European Biophysics Journal

, Volume 40, Issue 5, pp 627–639

Quantitative prediction of the arrhythmogenic effects of de novo hERG mutations in computational models of human ventricular tissues

Original Paper

DOI: 10.1007/s00249-010-0663-2

Cite this article as:
Benson, A.P., Al-Owais, M. & Holden, A.V. Eur Biophys J (2011) 40: 627. doi:10.1007/s00249-010-0663-2

Abstract

Mutations to hERG which result in changes to the rapid delayed rectifier current IKr can cause long and short QT syndromes and are associated with an increased risk of cardiac arrhythmias. Experimental recordings of IKr reveal the effects of mutations at the channel level, but how these changes translate to the cell and tissue levels remains unclear. We used computational models of human ventricular myocytes and tissues to predict and quantify the effects that de novo hERG mutations would have on cell and tissue electrophysiology. Mutations that decreased IKr maximum conductance resulted in an increased cell and tissue action potential duration (APD) and a long QT interval on the electrocardiogram (ECG), whereas those that caused a positive shift in the inactivation curve resulted in a decreased APD and a short QT. Tissue vulnerability to re-entrant arrhythmias was correlated with transmural dispersion of repolarisation, and any change to this vulnerability could be inferred from the ECG QT interval or T wave peak-to-end time. Faster IKr activation kinetics caused cell APD alternans to appear over a wider range of pacing rates and with a larger magnitude, and spatial heterogeneity in these cellular alternans resulted in discordant alternans at the tissue level. Thus, from channel kinetic data, we can predict the tissue-level electrophysiological effects of any hERG mutations and identify how the mutation would manifest clinically, as either a long or short QT syndrome with or without an increased risk of alternans and re-entrant arrhythmias.

Keywords

Cardiac arrhythmia Computational modelling Human ether-a-go-go-related gene hERG Long QT syndrome Short QT syndrome 

Abbreviations

APD

Action potential duration

cNBD

Cyclic nucleotide binding domain

ECG

Electrocardiogram

hERG

Human ether-a-go-go-related gene

IKr

Rapid delayed rectifier potassium current

LQTS

Long QT syndrome

M

Midmyocardial

PAS

Per-Arnt-Sim

SQTS

Short QT syndrome

TDR

Transmural dispersion of repolarisation

VF

Ventricular fibrillation

WT

Wild type

Copyright information

© European Biophysical Societies' Association 2011

Authors and Affiliations

  • Alan P. Benson
    • 1
  • Moza Al-Owais
    • 2
  • Arun V. Holden
    • 1
  1. 1.Institute of Membrane & Systems Biology, and Multidisciplinary Cardiovascular Research CentreUniversity of LeedsLeedsUK
  2. 2.Division of Cardiovascular & Neuronal Remodelling, and Multidisciplinary Cardiovascular Research CentreUniversity of LeedsLeedsUK