No description available.

No description available.

Cardiovascular diseases (CVD) contributed to almost 30% of worldwide mortality; with heart failure being one class of CVD. One popular and widely available treatment for heart failure is the intra-aortic balloon pump (IABP). This heart assist device is used in counterpulsation to improve myocardial function by increasing coronary perfusion, and decreasing aortic end-diastolic pressure (i.e. the resistance to blood ejection from the heart). However, this device can only be used acutely, and patients are bedridden. The subject of this research is a novel heart assist treatment called the Chronic Intermittent Mechanical Support (CIMS) which was conceived to offer advantages of the IABP device chronically, whilst overcoming its disadvantages. The CIMS device comprises an implantable balloon pump, a percutaneous drive line, and a wearable driver console. The research here aims to determine the haemodynamic effect of balloon pump activation under in vitro conditions. A human mock circulatory loop (MCL) with systemic and coronary perfusion was constructed, capable of simulating various degrees of heart failure. Two prototypes of the CIMS balloon pump were made with varying stiffness. Several experimental factors (balloon inflation/deflation timing, Helium gas volume, arterial compliance, balloon pump stiffness and heart valve type) form the factorial design experiments. A simple modification to the MCL allowed flow visualisation experiments using video recording. Suitable statistical tests were used to analyse the data obtained from all experiments. Balloon inflation and deflation in the ascending aorta of the MCL yielded favourable results. The sudden balloon deflation caused the heart valve to open earlier, thus causing longer valve opening duration in a cardiac cycle. It was also found that pressure augmentation in diastole was significantly correlated with increased cardiac output and coronary flowrate. With an optimum combination (low arterial compliance and low balloon pump stiffness), systemic and coronary perfusions were increased by 18% and 21% respectively, while the aortic end-diastolic pressure (forward flow resistance) decreased by 17%. Consequently, the ratio of oxygen supply and demand to myocardium (endocardial viability ratio, EVR) increased between 33% and 75%. The increase was mostly attributed to diastolic augmentation rather than systolic unloading.

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No description available.

Calcium entry through voltage-gated calcium (CaV) channels is important in diverse cellular processes including neurotransmitter release, gene expression and cardiac pacemaker activity. CaV channels auxiliary CaVβ subunits enhance plasma membrane expression and modify the biophysical properties of CaVα1 subunits. Due to their multi-domain structures - including a conserved SH3-GK 'core' and hypervariable N- and C- terminal domains - CaVβs are also considered to be members of the membrane-associated guanylate kinase (MAGUK) family of scaffolding proteins, and may therefore act as molecular scaffolds both within and outside the CaV channel complex. This project studied the roles of CaVβ N- and C-terminal hypervariable domains in contributing to isoform-specific differences in CaVβ functions both in a) CaV channel complex expression and distribution, and b) interactions with non channel proteins. To analyse such contributions a series of molecular tools were developed to assess the distributions of CaVβs (both within and outside the CaV channel complex) and their interactions with novel potential partner proteins. This involved systematically testing fluorophore- and epitope-tagged CaVβs for co-localisation with both fluorophore-tagged CaV2.2 and a range of myc-tagged potential interaction partners (as quantified either by a 'Membrane Localisation Index' developed during this project or Intensity Correlation Analysis). This approach uncovered much detail about relative isoform specificities of CaVβ non-channel complex protein-protein interactions, however one particularly striking interaction was discovered between CaVβ1b/CaVβ4 and the nuclear protein Heterochromatin 1 γ (HP1γ), where nuclear translocation of CaVβ1b or CaVβ4 was induced upon association with HP1γ. Given the similarity of CaVβ1b and CaVβ4 N termini, a series of CaVβ1b N-terminal chimeras were then created, where the N terminus was exchanged with that of CaVβ3 (which did not interact with HP1γ). Subsequent imaging studies using these chimeras then confirmed that the CaVβ1b N terminus is necessary for co-localisation with HP1γ and subsequent HP1γ mediated CaVβ nuclear uptake. Given that an interaction between the CaVβ3 isoform and Pax6(S) - another nuclear protein - have been reported, where the CaVβ3-Pax6(S) interaction also induces nuclear translocation of both proteins, the CaVβ1b/CaVβ4-HP1γ interaction may represent one of a range of as-yet undiscovered CaVβ1b/gene regulatory protein interactions. As interaction with CaVβ3 suppresses the transcriptional activity of Pax6(S), nuclear targeting may be an important means by which CaVβs modulate gene expression - which in the case of HP1γ interactions may occur via de-repression.

