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1 Division of Cardiology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States
2 Guidant Corporation, St. Paul, Minnesota, United States
3 Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, United States
4 Agilent Technologies, Columbia, Maryland, United States
* To whom correspondence should be addressed. E-mail: dkass{at}jhmi.edu.
Routine clinical right ventricular pacing generates left ventricular dyssynchrony manifested by early septal shortening followed by late lateral contraction that in turn reciprocally stretches the septum. Dyssynchrony is disadvantageous to cardiac mechano-energetics and worsens clinical prognosis, yet little is known about its molecular consequences. Here we report the influence of cardiac dyssynchrony on regional cardiac gene expression in mice. Mice were implanted with a custom-designed miniature cardiac pacemaker and subjected to 1-week overdrive right ventricular free-wall pacing (720 min-1, baseline HR 520-620 min-1) to generate dyssynchrony (pacemaker: 3V lithium battery, rate programmable, 1.5 grams, bipolar lead). Electrical capture was confirmed by pulsed-wave Doppler and dyssynchrony by echocardiography. Gene expression from left ventricular septal and lateral wall myocardium was assessed by microarray (dual-dye method, Agilent) using oligonucleotide probes and dye swap. Identical analysis was applied to 4 synchronously contracting controls. Of 22,000 genes surveyed, only 18 genes displayed significant (p<0.01) differential expression between septal/lateral walls >1.5 times that in the synchronous controls. Gene changes were confirmed by qPCR with excellent correlations. Most of the genes (n=16) showed greater septal expression. Of particular interest were 7 genes coding proteins involved with stretch responses, matrix remodeling, stem cell differentiation to myocyte lineage, and Purkinje fiber differentiation. One week of iatrogenic cardiac dyssynchrony triggers regional differential expression in relatively few select genes. Such analysis using a murine implantable pacemaker should facilitate molecular studies of cardiac dyssynchrony and help elucidate novel mechanisms by which stress/stretch stimuli due to dyssynchrony impact the normal and failing heart.
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