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In mammalian hearts, initiation of the heartbeat occurs in a region of specialised pacemaker cells known as the sinoatrial node (SAN). The SAN is a highly complex spatially distributed structure which displays considerable cellular heterogeneity and is subject to complex electrotonic interactions with the surrounding atrial tissue. In this study, biophysically detailed ionic models of central and peripheral SAN pacemaker cells are described. These models are able to accurately reproduce experimental recordings of the membrane potential from central and peripheral SAN tissue. These models are used to investigate frequency synchronisation of electrically coupled cardiac pacemaker cells. Based on simulation results presented, it is proposed that cellular heterogeneity in the SAN plays an important role in achieving rhythm coordination and possibly contributes to the efficient activation of the surrounding atrial myocardium. This represents an important, previously unexplored, mechanism underlying pacemaker synchronisation and cardiac activation in vivo. A spatial-gradient model of action potential heterogeneity within the SAN is then formulated using a large-scale least squares optimisation technique. This model accurately reproduces the smooth spatial variation in action potential characteristics observed in the SAN. One and two dimensional models of the intact SAN are then formulated and three proposed models of SAN heterogeneity are investigated: 1) the discrete-region model, in which the SAN consists of a compact central region surrounded by a region of transitional pacemaker cells, 2) the gradient model, in which cells of the SAN exhibit a smooth variation in properties from the centre to the periphery of the SAN, and 3) the mosaic model, in which SAN and atrial cells are scattered throughout the SAN region with the proportion of atrial cells increasing towards the periphery. Simulation results suggest that the gradient model achieves frequency entrainment more easily than the other models of SAN heterogeneity. The gradient model also reproduces action potential waveshapes and a site of earliest activation consistent with experimental observations in the intact SAN. It is therefore proposed that the gradient model of SAN heterogeneity represents the most plausible model of SAN organisation.

Le noeud sinusal (NS) est le centre de l‟automatisme cardiaque. Grâce à son activité électrique spontanée, il dicte la fréquence cardiaque (FC) en réponse aux demandes physiologiques. A ce jour, le NS demeure un sujet de recherche important puisque les mécanismes moléculaires responsables de sa régulation sont encore méconnus. Par exemple, les processus menant à la bradycardie sinusale et à la maladie du sinus (MS) chez les personnes âgées sont mécompris et présentement l‟implantation d‟un stimulateur cardiaque demeure le seul traitement disponible. Ainsi, l‟objectif de cette thèse était de déterminer les changements moléculaires et cellulaires se produisant au niveau du NS en réponse à divers stimuli physiologiques et pathologiques afin d'établir leurs rôles potentiels dans la régulation de la FC et le développement de la MS. Dans les deux premiers chapitres, la grossesse est présentée comme modèle physiologique. En effet, la réponse adaptative aux demandes croissantes de la mère et du foetus engendre des changements physiologiques considérables au niveau du myocarde, dont une augmentation de la FC essentielle pour la perfusion adéquate des organes. Toutefois, cette augmentation peut aussi favoriser le développement d‟arythmies. Dans le troisième chapitre, l‟inflammation, un facteur présent lors du vieillissement et dans plusieurs pathologies où la MS se manifeste, a fait l‟objet d‟une étude dans le but de déterminer son rôle dans le développement de la MS. Les résultats obtenus dans cette thèse démontrent que la grossesse induit une hausse de la FC chez la souris gestante similaire à celle retrouvée chez la femme enceinte. Cette accélération était due à un remodelage électrique du NS. Plus spécifiquement, la fréquence des potentiels d‟action ainsi que la densité et l‟expression des courants pacemaker (If) et calcique de type L (ICaL) étaient augmentées. De plus, une accélération des transitoires calciques spontanés et de la vitesse de relâche calcique du réticulum sarcoplasmique a été observée. La régulation de l‟automaticité par un stimulus pathologique, l‟interleukine-1β, est abordée par la