Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare cardiomyopathy but significantly contributes to sudden cardiac death in young otherwise healthy patients, especially endurance athletes. 5-10% of patients with ARVC harbour mutations in the extracellular domains of the desmoglein (DSG) 2 gene. To assess the role of DSG2 in ARVC pathomechanism, mice lacking exons 4-6 of the endogenous DSG2 gene (DSG2mt) were generated. Homozygous DSG2mt/mice developed dilatation of ventricles and pronounced fibrosis. Heterozygous DSG2mt/wt mutants did not show such morphological alterations. Objective: To study whether physical exercise provokes a cardiac phenotype in DGSwt/mt mice, they were subjected to endurance training and compared with wild-type (WT) littermates. Methods/Results: Group swimming training sessions were performed 6 times a week, starting with 5 minutes and gradually incrementing to 90 minutes per day for 7 weeks. Echocardiography was performed before and after training, on mice anaesthetised with 2% isoflurane + oxygen, using a small animal ultrasound unit. Right ventricular (RV) diameters were increased in DSG2wt/mt both compared to pre-training, and compared to WT after training. Right ventricular function was also decreased after training compared to pre-training and compared to WT littermates (see table for values, *p<0.05, d= diastolic, s= systolic, lav= long axis view, sav= short axis view, FAC= fractional area shortening, HR= heart rate). Neither left ventricular diameters nor function differed between DSG2wt/mt and WT littermates. Electrophysiological studies in isolated Langendorff DSGwt/mt and Wt hearts from mice terminally anaesthetised with urethane (2mg/kg) showed comparable ventricular action potential duration and effective refractory periods. DSG2 mutation correlated with increased arrhythmia inducibility after endurance training. Ventricular arrhythmias were induced by a single extrastimulus during right ventricular stimulation in 5 of 8 DSG2wt/mt, but in none of the 7 WT hearts (p=0.03). In conclusion, endurance training reveals an ARVC-like phenotype in otherwise healthy and morphologically inconspicuous DSG2wt/mt mice presenting right ventricular dilation, decreased right ventricular contractility, and increased inducibility of ventricular arrhythmias during right ventricular pacing.
University of Manchester (2012) Proc Physiol Soc 28, PC37
Poster Communications: Endurance training in heterozygous desmoglein-2 mutant mice reveals an arrhythmogenic right ventricular cardiomyopathy-like phenotype
L. Fabritz1, L. Fortmueller2, S. Sakhtivel2, F. Syeda1, P. Kirchhof1, R. Leube3, C. Krusche3
1. University of Birmingham, Birmingham, United Kingdom. 2. University Hospital Muenster, Muenster, Germany. 3. RWTH Aachen University, Aachen, Germany.
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