Key result
Administration of the α1-AR blocker doxazosin significantly reduced the incidence of LPS-induced sustained atrial fibrillation from 60% to 20% in a canine model.
Why the study?
Does doxazosin prevent systemic inflammation-induced atrial fibrillation vulnerability and connexin 43 remodeling in a canine model?
Does doxazosin prevent systemic inflammation-induced atrial fibrillation vulnerability and connexin 43 remodeling in a canine model?
In a canine model, chronic low-grade systemic inflammation increases atrial fibrillation inducibility via an α1-adrenergic receptor-dependent pathway involving NF-κB activation and Cx43 remodeling, which can be attenuated by doxazosin.
Answers are grounded in this paper and cite their sources.
Doxazosin attenuated LPS-induced AF in canines; hypothesis-generating for α1-AR blockade in inflammation-related AF and requires clinical validation.
The exact mechanism associated with inflammation and atrial fibrillation (AF) remains unknown. The aim of the present study was to investigate the roles of connexin 43 (Cx43) and a1‑adrenergic receptor (α1‑AR) activation in the pathogenesis of system inflammation‑induced AF. A canine model of chronic low‑grade system inflammation was established by administrating a low dose of lipopolysaccharide (LPS; 0.1 µg/kg) for 2 weeks. Programmed stimulation was applied on the right atrial appendage to determine the effective refractory periods (ERP) and the window of vulnerability (WOV). Tumor necrosis factor α (TNF‑α) and interleukin 6 (IL‑6) levels in plasma and atrial tissue were measured by ELISA. Cx43, Toll‑like receptor 4 (TLR4) and nuclear factor κB (NF‑κB) proteins were analyzed using western blotting or immunohistochemistry. Administration of LPS for 2 weeks increased the concentration of TNF‑α and IL‑6 in the plasma and right atrium. ERP was markedly shortened and cumulative WOV was significantly widened in the LPS group. Following treatment with LPS, the amount of Cx43 protein in the area of intercalated disk increased. In addition, a high‑density of Cx43 in the lateral connection was identified. LPS also induced the activation of NF‑κB in the canine atrium. Administration with the α1‑AR blocker doxazosin prevented the production of LPS‑induced inflammatory cytokine and reversed the enhanced vulnerability to atrial fibrillation. Doxazosin inhibited the LPS‑induced increase in Cx43 protein and heterogeneous distribution, and prevented the activation of NF‑κB. These results indicated that chronic low‑grade system inflammation may increase the inducibility of AF in a canine model. The underlying mechanism may be involved in the LPS‑induced activation of NF‑κB, and the increase in Cx43 expression and lateral distribution via an α1-AR-dependent pathway.
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Chen et al. (2017) studied Atrial fibrillation (n=20). Doxazosin vs. LPS only was evaluated on Sustained AF inducibility (p=<0.05). Administration of the α1-AR blocker doxazosin significantly reduced the incidence of LPS-induced sustained atrial fibrillation from 60% to 20% in a canine model.
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