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La grossesse induit de profonds changements hémodynamiques et métaboliques de l’organisme maternel qui ont des conséquences sur le cœur. L’adaptation du cœur à cette condition physiologique nécessite un remodelage de sa structure et par conséquent des ajustements de sa fonction. Les mécanismes responsables de ces adaptations sont en grande partie inconnus. Cependant, ces connaissances sont essentielles pour la compréhension des complications cardiovasculaires, telle que l’hypertension gestationnelle (HG), qui constituent un risque pour la santé de la mère et du fœtus. Afin de caractériser les adaptations du cœur lors de la grossesse, l’originalité de notre approche expérimentale consistait à étudier le remodelage à l’échelle des cardiomyocytes du ventricule gauche. Ainsi, notre premier objectif était de déterminer les modifications structurales et fonctionnelles des cardiomyocytes chez la rate en vue d’identifier les altérations lors de l’HG. Chez les rates gestantes, le remodelage structural des cardiomyocytes se caractérise par une hypertrophie cellulaire avec une augmentation proportionnelle des dimensions. L’HG a été induite par un supplément sodique (0.9% NaCl) dans la diète. L’inadaptation structurale lors de l’HG se traduit par une diminution du volume cellulaire. L’étude des modifications fonctionnelles a révélé que lors de la gestation le fonctionnement contractile des cellules est dépendant de l’adaptation du métabolisme maternel. En effet, les substrats énergétiques, lactate et pyruvate, induisent une augmentation de la contractilité des cardiomyocytes. Cet effet est plus faible dans les cellules des rates hypertendues, ce qui suggère des anomalies du couplage excitation-contraction, dans lequel les courants calciques de type L (ICa-L) jouent un rôle important. Paradoxalement, le lactate et le pyruvate ont induit une augmentation de la densité des courants ICa-L seulement chez les rates hypertendues. Le récepteur aux minéralocorticoïdes (RM) est connu pour son implication dans le remodelage structuro-fonctionnel du cœur dans les conditions pathologiques mais pas dans celui induit par la grossesse. Notre deuxième objectif était donc de déterminer le rôle du RM dans l’adaptation de la morphologie et de la contractilité des cardiomyocytes. Des rates gestantes ont été traitées avec le canrénoate de potassium (20 mg/kg/jr), un antagoniste des RM. L’inhibition des RM pendant la gestation empêche l’hypertrophie cellulaire. De plus, l’inhibition des RM bloque l’effet du lactate et du pyruvate sur la contractilité. Chez la femme, la grossesse est associée à des changements des propriétés électriques du cœur. Sur l’électrocardiogramme, l’intervalle QTc est plus long, témoignant de la prolongation de la repolarisation. Les mécanismes régulant cette adaptation restent encore inconnus. Ainsi, notre troisième objectif était de déterminer le rôle du RM dans l’adaptation de la repolarisation. Chez la rate gestante, l’intervalle QTc est prolongé ce qui est corroboré par la diminution des courants potassiques Ito et IK1. L’inhibition des RM pendant la gestation empêche la prolongation de l’intervalle QTc et la diminution des courants Ito. Les travaux exposés dans cette thèse apportent une vision plus précise du remodelage cardiaque induit par la grossesse, qui est permise par l’étude à l’échelle cellulaire. Nos résultats montrent que lors de la gestation et de l’HG les cardiomyocytes subissent des remodelages morphologiques contrastés. Notre étude a aussi révélé que lors de la gestation, la fonction contractile est tributaire des adaptations métaboliques et que cette relation est altérée lors de l’HG. Nos travaux montrent que la régulation de ces adaptations gestationnelles fait intervenir le RM au niveau de la morphologie, de la relation métabolisme/fonctionnement contractile et de la repolarisation. En