suite. L‟interleukine-1β, une cytokine ayant un rôle majeur comme médiateur inflammatoire, se retrouve en concentrations élevées dans plusieurs maladies associées avec la ii MS. Nos résultats démontrent que l‟interleukine-1β engendre une diminution de l‟automaticité associée à une réduction de If et ICaL dans les cardiomyocytes humains de type nodal dérivés de cellules souches induites pluripotentes (hiPSC-CM). En parallèle, le phénotype électrophysiologique et moléculaire des hiPSC-CM a été caractérisé démontrant leur homologie avec les cellules du NS humain adulte, les validant comme modèle in vitro de cellules nodales humaines. En conclusion, les études présentées dans cette thèse démontrent que le NS est plus qu‟un simple tissu régulé par l‟innervation autonome. En effet, son automaticité est dynamique et peut être influencée par des facteurs physiologiques ou pathologiques. Nos résultats contribuent ainsi à une meilleure compréhension des mécanismes sous-jacents à l‟automaticité. Ces avancées sont importantes non seulement pour la santé des femmes, mais aussi pour les individus souffrant de la MS. À terme, nous espérons que ces résultats contribueront au développement de stratégies thérapeutiques pour traiter des complications liées aux troubles d‟automaticité cardiaque. / The sinoatrial node (SAN) is the dominant cardiac pacemaker. With its spontaneous automaticity, it dictates rhythm and controls heart rate in response to varying physiological demands. Despite its modest size, the SAN is a very heterogeneous and complex structure that remains the topic of research efforts due, in part, to uncertainties in the mechanisms that regulate pacemaking in various conditions. For instance, the processes that lead to severe sinus bradycardia and SAN dysfunction (SND) in the elderly are unknown and to date, the implantation of electronic pacemaker remains the only SND treatment. Accordingly, the overall objective of this thesis was to explore and highlight the molecular and cellular changes that occur within the SAN in both physiological and pathological states, while determining how they contribute to regulation of heart rate and potentially SND. In the first two chapters, we present pregnancy as a physiological model considering it is a period during which substantial adaptive changes to the myocardium and increases in heart rate occur. Paradoxically, the rapid rate, which is essential for adequate organ perfusion of both mother and foetus, may also increase vulnerability to certain arrhythmias. In the third chapter, inflammation, a central process in pathology and common factor to several diseases and even ageing, was evaluated as potential underlying circumstance contributing to the development of sinus bradycardia and SND. Combinations of in vivo, ex vivo, biochemical, molecular and cellular approaches were used in order to generate an integrated understanding of the models we examined. Our data shows that in pregnant mice, an increase in heart rate similar to that of pregnant women occurs and was due to an electrical remodelling of the SAN. Specifically, an increase in action potential frequency of isolated individual SAN cells was observed. This was attributed to increased expression and density of pacemaker (If) and L-type Ca2+ currents (ICaL) along with a rapid spontaneous Ca2+ transient rate and faster intracellular sarcoplasmic reticulum Ca2+ release. We then demonstrate that the pro-inflammatory cytokine interleukin-1β which is a major inflammatory mediator that is upregulated in several diseases associated with SND, iv dramatically slows automaticity by reducing If and ICaL density in nodal-like cardiomyocytes derived from human-induced pluripotent stem cells (hiPSC-CM). Importantly, in that study, hiPSC-CMs were also physiologically and molecularly characterized revealing their high resemblance to adult human SAN and a potential use as a novel in vitro model to study pacemaking in humans. In conclusion, the results of this thesis demonstrate that the SAN is not a simple, neurally controlled tissue, but a rather dynamic pacemaker that undergoes extensive intrinsic remodelling during states of health and disease. The results contribute to understanding physiological mechanisms of pacemaking and how they are altered by disease and may be relevant for both women‟s health and the individuals affected by SND. Ultimately, we hope these findings will be helpful in the development of therapeutic strategies to treat pacemaking-related complications.

