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Circulation. 1993;88:864-875

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Circulation, Vol 88, 864-875, Copyright © 1993 by American Heart Association


ARTICLES

Reduced content of connexin43 gap junctions in ventricular myocardium from hypertrophied and ischemic human hearts

NS Peters, CR Green, PA Poole-Wilson and NJ Severs
Department of Cardiac Medicine, National Heart and Lung Institute, London, England.

BACKGROUND. Gap junctions are a determinant of myocardial conduction. Disturbances of gap-junctional content may account for abnormalities of impulse propagation, contributing to the arrhythmic tendency and mechanical inefficiency of ischemic and hypertrophied myocardium. The aim of this study was to characterize gap junction organization in normal human ventricular myocardium and to establish whether abnormalities exist in myocardium of chronically ischemic and hypertrophied hearts. METHODS AND RESULTS. Cardiac gap-junctional connexin43 antibodies and confocal microscopy were used in a quantitative immunohistochemical study of surgical myocardial samples to explore the structural basis of electromechanical ventricular dysfunction in chronic ischemic and hypertrophic heart diseases. Normal adult human left ventricular myocardium had a gap-junctional surface area of 0.0051 micron2/micron3 myocyte volume; gap junctions were confined to intercalated disks, of which there was a mean of 11.6 per cell. The right ventricle showed similar gap junction surface area. Left ventricular myocardium from ischemic hearts (distant from any fibrotic scarring), despite normal numbers of intercalated disks per cell, had a reduced gap junction surface area (0.0027 micron2/micron3; P = .02), as did hypertrophied myocardium (0.0031 micron2/micron3; P = .05). The cardiac myocytes in the pathological tissues were larger than normal, and estimated gap-junctional content per cell was reduced in ischemic ventricle (P = .02) compared with normal. CONCLUSIONS. Gap junctions in normal adult human working ventricular myocardium occupy an area of 0.0051 micron2/micron3 myocyte volume. This surface area is reduced in ventricular myocardium from hearts subject to chronic hypertrophy and ischemia, despite a normal number of intercellular abutments, and this alteration may contribute to abnormal impulse propagation in these hearts.


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Cardiovasc ResHome page
K. Yasui, K. Kada, M. Hojo, J.-K. Lee, K. Kamiya, J. Toyama, T. Opthof, and I. Kodama
Cell-to-cell interaction prevents cell death in cultured neonatal rat ventricular myocytes
Cardiovasc Res, October 1, 2000; 48(1): 68 - 76.
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Circ. Res.Home page
G. E. Morley and J. Jalife
Cardiac Gap Junction Remodeling by Stretch : Is It a Good Thing?
Circ. Res., August 18, 2000; 87(4): 272 - 274.
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J. Zhuang, K. A. Yamada, J. E. Saffitz, and A. G. Kleber
Pulsatile Stretch Remodels Cell-to-Cell Communication in Cultured Myocytes
Circ. Res., August 18, 2000; 87(4): 316 - 322.
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Cardiovasc ResHome page
R.C. Saumarez and A.A. Grace
Paced ventricular electrogram fractionation and sudden death in hypertrophic cardiomyopathy and other non-coronary heart diseases
Cardiovasc Res, July 1, 2000; 47(1): 11 - 22.
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H. J. Jongsma and R. Wilders
Gap Junctions in Cardiovascular Disease
Circ. Res., June 23, 2000; 86(12): 1193 - 1197.
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Cardiovasc ResHome page
H. M.W. van der Velden, J. Ausma, M. B. Rook, A. J.C.G.M. Hellemons, T. A.A.B. van Veen, M. A. Allessie, and H. J. Jongsma
Gap junctional remodeling in relation to stabilization of atrial fibrillation in the goat
Cardiovasc Res, June 1, 2000; 46(3): 476 - 486.
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Am. J. Physiol. Heart Circ. Physiol.Home page
J. E. Saffitz, K. G. Green, W. J. Kraft, K. B. Schechtman, and K. A. Yamada
Effects of diminished expression of connexin43 on gap junction number and size in ventricular myocardium
Am J Physiol Heart Circ Physiol, May 1, 2000; 278(5): H1662 - H1670.
[Abstract] [Full Text] [PDF]