faisant avancer les connaissances sur l’hypertrophie de la grossesse, ces travaux vont permettre d’améliorer la compréhension des complications cardiovasculaires gestationnelles. / Pregnancy is characterized by marked hemodynamic and metabolic changes, which have consequences on the heart. The adaptation of the heart to this physiological situation requires a remodeling of its structure, and consequently functioning adjustments. Mechanisms responsible for these adaptations are largely unknown. However, this knowledge is essential for the understanding of cardiovascular complications, such as gestational hypertension (GH), which represents a risk for the mother and the fœtus. To characterize cardiac adaptations to pregnancy, our experimental approach consisted in studying this remodelling at the level of left ventricle cardiomyocytes. Therefore, our first objective was to determine structural and functional modifications of cardiomyocytes in pregnant rats to be able to identify their variations in GH. In pregnant rats, structural remodelling of cardiomyocytes was characterized by a proportional volume expansion. GH was induced by a high sodium supplement (0.9% NaCl). In hypertensive rats, we observe significant cell volume shrinkage. The study of functional modifications elicited a strong relationship between metabolic adaptations and cell contractility. According to our results, in pregnant rats cardiomyocyte contractility was increased in presence of energy substrates lactate and pyruvate. This effect was weaker in the cells from hypertensive rats. This suggested modifications of the excitation-contraction coupling, in which L-type calcium currents (ICa-L) play an important role. Unexpectedly, lactate and pyruvate induced a significant increase in ICa-L only in hypertensive rats. In pathological conditions, mineralocorticoid receptors (MR) have been shown to mediate structural as well as functional remodelling of the heart. Our study is the first to investigate MR involvement in cardiac remodelling during pregnancy. Thus, our second objective was to determine MR involvement in cardiomyocyte remodelling. For this study, pregnant rats were treated with potassium canrenoate of (20 mg / kg / day), a MR antagonist. Our results revealed that MR inhibition during the pregnancy elicited a significant decrease of cell volume. MR inhibition has also affected metabolism and cellular functioning relationship. Indeed, plasma concentration of lactate was lower, which was in correlation with its blunted effect on cell contractility. In women, pregnancy-induced hypertrophy is associated with changes in electrical properties of the heart. Indeed, repolarisation is prolonged, which is characterised by a longer duration of QTc interval on the electrocardiogram. Regulation mechanisms involved in this adaptation are still largely unknown. Our third objective was therefore to determine the role of MR in the adaptation of repolarisation to pregnancy. Pregnancy induced a prolongation in QTc interval, which correlates with a decrease in potassium currents Ito and IK1. MR inhibition prevented QTc interval prolongation and the lowering of Ito. Our study gives a new insight of pregnancy-induced cardiac hypertrophy, which is provided by investigations at the cellular level. Our results demonstrate that pregnancy and GH are characterised by opposite remodellings. Moreover, in pregnancy the contractile function is dependent on metabolic adaptations. This is all the more glaring in GH as metabolic alterations induced modifications of electric properties to maintain contractile functioning. Furthermore, our work reveals MR involvement in the regulation of morphology, metabolism/contractility relationship, and repolarisation. By improving the knowledge of hypertrophy during pregnancy, this work contributes to improve the understanding of pregnancy-induced cardiac complications.