Estudou-se o efeito do treinamento físico sobre a freqüência cardíaca (FC), a freqüência cardíaca intrínseca (FCI), o efeito vagal (EV), o tônus vagal (TV), o efeito simpático (ES) e o tônus simpático (TS), de ratos idosos em repouso volitivo, na esteira, e durante o exercício de intensidade progressiva (4 estágios de 5 min à 5; 7,5; 10 e 15 m.min-1). Verificaram-se, também, as respostas da FC à doses crescentes de agonistas ?-adrenérgico (isoproterenol) e muscarínico (metacolina). Utilizaram-se 20 ratos Wistar machos, aleatoriamente divididos em dois grupos: Treinado (T, 28+2 meses, 460+36 g), submetido a 10 semanas de treinamento físico de moderada intensidade; e Sedentário-controle (S, 28+2 meses, 461+43 g), apenas manipulado, três a cinco vezes por semana, durante nove semanas, e submetido a cinco minutos de exercício diário, na décima semana, para habituação ao pesquisador e ao ambiente experimental. Utilizaram-se duplos bloqueios farmacológicos (propranolol/atropina e atropina/propranolol) para determinação da FCI, bem como bloqueios farmacológicos autonômicos unilaterais que permitiram a medida do EV, do TV, do ES e do TS. Definições: EV = FC após atropina - FC controle, ES = FC controle - FC após propranolol, TV = FCI - FC após propranolol, TS = FC após atropina - FCI. Registros: batimento-a-batimento, 500Hz (AT/CODAS). Para comparação realizou-se análise de variância de dois caminhos para medidas repetidas, com contraste. Significância estatística, P<0,05. FC e FCI foram menores em T que S, em repouso e nos quatro estágios estudados: FC = 296+6, T vs. 325+16, S; 374+33, T vs. 420+29, S; 380+ 39, T vs. 423+29, S; 407+46, T vs. 434+25, S; 441+48, T vs. 455+30, S; e FCI = 288+28, T vs. 312+18, S; 302+27, T vs. 332+24, S; 301+30, T vs. 339+26, S; 308+30, T vs. 344+30, S; 316+31, T vs. 348+31, S. Não houve diferença na atividade vagal entre T e S, tanto considerando o EV, como o TV, em nenhuma das condições estudadas. A influência simpática para o coração se mostrou semelhante entre T e S, tanto se considerando o ES quanto o TS, em todas as condições estudadas. T e S responderam de forma semelhante aos agonistas muscarínico e adrenérgico. Tanto a FC, quanto a FCI aumentaram do repouso para o exercício, e com o aumento da intensidade do mesmo. A atividade vagal diminuiu do repouso para o exercício, mas apenas em intensidade elevada. A atividade simpática aumentou na passagem do repouso para o exercício, e com o aumento da intensidade do mesmo. Concluiu-se que, em ratos idosos: a) o treinamento físico de moderada intensidade promoveu bradicardia de repouso e atenuação da taquicardia induzida pelo exercício essencialmente à custa de redução da FCI; e b) independentemente da condição de treinamento físico, a estimulação simpática contribuiu para o aumento da FC, em resposta ao exercício, de leve à alta intensidade, enquanto a retirada vagal o fez, apenas em alta intensidade. / We studied the effect of exercise training on heart rate (HR), on intrinsic heart rate (IHR), on vagal effect (VE), on vagal tone (VT), on sympathetic effect (SE) and on sympathetic tone (ST) during both treadmill resting and exercise of progressive intensity (four 5-min stages at 5, 7.5, 10 and 15 m.min-1) in old rats. HR responses to crescent doses of ?-adrenergic (isoproterenol) and muscarinic (metacholine) agonists were also verified. We used 20 male Wistar rats randomly assigned to two groups: trained (T, 28+2 months, 460+36 g) and sedentary control (S, 28+2 months, 461+43 g) rats. T was submitted to a ten-week moderate intensity exercise training program, while S was just handled, three to five times a week, for nine weeks and submitted to five-min bouts of daily exercise during the tenth week for taming and to become accustomed to experimental environment. Double pharmacological blockades (propranolol/ methylatropine and methylatropine/propranolol) were performed in order to determine