Genetic suppression of Gαs protein provides rate control in atrial fibrillation

Basic Res Cardiol. 2012 May;107(3):265. doi: 10.1007/s00395-012-0265-5. Epub 2012 Mar 29.

Abstract

Gene therapy-based modulation of atrioventricular (AV) conduction by overexpression of a constitutively active inhibitory Gα(i) protein effectively reduced heart rates in atrial fibrillation (AF). However, catecholamine stimulation caused an excessive increase in ventricular rate. We hypothesized that modest genetic suppression of a stimulatory G protein in the AV node would allow persistent rate control in acute AF and would prevent undesired heart rate acceleration during β-adrenergic activation. Atrial fibrillation was induced in 12 pigs by atrial burst pacing via an implanted cardiac pacemaker. Study animals were then assigned to receive either Ad-siRNA-Gα(s) gene therapy to inactivate Gα(s) protein or Ad-β-gal as control. Gα(s) protein inactivation resulted in a 20 % heart rate reduction (P < 0.01). AH and HV intervals were prolonged by 37 ms (P < 0.001) and 28 ms (P < 0.001), respectively, demonstrating atrioventricular conduction delay. Impairment of left ventricular ejection fraction (LVEF) during AF was attenuated by Gα(s) suppression (LVEF 49 %) compared with controls (LVEF 34 %; P = 0.03). Isoproterenol application accelerated ventricular heart rate from 233 to 281 bpm (P < 0.001) in control animals but did not significantly affect pigs treated with Ad-siRNA-Gα(s) (192 vs. 216 bpm; P = 0.19). In conclusion, genetic inhibition of Gα(s) protein in the AV node reduced heart rate and prevented AF-associated reduction of cardiac function in a porcine model. Rate control by gene therapy may provide an alternative to current pharmacological treatment of AF.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Agonists / administration & dosage
  • Animals
  • Atrial Fibrillation / etiology
  • Atrial Fibrillation / genetics
  • Atrial Fibrillation / metabolism
  • Atrial Fibrillation / pathology
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / therapy*
  • Atrioventricular Node / metabolism*
  • Atrioventricular Node / pathology
  • Atrioventricular Node / physiopathology
  • Cardiac Pacing, Artificial
  • Disease Models, Animal
  • Electrocardiography
  • Fibrosis
  • GTP-Binding Protein alpha Subunits, Gs / genetics*
  • GTP-Binding Protein alpha Subunits, Gs / metabolism
  • Genetic Therapy / adverse effects
  • Genetic Therapy / methods*
  • Heart Rate / drug effects
  • Heart Rate / genetics*
  • Isoproterenol / administration & dosage
  • Pacemaker, Artificial
  • RNA Interference*
  • RNA, Small Interfering / administration & dosage*
  • Stroke Volume
  • Sus scrofa
  • Time Factors
  • Ventricular Function, Left

Substances

  • Adrenergic beta-Agonists
  • RNA, Small Interfering
  • GTP-Binding Protein alpha Subunits, Gs
  • Isoproterenol