Aging Disrupts Normal Time-of-Day Variation in Cardiac Electrophysiology

Supplemental Digital Content is available in the text. Background: Cardiac gene expression and arrhythmia occurrence have time-of-day variation; however, daily changes in cardiac electrophysiology, arrhythmia susceptibility, and Ca2+ handling have not been characterized. Furthermore, how these patterns change with age is unknown. Methods: Hearts were isolated during the light (zeitgeber time [ZT] 4 and ZT9) and dark cycle (ZT14 and ZT21) from adult (12–18 weeks) male mice. Hearts from aged (18–20 months) male mice were isolated at ZT4 and ZT14. All hearts were Langendorff-perfused for optical mapping with voltage- and Ca2+-sensitive dyes (n=4–7/group). Cardiac gene and protein expression were assessed with real-time polymerase chain reaction (n=4–6/group) and Western blot (n=3–4/group). Results: Adult hearts had the shortest action potential duration (APD) and Ca2+ transient duration (CaTD) at ZT14 (APD80: ZT4: 45.4±4.1 ms; ZT9: 45.1±8.6 ms; ZT14: 34.7±4.2 ms; ZT21: 49.2±7.6 ms, P<0.05 versus ZT4 and ZT21; and CaTD80: ZT4: 70.1±3.3 ms; ZT9: 72.7±2.7 ms; ZT14: 64.3±3.3 ms; ZT21: 74.4±1.2 ms, P<0.05 versus other time points). The pacing frequency at which CaT alternans emerged was faster, and average CaT alternans magnitude was significantly reduced at ZT14 compared with the other time points. There was a trend for decreased spontaneous premature ventricular complexes and pacing-induced ventricular arrhythmias at ZT14, and the hearts at ZT14 had diminished responses to isoproterenol compared with ZT4 (ZT4: 49.5.0±5.6% versus ZT14: 22.7±9.5% decrease in APD, P<0.01). In contrast, aged hearts exhibited no difference between ZT14 and ZT4 in nearly every parameter assessed (except APD80: ZT4: 39.7±1.9 ms versus ZT14: 33.8±3.1 ms, P<0.01). Gene expression of KCNA5 (potassium voltage-gated channel subfamily A member 5; encoding Kv1.5) was increased, whereas gene expression of ADRB1 (encoding β1-adrenergic receptors) was decreased at ZT14 versus ZT4 in adult hearts. No time-of-day changes in expression or phosphorylation of Ca2+ handling proteins (SERCA2 [sarco/endoplasmic reticulum Ca2+-ATPase], RyR2 [ryanodine receptor 2], and PLB [phospholamban]) was found in ex vivo perfused adult isolated hearts. Conclusions: Isolated adult hearts have strong time-of-day variation in cardiac electrophysiology, Ca2+ handling, and adrenergic responsiveness, which is disrupted with age.

[1]  Halina Dobrzynski,et al.  Circadian rhythm of cardiac electrophysiology, arrhythmogenesis, and the underlying mechanisms , 2019, Heart rhythm.

[2]  C. Ripplinger,et al.  Exposure to Secondhand Smoke and Arrhythmogenic Cardiac Alternans in a Mouse Model , 2018, Environmental health perspectives.

[3]  D. Bechtold,et al.  Misalignment with the external light environment drives metabolic and cardiac dysfunction , 2017, Nature Communications.

[4]  S. Amir,et al.  The aging clock: circadian rhythms and later life , 2017, The Journal of clinical investigation.

[5]  M. Thomsen,et al.  Circadian rhythm in QT interval is preserved in mice deficient of potassium channel interacting protein 2 , 2017, Chronobiology international.

[6]  Pablo Laguna,et al.  Circadian modulation on T-wave alternans activity in chronic heart failure patients , 2015, 2015 Computing in Cardiology Conference (CinC).

[7]  K. Gamble,et al.  Cardiomyocyte-Specific BMAL1 Plays Critical Roles in Metabolism, Signaling, and Maintenance of Contractile Function of the Heart , 2014, Journal of biological rhythms.

[8]  M. Bentivoglio,et al.  Differential modulation of clock gene expression in the suprachiasmatic nucleus, liver and heart of aged mice , 2014, Experimental Gerontology.

[9]  Donald M Bers,et al.  Optical Mapping of Sarcoplasmic Reticulum Ca2+ in the Intact Heart: Ryanodine Receptor Refractoriness During Alternans and Fibrillation , 2014, Circulation research.

[10]  C. Ripplinger,et al.  Optical Mapping of Sarcoplasmic Reticulum Ca2+ in the Intact HeartNovelty and Significance , 2014 .

[11]  N. Samani,et al.  Diurnal variation in excitation-contraction coupling is lost in the adult spontaneously hypertensive rat heart , 2013, Journal of hypertension.