IHR. Autonomic influences on heart rate were evaluated using also unilateral autonomic pharmacological blockade, which allowed us to measure VE and VT as well as SE and ST. Definitions: VE = HR after atropine - control HR, SE = control HR - HR after propranolol, VT = IHR - HR after propranolol, ST = HR after atropine - IHR. HR was recorded on a beat-to-beat basis with a 500 Hz acquisition frequency (AT/CODAS). For statistical analysis we used two-way ANOVA for repeated measurements with contrast, considering a P<0.05 as statistically significant. T rats had lower HR as well as IHR than their sedentary counterparts both at rest and during all progressive exercise stages: HR = 296+6,T vs. 325+16,S; 374+33,T vs. 420+29,S; 380+39,T vs. 423+29,S; 407+46,T vs. 434+25,S; 441+48,T vs. 455+30,S, respectively; and IHR = 288+28,T vs. 312+18,S; 302+27,T vs. 332+24,S; 301+30,T vs. 339+26,S; 308+30,T vs. 344+30,S; 316+31,T vs. 348+31,S, respectively. Vagal activity was not significantly different between groups, either considering VE or VT. Sympathetic influence was also similar between S and T considering both SE and ST in all of the studied conditions. T and S responded similarly to both muscarinic and ?-adrenergic agonists. Both HR and IHR increased from rest to exercise and with increasing exercise intensity. Vagal activity decreased from rest to exercise but only in high intensity exercise. Sympathetic activity increased from rest to exercise and also with increasing exercise intensity. We concluded that in old rats: a) exercise training of moderate intensity led to resting bradycardia and attenuation of exercise tachycardia essentially due to the decrease in IHR; and b) independently from exercise training status, sympathetic stimulation contributed to HR increase from light to high intensity exercise while vagal withdrawal became important only at high intensity exercise

Los receptores &#946;-adrenérgicos (&#946;AR) y de serotonina (5-HT4) median sus efectos en tejidos cardiacos a través de la ruta receptor-Gs-AC-AMPc. Las fosfodiesterasas (PDE) son una amplia familia de enzimas cuya función es la degradación del AMPc. Se desconocía que isoenzimas de PDEs son responsables de la hidrólisis de AMPc en las diferentes regiones cardiacas. El objetivo de esta tesis doctoral es investigar que isoenzimas de PDEs tienen actividad en el miocardio humano, porcino y de roedores. Se han realizado estudios cronotrópicos, inotrópicos, lusitrópicos, bioquímicos y electrofisiológicos. Los principales resultados son: Las PDEs se comportan de manera distinta en las diferentes regiones cardiacas y compartimentos celulares; y La frecuencia basal de nódulo sinusal está controlada por PDEs pero en ninguna especie estudiada las PDEs controlan la taquicardia causada por los &#946;ARs y los receptores 5-HT4. La extrapolación de la función de las PDEs al humano debe h acerse con cautela. / Myocardial &#946;-adrenoceptors (&#946;AR) and serotonin receptors (5-HT4) mediate their signals through the receptor-Gs-AC-cAMP pathway. Phosphodiesterases (PDEs) are a large enzyme family that degrade cAMP. It was unknown which PDE isoenzymes are responsible for the hydrolysis of the cAMP in different cardiac regions. The aim of this doctoral thesis is to investigate which isoenzymes have a role in human, porcine and rodent myocardium. We performed chronotropic, inotropic, lusitropic, biochemical and electrophysiological studies. The key results are: PDEs have different roles in different cardiac regions and cellular compartments; and the basal beating rate of the sinoatrial node is controlled by PDE3 and/or PDE4, but these PDEs do not limit the tachycardia mediated through the stimulation of &#946;1AR, &#946;2AR and 5-HT4. Given the diverse roles of PDE3 and PDE4 and their dependence on species, extrapolation to humans should be done cautiously because these animal models usually do not reflect the human myocardium.