During excitation-contraction coupling, Ca2+ transient induced by the depolarization of membrane potential is the trigger of mechanical contraction in cardiac myocytes, which is responsible for the pumping function of the heart. However, mechanisms underlying intracellular Ca2+ regulation and the coupling between Ca2+ transient and membrane potential are not completely understood. Abnormalities in intracellular Ca2+ regulation have been observed during heart failure and cardiac arrhythmias, such as intracellular Ca2+ alternans and T-tubule disorganization. In this project, intracellular Ca2+ dynamics in different types of cardiac myocytes were investigated by using computer modelling. For atrial myocytes, a biophysically detailed computer model was developed to describe the observations of Ca2+ alternans and Ca2+ wave propagation in cardiac myocytes lacking T-tubules. The model was validated by its ability to reproduce experimental observed Ca2+ wave propagation under normal condition and the influences on spatial Ca2+ distribution by modifying various aspects of Ca2+ cycling, such as Ca2+ influx, SR Ca2+ uptake and SR Ca2+ release in cardiac myocytes lacking T-tubules. Mechanisms underlying the genesis of Ca2+ alternans in this type of cell were investigated by the model. Furthermore, a spontaneous second Ca2+ release was observed in response to a single voltage stimulus pulse with enhanced Ca2+ influx as well as SR Ca2+ overload. For the ventricular myocytes, an existing canine model was used to study the genesis of APD and intracellular Ca2+ alternans under various conditions. The genesis of Ca2+ alternans was investigated by analyzing the relationship between systolic Ca2+ concentration and SR Ca2+ content. On the other side, the roles of SR Ca2+ regulation and action potential restitution in the genesis of intracellular Ca2+ and APD alternans were also examined under various conditions. In addition, it was shown that spatially discordant Ca2+ alternans was generated when the Ca2+-dependent inactivation of ICa,L was strong. It tended to be concordant for weak Ca2+-dependent inactivation of ICa,L. For the sinoatrial node cells, a mathematical model was developed to simulate stochastic opening of unitary L-type Ca2+ channel and single RyR channel, thereby reproducing experimental observed local Ca2+ release during diastolic depolarization phase of the action potential. Simulation results of ionic channel block and modifications of SR Ca2+ regulation suggested a limited role of intracellular Ca2+ in the automaticity of central SA node cells.

The sinoatrial node (SAN) is the primary pacemaker in mammalian hearts and is vital to cardiac function. Genetic mutations in SAN can result in lose-of-function of ion channels, consequently arouse sinus node dysfunction (SND), Brugada syndrome (BrS) and progressive cardiac conduction disease (PCCD). The mechanisms underlying the he pathogenesis for cardiac pacemaker dysfunctions associated with genetic mutations has not been defined. In this project, by using computer modeling, mechanisms by which the HCN4 mutations impair cardiac pacemaking and possible pro-arrhythmic effects of ivabradine were investigated. Action potential (AP) models for rabbit sinoatrial node cells were modified to incorporate experimentally reported If changes induced by HCN4 gene mutations. At both the cellular and intact SAN-atrium tissue level, If reduction due to the HCN4 mutations slowed down pacemaking. At the tissue level, these mutations compromised the AP conduction across the SAN-atrium, leading to a possible sinus arrest or SAN exit block. Moreover, vagal nerve activity could amplify the bradycardiac effects of the HCN4 gene mutations, leading to sinus arrest and SAN exit block that was not observed with the mutations or ACh alone. Similarly, SND associated with SCN5A mutations and acquired cardiac conditions were studied. 1) Mathematical models of rabbit SAN cells and 2D tissue models were modified to investigate SAN function and intracardiac conduction in a murine model of long QT syndrome type 3. A prolonged tail current INa,L was introduced and incorporated with a normal INa,T to test the SAN pacemaker function and AP conduction from the SAN to atrial septum. Simulation results showed that a combined reduction in INa,T and introduction of INa,L achieved alterations in both pacemaking rate and conduction. 2) Mathematical models of mouse SAN cells were modified to investigate the mechanisms underlies the SAN associated with SCN5A deficiency and aging. A coupled SAN-atrium cell model was developed to replicate the experimentally observed slowing of SAN conduction with aging and SCN5A-disruption The modelling studies reconstructed the physiological mechanisms by which both aging and SCN5A-disruption lead to SND, thereby drawing parallels between these and similar conduction changes in the ventricle that occur in the possibly related condition of PCCD. At last, a 2D anatomically based model of the SAN-atrium was constructed. This model successfully reproduced the effects of vagal nerve stimulation and SCN5A-E161K gene mutation on spontaneous activity of the SAN and AP conduction across the SAN-atrium.