudden cardiac death is the leading mode of death in patients with heart failure. Yet, the mechanisms that prevent ventricular arrhythmias in heart failure are not well characterized. Using a mouse model of heart failure created by transverse aorta constriction, we show that GIRK channel, an important regulator of cardiac action potentials, is constitutively active in failing ventricles in contrast to normal cells. Evidence is presented indicating that the tonic activation of M 2 muscarinic acetylcholine receptors by endogenously released acetylcholine contributes to the constitutive GIRK activity. This constitutive GIRK activity prevents the action potential prolongation in heart failure ventricles. Consistently, GIRK channel blockade with tertiapin-Q induces QT interval prolongation and increases the incidence of arrhythmia in heart failure, but not in control mice. These results suggest that constitutive GIRK channels comprise a key mechanism to protect against arrhythmia by providing repolarizing currents in heart failure ventricles.
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An et al. (2023) studied Heart failure (n=107). Tertiapin-Q vs. Baseline was evaluated on QT interval (ms) (p=<0.05). GIRK channel blockade with tertiapin-Q markedly prolonged the QT interval from 67.4 ms to 99.8 ms and increased the incidence of ventricular arrhythmia in heart failure mice, but not in sham mice.
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