Estudou-se o efeito do treinamento físico sobre a freqüência cardíaca (FC), a freqüência cardíaca intrínseca (FCI), o efeito vagal (EV), o tônus vagal (TV), o efeito simpático (ES) e o tônus simpático (TS), de ratos idosos em repouso volitivo, na esteira, e durante o exercício de intensidade progressiva (4 estágios de 5 min à 5; 7,5; 10 e 15 m.min-1). Verificaram-se, também, as respostas da FC à doses crescentes de agonistas ?-adrenérgico (isoproterenol) e muscarínico (metacolina). Utilizaram-se 20 ratos Wistar machos, aleatoriamente divididos em dois grupos: Treinado (T, 28+2 meses, 460+36 g), submetido a 10 semanas de treinamento físico de moderada intensidade; e Sedentário-controle (S, 28+2 meses, 461+43 g), apenas manipulado, três a cinco vezes por semana, durante nove semanas, e submetido a cinco minutos de exercício diário, na décima semana, para habituação ao pesquisador e ao ambiente experimental. Utilizaram-se duplos bloqueios farmacológicos (propranolol/atropina e atropina/propranolol) para determinação da FCI, bem como bloqueios farmacológicos autonômicos unilaterais que permitiram a medida do EV, do TV, do ES e do TS. Definições: EV = FC após atropina - FC controle, ES = FC controle - FC após propranolol, TV = FCI - FC após propranolol, TS = FC após atropina - FCI. Registros: batimento-a-batimento, 500Hz (AT/CODAS). Para comparação realizou-se análise de variância de dois caminhos para medidas repetidas, com contraste. Significância estatística, P<0,05. FC e FCI foram menores em T que S, em repouso e nos quatro estágios estudados: FC = 296+6, T vs. 325+16, S; 374+33, T vs. 420+29, S; 380+ 39, T vs. 423+29, S; 407+46, T vs. 434+25, S; 441+48, T vs. 455+30, S; e FCI = 288+28, T vs. 312+18, S; 302+27, T vs. 332+24, S; 301+30, T vs. 339+26, S; 308+30, T vs. 344+30, S; 316+31, T vs. 348+31, S. Não houve diferença na atividade vagal entre T e S, tanto considerando o EV, como o TV, em nenhuma das condições estudadas. A influência simpática para o coração se mostrou semelhante entre T e S, tanto se considerando o ES quanto o TS, em todas as condições estudadas. T e S responderam de forma semelhante aos agonistas muscarínico e adrenérgico. Tanto a FC, quanto a FCI aumentaram do repouso para o exercício, e com o aumento da intensidade do mesmo. A atividade vagal diminuiu do repouso para o exercício, mas apenas em intensidade elevada. A atividade simpática aumentou na passagem do repouso para o exercício, e com o aumento da intensidade do mesmo. Concluiu-se que, em ratos idosos: a) o treinamento físico de moderada intensidade promoveu bradicardia de repouso e atenuação da taquicardia induzida pelo exercício essencialmente à custa de redução da FCI; e b) independentemente da condição de treinamento físico, a estimulação simpática contribuiu para o aumento da FC, em resposta ao exercício, de leve à alta intensidade, enquanto a retirada vagal o fez, apenas em alta intensidade. / We studied the effect of exercise training on heart rate (HR), on intrinsic heart rate (IHR), on vagal effect (VE), on vagal tone (VT), on sympathetic effect (SE) and on sympathetic tone (ST) during both treadmill resting and exercise of progressive intensity (four 5-min stages at 5, 7.5, 10 and 15 m.min-1) in old rats. HR responses to crescent doses of ?