[12]  Daniel C Bartos,et al.  The cardiomyocyte molecular clock, regulation of Scn5a, and arrhythmia susceptibility. , 2013, American journal of physiology. Cell physiology.

[13]  M. Cutler,et al.  Targeted Sarcoplasmic Reticulum Ca2+ ATPase 2a Gene Delivery to Restore Electrical Stability in the Failing Heart , 2012, Circulation.

[14]  E. Watanabe,et al.  Circadian expressions of cardiac ion channel genes in mouse might be associated with the central clock in the SCN but not the peripheral clock in the heart , 2012, Biological rhythm research.

[15]  V. Shusterman,et al.  Nocturnal Peak in Atrial Tachyarrhythmia Occurrence as a Function of Arrhythmia Burden , 2012, Journal of cardiovascular electrophysiology.

[16]  David S. Rosenbaum,et al.  Circadian rhythms govern cardiac repolarization and arrhythmogenesis , 2012, Nature.

[17]  C. Guilleminault,et al.  REM-related bradyarrhythmia syndrome. , 2011, Sleep medicine reviews.

[18]  J. Bibb,et al.  Sustained Hemodynamic Stress Disrupts Normal Circadian Rhythms in Calcineurin-Dependent Signaling and Protein Phosphorylation in the Heart , 2011, Circulation research.

[19]  J. Tamargo,et al.  IKur/Kv1.5 channel blockers for the treatment of atrial fibrillation , 2009 .

[20]  F. Scheer,et al.  Adverse metabolic and cardiovascular consequences of circadian misalignment , 2009, Proceedings of the National Academy of Sciences.

[21]  C. Shaw,et al.  Disruption of the circadian clock within the cardiomyocyte influences myocardial contractile function, metabolism, and gene expression. , 2008, American journal of physiology. Heart and circulatory physiology.

[22]  Itsuo Kodama,et al.  Prognostic significance of circadian variability of RR and QT intervals and QT dynamicity in patients with chronic heart failure. , 2007, Heart rhythm.

[23]  C. Shaw,et al.  The intrinsic circadian clock within the cardiomyocyte. , 2005, American journal of physiology. Heart and circulatory physiology.

[24]  P. Hardin,et al.  Circadian rhythms from multiple oscillators: lessons from diverse organisms , 2005, Nature Reviews Genetics.

[25]  M. Menaker,et al.  Cardiovascular Tissues Contain Independent Circadian Clocks , 2005, Clinical and experimental hypertension.

[26]  Y. Iwasaki,et al.  Circadian Variation of Cardiac K+ Channel Gene Expression , 2003, Circulation.

[27]  A. Brandes,et al.  Circadian Profile of QT Interval and QT Interval Variability in 172 Healthy Volunteers , 2003, Pacing and clinical electrophysiology : PACE.

[28]  S. Reppert,et al.  Coordination of circadian timing in mammals , 2002, Nature.

[29]  I. Maia,et al.  Electrical behavior of T-wave polarity alternans in patients with congenital long QT syndrome. , 2000, Journal of the American College of Cardiology.

[30]  R. Ideker,et al.  Estimation of conduction velocity vector fields from epicardial mapping data , 1998, IEEE Transactions on Biomedical Engineering.

[31]  A. Camm,et al.  Circadian variation of the QT interval in patients with sudden cardiac death after myocardial infarction. , 1998, The American journal of cardiology.

[32]  T. Saikawa,et al.  Circadian variation of QT interval dispersion: correlation with heart rate variability. , 1997, Journal of electrocardiology.

[33]  A. Kadish,et al.  Circadian variation in human ventricular refractoriness. , 1995, Circulation.

[34]  J. Muller,et al.  Morning peak in ventricular tachyarrhythmias detected by time of implantable cardioverter/defibrillator therapy. The CPI Investigators. , 1995, Circulation.

[35]  S. Willich,et al.  Circadian Variation of Sudden Cardiac Death Reflects Age‐Related Variability in Ventricular Fibrillation , 1993, Circulation.

[36]  W. Aronow,et al.  Circadian variation of primary cardiac arrest or sudden cardiac death in patients aged 62 to 100 years (mean 82). , 1993, The American journal of cardiology.

[37]  S. Lightman,et al.  Circadian rhythms of epinephrine and norepinephrine in man. , 1985, The Journal of clinical endocrinology and metabolism.

[38]  D. Glogar,et al.  Frequency and Variability of Ventricular Premature Contractions—The Influence of Heart Rate and Circadian Rhythms , 1982, Pacing and clinical electrophysiology : PACE.

[39]  M. Lindsey,et al.  Atherosclerosis exacerbates arrhythmia following myocardial infarction: Role of myocardial inflammation. , 2015, Heart rhythm.

[40]  A. Richards,et al.  Diurnal patterns of blood pressure, heart rate and vasoactive hormones in normal man. , 1986, Clinical and experimental hypertension. Part A, Theory and practice.