Os processos de agregação de dipolos I-V (dipolos impureza divalente catiônica-vacância catiônica) em cristais de fluoreto de lítio com impurezas de magnésio, titânio e hidroxila foram estudados pelas técnicas de correntes de despolarização termicamente estimuladas e absorção óptica (nas regiões ultravioleta, visível e infravermelho). Da correlação com medidas da termoluminescência (TL) desses cristais foi avaliado o papel dos dipolos e dos agregados de dipolos na emissão de luz TL. Tratamentos térmicos diversos e irradiação com raios gama foram empregados para produzir modificações na distribuição dos dipolos I-V presentes na solução sólida das amostras cristalinas. Nas curvas de correntes termoiônicas observou-se a banda em (219 mais ou menos 3) K (aqui denominada banda B), já conhecida e devida a dipolos I-V livres no cristal, além de duas outras: a primeira (banda A), à temperatura de (200 mais ou menos 4) K, foi identificada com pequenos agregados de dipolos, possivelmente dímeros; a segunda (banda C) se manifesta a temperaturas entre 300 e 330 K, dependendo da quantidade de impurezas presenta na amostra e do tratamento térmico efetuado, e está provavelmente associada a gnrades agregados de defeitos, com participação de impurezas e vacâncias. Uma quarta banda foi observada (banda D), também acima da temperatura ambiente, sendo mais destacada para amostras de LIF nominalmente puro. Provavelmente está associada à relaxação de defeitos intrínsecos que se concentram próximos a deslocações existentes nos cristais. As energias de ativação para a relaxação térmica das bandas foram determinadas: E IND O = 0,66 eV, E IND B = 0,64 eV sendo que, para as bandas C e D, os resultados obtidos apontam para a existência de uma distribuição de valores de energia de ativação, no intervalo de 0,3 a 1,0 eV. Estudos da cinética de agregação dos dipolos I-V indicam que o desaparecimento dos dipolos da solução sólida durante recozimentos isotérmicos se dá ora pela formação de dímeros, ora de trímeros, de acordo com a temperatura e o intervalo de tempo do recozimento. As energias de ativação determinadas para os dois processos são bastante similares e valem (0,75 mais ou menos 0,17) eV para dímeros e (0,71 mais ou menos 0,07) eV para a formação de trímeros. A absorção óptica de amostras não irradiadas apresenta uma banda em 200 nm, relacionada a transições atômicas do titânio, cuja intensidade decresce com tratamentos térmicos a 100 GRAUS C. Esse resultado faz supor uma participação dos íons de titânio na formação de agregados de defeitos. Para amostras irradiadas observou-se que a absorção óptica em 310 nm aumenta quando o tratamento térmico pré-irradiação inclui um recozimento a 100 GRAUS por 120 minutos após têmpera. Esta banda está associada à presença de pequenos agregados de dipolos I-V. As medidas de absorção óptica no infravermelho não revelaram a presença de linhas de absorção devidas a íons hidroxila associados às impurezas em algumas amostras propositalmente dopadas com OH e revelaram a sua presença em cristais nominalmente livres de OH. A principal linha de absorção está centrada em 3568 cm POT. -1. As mudanças observadas nas curvas de emissão TL de LIF com impurezas de magnésio e titânio evidenciam que as amostras submetidas a tratamentos de têmpera seguido de recozimento a 100 GRAUS C por 120 minutos, responsáveis pela diminuição da concentração de dipolos I-V livres e pelo aumento considerável da concentração de pequenos e grandes agregados de dipolos, apresentam com maior densidade o pico TL em 190 GRAUSC (denominado pico V), enquanto que o tratamento de têmpera isolado ressalta um conjunto de picos TL (picos II e III) na região de 80 a 100 GRAUS C. As hipóteses feitas diante desses resultados são que as armadilhas de carga responsáveis pelos picos II e III são defeitos simples, enquanto que as armadilhas relacionadas ao pico V são grandes agregados de defeitos, contendo íons de magnésio e titânio, vacâncias de íons da rede e, provavelmente, íons hidroxila. / Aggregation process of divalent impurity-cation vacancy dipoles (1-V dipoles) in lithium fluoride doped with magnesium, titanium and hydroxyl were studied with techniques of thermally stimulated depolarization currents and optical absorption from near ultraviolet to near infrared regions. These results are correlated with thermoluminescent (TL) measurements in order to understand of the role of 1-V dipoles and aggregates in the TL phenomenon. Changes in the dipole distribution inside the samples were attained with suitable thermal treatments and gamma irradiation.