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M. Uzzaman, H. Honjo, Y. Takagishi, L. Emdad, A. I. Magee, N. J. Severs, and I. Kodama
Remodeling of Gap Junctional Coupling in Hypertrophied Right Ventricles of Rats With Monocrotaline-Induced Pulmonary Hypertension
Circ. Res., April 28, 2000; 86(8): 871 - 878.
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M. S. Spach, J. F. Heidlage, P. C. Dolber, and R. C. Barr
Electrophysiological Effects of Remodeling Cardiac Gap Junctions and Cell Size : Experimental and Model Studies of Normal Cardiac Growth
Circ. Res., February 18, 2000; 86(3): 302 - 311.
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EuropaceHome page
R. Wolk
Arrhythmogenic mechanisms in left ventricular hypertrophy
Europace, January 1, 2000; 2(3): 216 - 223.
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Eur Heart JHome page
J.-A. Haefliger, J.J. Goy, and G. Waeber
Sporadic cases of dilated cardiomyopathies associated with atrioventricular conduction defects are not linked to mutation within the connexins 40 and 43 genes
Eur. Heart J., December 2, 1999; 20(24): 1843 - 1843.
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T. Matsushita, M. Oyamada, K. Fujimoto, Y. Yasuda, S. Masuda, Y. Wada, T. Oka, and T. Takamatsu
Remodeling of Cell-Cell and Cell-Extracellular Matrix Interactions at the Border Zone of Rat Myocardial Infarcts
Circ. Res., November 26, 1999; 85(11): 1046 - 1055.
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T. Toyofuku, M. Yabuki, K. Otsu, T. Kuzuya, M. Tada, and M. Hori
Functional Role of c-Src in Gap Junctions of the Cardiomyopathic Heart
Circ. Res., October 15, 1999; 85(8): 672 - 681.
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S. Kostin, S. Hein, E. P. Bauer, and J. Schaper
Spatiotemporal Development and Distribution of Intercellular Junctions in Adult Rat Cardiomyocytes in Culture
Circ. Res., July 23, 1999; 85(2): 154 - 167.
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Cardiovasc ResHome page
J. E. Saffitz, R. B. Schuessler, and K. A. Yamada
Mechanisms of remodeling of gap junction distributions and the development of anatomic substrates of arrhythmias
Cardiovasc Res, May 1, 1999; 42(2): 309 - 317.
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CirculationHome page
A. Hagendorff, B. Schumacher, S. Kirchhoff, B. Luderitz, and K. Willecke
Conduction Disturbances and Increased Atrial Vulnerability in Connexin40-Deficient Mice Analyzed by Transesophageal Stimulation
Circulation, March 23, 1999; 99(11): 1508 - 1515.
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J. G Laing, P. N Tadros, K. Green, J. E Saffitz, and E. C Beyer
Proteolysis of connexin43-containing gap junctions in normal and heat-stressed cardiac myocytes
Cardiovasc Res, June 1, 1998; 38(3): 711 - 718.
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CirculationHome page
L. R. C. Dekker, H. Rademaker, J. T. Vermeulen, T. Opthof, R. Coronel, J. A. E. Spaan, and M. J. Janse
Cellular Uncoupling During Ischemia in Hypertrophied and Failing Rabbit Ventricular Myocardium : Effects of Preconditioning
Circulation, May 5, 1998; 97(17): 1724 - 1730.
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CirculationHome page
N. S. Peters and A. L. Wit
Myocardial Architecture and Ventricular Arrhythmogenesis
Circulation, May 5, 1998; 97(17): 1746 - 1754.
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CirculationHome page
R. R. Kaprielian, M. Gunning, E. Dupont, M. N. Sheppard, S. M. Rothery, R. Underwood, D. J. Pennell, K. Fox, J. Pepper, P. A. Poole-Wilson, et al.
Downregulation of Immunodetectable Connexin43 and Decreased Gap Junction Size in the Pathogenesis of Chronic Hibernation in the Human Left Ventricle
Circulation, February 24, 1998; 97(7): 651 - 660.
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D. Garcia-Dorado, J. Inserte, M. Ruiz-Meana, M. A. Gonzalez, J. Solares, M. Julia, J. A. Barrabes, and J. Soler-Soler
Gap Junction Uncoupler Heptanol Prevents Cell-to-Cell Progression of Hypercontracture and Limits Necrosis During Myocardial Reperfusion
Circulation, November 18, 1997; 96(10): 3579 - 3586.
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M. Cooklin, W. R. J. Wallis, D. J. Sheridan, and C. H. Fry
Changes in Cell-to-Cell Electrical Coupling Associated With Left Ventricular Hypertrophy
Circ. Res., June 19, 1997; 80(6): 765 - 771.
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CirculationHome page
N. S. Peters, J. Coromilas, N. J. Severs, and A. L. Wit
Disturbed Connexin43 Gap Junction Distribution Correlates With the Location of Reentrant Circuits in the Epicardial Border Zone of Healing Canine Infarcts That Cause Ventricular Tachycardia
Circulation, February 18, 1997; 95(4): 988 - 996.
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B. D. Angst, L. U.R. Khan, N. J. Severs, K. Whitely, S. Rothery, R. P. Thompson, A. I. Magee, and R. G. Gourdie
Dissociated Spatial Patterning of Gap Junctions and Cell Adhesion Junctions During Postnatal Differentiation of Ventricular Myocardium
Circ. Res., January 1, 1997; 80(1): 88 - 94.
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A. M. Gillis, V. G. Fast, S. Rohr, and A. G. Kleber
Spatial Changes in Transmembrane Potential During Extracellular Electrical Shocks in Cultured Monolayers of Neonatal Rat Ventricular Myocytes
Circ. Res., October 1, 1996; 79(4): 676 - 690.
[Abstract] [Full Text]