-adrenergic (isoproterenol) and muscarinic (metacholine) agonists were also verified. We used 20 male Wistar rats randomly assigned to two groups: trained (T, 28+2 months, 460+36 g) and sedentary control (S, 28+2 months, 461+43 g) rats. T was submitted to a ten-week moderate intensity exercise training program, while S was just handled, three to five times a week, for nine weeks and submitted to five-min bouts of daily exercise during the tenth week for taming and to become accustomed to experimental environment. Double pharmacological blockades (propranolol/ methylatropine and methylatropine/propranolol) were performed in order to determine IHR. Autonomic influences on heart rate were evaluated using also unilateral autonomic pharmacological blockade, which allowed us to measure VE and VT as well as SE and ST. Definitions: VE = HR after atropine - control HR, SE = control HR - HR after propranolol, VT = IHR - HR after propranolol, ST = HR after atropine - IHR. HR was recorded on a beat-to-beat basis with a 500 Hz acquisition frequency (AT/CODAS). For statistical analysis we used two-way ANOVA for repeated measurements with contrast, considering a P<0.05 as statistically significant. T rats had lower HR as well as IHR than their sedentary counterparts both at rest and during all progressive exercise stages: HR = 296+6,T vs. 325+16,S; 374+33,T vs. 420+29,S; 380+39,T vs. 423+29,S; 407+46,T vs. 434+25,S; 441+48,T vs. 455+30,S, respectively; and IHR = 288+28,T vs. 312+18,S; 302+27,T vs. 332+24,S; 301+30,T vs. 339+26,S; 308+30,T vs. 344+30,S; 316+31,T vs. 348+31,S, respectively. Vagal activity was not significantly different between groups, either considering VE or VT. Sympathetic influence was also similar between S and T considering both SE and ST in all of the studied conditions. T and S responded similarly to both muscarinic and ?-adrenergic agonists. Both HR and IHR increased from rest to exercise and with increasing exercise intensity. Vagal activity decreased from rest to exercise but only in high intensity exercise. Sympathetic activity increased from rest to exercise and also with increasing exercise intensity. We concluded that in old rats: a) exercise training of moderate intensity led to resting bradycardia and attenuation of exercise tachycardia essentially due to the decrease in IHR; and b) independently from exercise training status, sympathetic stimulation contributed to HR increase from light to high intensity exercise while vagal withdrawal became important only at high intensity exercise

Une accélération de la fréquence cardiaque (FC) au repos est observée chez les femmes enceintes. Au dernier trimestre, la FC accélère en moyenne de 15%, ce qui représente un facteur de risque dans le développement d’arythmies de novo ou dans l’exacerbation d’arythmies cardiaques préexistantes. Ceci est dangereux pour la mère ainsi que pour le fœtus. Cependant, les mécanismes responsables de ce changement cardiovasculaire restent peu connus. Notre laboratoire a récemment démontré que la grossesse était associée à une augmentation de la densité du courant pacemaker (If) et du courant calcique de type L (ICaL), ainsi qu’à des changements de l’homéostasie calcique dans les cellules de nœud sinusal (NS) de souris. Sachant que les concentrations plasmatiques en œstrogènes sont significativement augmentées pendant la grossesse et que ces hormones sexuelles féminines ont la capacité de modifier les propriétés électrophysiologiques du cœur, l’hypothèse de ce projet de recherche est que les œstrogènes jouent un rôle important dans l’augmentation de la FC associée à la grossesse et régulent les propriétés électrophysiologiques du NS. Les objectifs de ce projet de recherche sont de déterminer le rôle du 17β-œstradiol (E2) dans l’augmentation de la FC, d’examiner