Os processos de agregação de dipolos I-V (dipolos impureza divalente catiônica-vacância catiônica) em cristais de fluoreto de lítio com impurezas de magnésio, titânio e hidroxila foram estudados pelas técnicas de correntes de despolarização termicamente estimuladas e absorção óptica (nas regiões ultravioleta, visível e infravermelho). Da correlação com medidas da termoluminescência (TL) desses cristais foi avaliado o papel dos dipolos e dos agregados de dipolos na emissão de luz TL. Tratamentos térmicos diversos e irradiação com raios gama foram empregados para produzir modificações na distribuição dos dipolos I-V presentes na solução sólida das amostras cristalinas. Nas curvas de correntes termoiônicas observou-se a banda em (219 mais ou menos 3) K (aqui denominada banda B), já conhecida e devida a dipolos I-V livres no cristal, além de duas outras: a primeira (banda A), à temperatura de (200 mais ou menos 4) K, foi identificada com pequenos agregados de dipolos, possivelmente dímeros; a segunda (banda C) se manifesta a temperaturas entre 300 e 330 K, dependendo da quantidade de impurezas presenta na amostra e do tratamento térmico efetuado, e está provavelmente associada a gnrades agregados de defeitos, com participação de impurezas e vacâncias. Uma quarta banda foi observada (banda D), também acima da temperatura ambiente, sendo mais destacada para amostras de LIF nominalmente puro. Provavelmente está associada à relaxação de defeitos intrínsecos que se concentram próximos a deslocações existentes nos cristais. As energias de ativação para a relaxação térmica das bandas foram determinadas: E IND O = 0,66 eV, E IND B = 0,64 eV sendo que, para as bandas C e D, os resultados obtidos apontam para a existência de uma distribuição de valores de energia de ativação, no intervalo de 0,3 a 1,0 eV. Estudos da cinética de agregação dos dipolos I-V indicam que o desaparecimento dos dipolos da solução sólida durante recozimentos isotérmicos se dá ora pela formação de dímeros, ora de trímeros, de acordo com a temperatura e o intervalo de tempo do recozimento. As energias de ativação determinadas para os dois processos são bastante similares e valem (0,75 mais ou menos 0,17) eV para dímeros e (0,71 mais ou menos 0,07) eV para a formação de trímeros. A absorção óptica de amostras não irradiadas apresenta uma banda em 200 nm, relacionada a transições atômicas do titânio, cuja intensidade decresce com tratamentos térmicos a 100 GRAUS C. Esse resultado faz supor uma participação dos íons de titânio na formação de agregados de defeitos. Para amostras irradiadas observou-se que a absorção óptica em 310 nm aumenta quando o tratamento térmico pré-irradiação inclui um recozimento a 100 GRAUS por 120 minutos após têmpera. Esta banda está associada à presença de pequenos agregados de dipolos I-V. As medidas de absorção óptica no infravermelho não revelaram a presença de linhas de absorção devidas a íons hidroxila associados às impurezas em algumas amostras propositalmente dopadas com OH e revelaram a sua presença em cristais nominalmente livres de OH. A principal linha de absorção está centrada em 3568 cm POT. -1. As mudanças observadas nas curvas de emissão TL de LIF com impurezas de magnésio e titânio evidenciam que as amostras submetidas a tratamentos de têmpera seguido de recozimento a 100 GRAUS C por 120 minutos, responsáveis pela diminuição da concentração de dipolos I-V livres e pelo aumento considerável da concentração de pequenos e grandes agregados de dipolos, apresentam com maior densidade o pico TL em 190 GRAUSC (denominado pico V), enquanto que o tratamento de têmpera isolado ressalta um conjunto de picos TL (picos II e III) na região de 80 a 100 GRAUS C. As hipóteses feitas diante desses resultados são que as armadilhas de carga responsáveis pelos picos II e III são defeitos simples, enquanto que as armadilhas relacionadas ao pico V são grandes agregados de defeitos, contendo íons de magnésio e titânio, vacâncias de íons da rede e, provavelmente, íons hidroxila. / Aggregation process of divalent impurity-cation vacancy dipoles (1-V dipoles) in lithium fluoride doped with magnesium, titanium and hydroxyl were studied with techniques of thermally stimulated depolarization currents and optical absorption from near ultraviolet to near infrared regions. These results are correlated with thermoluminescent (TL) measurements in order to understand of the role of 1-V dipoles and aggregates in the TL phenomenon. Changes in the dipole distribution inside the samples were attained with suitable thermal treatments and gamma irradiation.