si ces effets sont régulés par les récepteurs aux œstrogènes alpha (ERα) et/ou bêta (ERβ) ainsi que d’évaluer les différents mécanismes de régulation de l’E2 sur l’électrophysiologie du NS. Des souris femelles adultes non-gestantes (2-4 mois) déficientes en ERα (ERKOα) ou en ERβ (ERKOβ) ont reçu un traitement chronique à l’E2 (30 μg deux fois par jour pendant quatre jours) simulant les concentrations plasmatiques en E2 retrouvées en fin de grossesse (23,3 ± 5,0 nM) chez la souris. L’analyse des électrocardiogrammes de surface montrent que la FC des souris ERKOβ (ERKOβ : 511 ± 15 bpm; ERKOβ +E2 : 580 ± 10 bpm, n = 10, p < 0,001) est significativement accélérée suivant le traitement à l’E2. Toutefois, la FC demeure inchangée chez les souris ERKOα (ERKOα : 520 ± 16 bpm; ERKOα +E2 : 530 ± 21 bpm, n = 7, p = 0,114). La méthode du patch-clamp en mode courant-imposé a permis de démontrer une accélération de l’automaticité des cellules du NS des souris ERKOβ suivant le traitement à l’E2, se traduisant par une augmentation de la fréquence des potentiels d’action spontanés (ERKOβ : 284 ± 24 bpm, n = 8; ERKOβ +E2 : 354 ± 23 bpm, n = 15, p = 0,0395) et par une pente de dépolarisation diastolique plus rapide (ERKOβ : 82 ± 12 mV/s, n = 8; ERKOβ +E2 : 140 ± 14 mV/s, n = 15, p < 0,003). En lien avec ces résultats, le patch-clamp en mode voltage-imposé a permis de démontrer que la densité de If est augmentée suivant un traitement à l’E2 (à -90 mV : ERKOβ : -6,6 ± 0,7 pA/pF, n = 12-15; ERKOβ +E2 : -11 ± 1 pA/pF, n = 9-11, p < 0,05). Cependant, If est similaire chez les souris ERKOα traitées ou non à l’E2. De plus, des cardiomyocytes humains dérivés de cellules souches pluripotentes induites de type nodal (N-hiPSC-CM) ont une accélération de la fréquence des potentiels d’action (CTL : 69 ± 5 bpm, n = 12; +E2 : 99 ± 6 bpm, n = 14, p < 0,001) ainsi qu’une augmentation de la densité de If (à -90 mV : CTL : -0,95 ± 0,14 pA/pF, n = 7-10; +E2 : -1,62 ± 0,17 pA/pF, n = 13-14, p < 0,05) suivant le traitement à l’E2. L’administration d’E2 ne modifie pas la fréquence des transitoires calciques des cellules de NS des souris ERKOα (139 ± 15, n = 13-14; +E2 : 142 ± 14, n = 15-16, p = ns) et ERKOβ (142 ± 11, n = 14-15; +E2 : 147 ± 13, n = 15-16, p = ns). En lien avec ces résultats, le courant ICaL des N-hiPSC-CM est inchangé suivant le traitement d’E2 (à 0 mV : CTL : -14,0 ± 1,3 pA/pF, n = 12-13; +E2 : -14,5 ± 1,4 pA/pF, n = 22, p = ns). En conclusion, l’accélération de l’automaticité cardiaque associée à la grossesse est, entre autres, expliquée par une augmentation de la densité de If, régulée par la voie de signalisation E2-ERα. Cependant, les changements de l’homéostasie calcique observés pendant la grossesse sont indépendants des niveaux élevés en œstrogènes. Les résultats obtenus sur les N-hiPSC-CM concordent avec ce qui est observé dans les cellules de NS de souris, ce qui démontre l’applicabilité humaine des résultats. Notre étude contribue à élucider l’influence de la grossesse et le rôle des hormones sexuelles féminines sur la fonction du NS et l’automaticité cardiaque. Ultimement, notre travail pourrait aider à développer une meilleure gestion des arythmies associées aux fluctuations hormonales féminines et/ou à la grossesse. / An increased heart rate (HR) is observed in pregnant women. In fact, in the last trimester, in average, the HR increases by 15%, which is a known risk factor to developing cardiac arrhythmias or exacerbating pre-existing arrhythmias. This can lead to major consequences for both the mother and fetus. However, the mechanisms underlying this increased HR remain largely unexplored. Our laboratory recently demonstrate that pregnancy is associated with an increased density of the pacemaker current (If) and the L-type calcium current (ICaL) as well as changes in calcium homeostasis of mouse sinoatrial node (SAN) cells. Knowing that estrogens are increased during pregnancy and that these sex hormones can modify cardiac electrophysiological properties, we hypothesized that estrogens play a key role in the pregnancy-induced increased HR and regulate the SAN electrophysiological properties. Our research project aims to determine the role of 17β-estradiol (E2) on the pregnancy-induced increased HR, to determine if these effects are regulated through estrogen receptor alpha (ERα) and/or beta (ERβ) and to study the E2 underlying mechanisms on SAN electrophysiology. Non-pregnant female mice (2-4 months) lacking ERα (ERKOα) or ERβ (ERKOβ) received a chronic E2 treatment (30 μg twice daily for four days) mimicking E2 concentrations found in late pregnancy (23.3 ± 5.0 nM). Surface electrocardiogram analysis showed a significant increased HR in ERKOβ mice (ERKOβ: 511 ± 15 bpm; ERKOβ +E2: 580 ± 10 bpm; n = 10; p<0.001) following E2 administration. However, the HR remains unchanged in ERKOα mice (ERKOα: 520 ± 16 bpm; ERKOα +E2: 530 ± 21 bpm, n = 7, p = 0.114). Following E2 treatment, current-clamp method demonstrates an increase SAN cells automaticity in ERKOβ mice, resulting in an increase in the spontaneous action potential frequency (ERKOβ : 284 ± 24 bpm, n = 8; ERKOβ +E2 : 354 ± 23 bpm, n = 15, p = 0.0395), associated with a steeper diastolic depolarization slope (ERKOβ : 82 ± 12 mV/s, n = 8; ERKOβ +E2 : 140 ± 14 mV/s, n = 15, p < 0.003), a major determinant of cardiac automaticity. In line with these results, voltage-clamp data showed an increased If density in SAN cells of ERKOβ mice treated with E2 (at -90 mV: ERKOβ: -6.6 ± 0.7 pA/pF, n = 12-15; ERKOβ +E2: -11.0 ± 1.3 pA/pF, n = 9-11, p < 0.05). Nevertheless, If density was similar in E2-treated ERKOα mice. E2-treated nodal-like human-induced pluripotent stem cell-derived cardiomyocytes (N-hiPSC-CM) also showed an increased spontaneous action potential frequency (CTL : 69 ± 5 bpm, n = 12; +E2 : 99 ± 6 bpm, n = 14, p < 0.001) and If density (at -90 mV: CTL: -0.95 ± 0.14 pA/pF, n = 7-10; +E2: -1.62 ± 0.17 pA/pF, n = 13-14, p < 0.05). Following E2 administration, the rate of calcium transient was similar in SAN cells from ERKOα (139 ± 15, n = 13-14; +E2 : 142 ± 14, n = 15-16, p = ns) and ERKOβ (142 ± 11, n = 14-15; +E2 : 147 ± 13, n = 15-16, p = ns) mice. In line with these results, no modification was seen on ICaL density in E2-treated N-hiPSC-CM (at 0 mV: CTL: -14.0 ± 1.3 pA/pF, n = 12-13; +E2: -14.5 ± 1.4 pA/pF, n = 22, p = ns). In conclusion, the increased cardiac automaticity observed during pregnancy is, in part, explained by an increased If density. This mechanism is mediated by the E2-ERα pathway. In the other hand, calcium homeostasis changes detected during pregnancy appear to be mediated by an E2-independent mechanism. Finally, results obtained on N-hiPSC-CM are consistent with our observations on mouse SAN cells, demonstrating the human applicability of our results. This study provides novel insight on the effects of female sex hormones on the SAN functions. Ultimately, this information can lead to improved management of arrhythmias associated with female hormone fluctuations and/or pregnancy-induced arrhythmias.