La grossesse induit de profonds changements hémodynamiques et métaboliques de l’organisme maternel qui ont des conséquences sur le cœur. L’adaptation du cœur à cette condition physiologique nécessite un remodelage de sa structure et par conséquent des ajustements de sa fonction. Les mécanismes responsables de ces adaptations sont en grande partie inconnus. Cependant, ces connaissances sont essentielles pour la compréhension des complications cardiovasculaires, telle que l’hypertension gestationnelle (HG), qui constituent un risque pour la santé de la mère et du fœtus. Afin de caractériser les adaptations du cœur lors de la grossesse, l’originalité de notre approche expérimentale consistait à étudier le remodelage à l’échelle des cardiomyocytes du ventricule gauche. Ainsi, notre premier objectif était de déterminer les modifications structurales et fonctionnelles des cardiomyocytes chez la rate en vue d’identifier les altérations lors de l’HG. Chez les rates gestantes, le remodelage structural des cardiomyocytes se caractérise par une hypertrophie cellulaire avec une augmentation proportionnelle des dimensions. L’HG a été induite par un supplément sodique (0.9% NaCl) dans la diète. L’inadaptation structurale lors de l’HG se traduit par une diminution du volume cellulaire. L’étude des modifications fonctionnelles a révélé que lors de la gestation le fonctionnement contractile des cellules est dépendant de l’adaptation du métabolisme maternel. En effet, les substrats énergétiques, lactate et pyruvate, induisent une augmentation de la contractilité des cardiomyocytes. Cet effet est plus faible dans les cellules des rates hypertendues, ce qui suggère des anomalies du couplage excitation-contraction, dans lequel les courants calciques de type L (ICa-L) jouent un rôle important. Paradoxalement, le lactate et le pyruvate ont induit une augmentation de la densité des courants ICa-L seulement chez les rates hypertendues. Le récepteur aux minéralocorticoïdes (RM) est connu pour son implication dans le remodelage structuro-fonctionnel du cœur dans les conditions pathologiques mais pas dans celui induit par la grossesse. Notre deuxième objectif était donc de déterminer le rôle du RM dans l’adaptation de la morphologie et de la contractilité des cardiomyocytes. Des rates gestantes ont été traitées avec le canrénoate de potassium (20 mg/kg/jr), un antagoniste des RM. L’inhibition des RM pendant la gestation empêche l’hypertrophie cellulaire. De plus, l’inhibition des RM bloque l’effet du lactate et du pyruvate sur la contractilité. Chez la femme, la grossesse est associée à des changements des propriétés électriques du cœur. Sur l’électrocardiogramme, l’intervalle QTc est plus long, témoignant de la prolongation de la repolarisation. Les mécanismes régulant cette adaptation restent encore inconnus. Ainsi, notre troisième objectif était de déterminer le rôle du RM dans l’adaptation de la repolarisation. Chez la rate gestante, l’intervalle QTc est prolongé ce qui est corroboré par la diminution des courants potassiques Ito et IK1. L’inhibition des RM pendant la gestation empêche la prolongation de l’intervalle QTc et la diminution des courants Ito. Les travaux exposés dans cette thèse apportent une vision plus précise du remodelage cardiaque induit par la grossesse, qui est permise par l’étude à l’échelle cellulaire. Nos résultats montrent que lors de la gestation et de l’HG les cardiomyocytes subissent des remodelages morphologiques contrastés. Notre étude a aussi révélé que lors de la gestation, la fonction contractile est tributaire des adaptations métaboliques et que cette relation est altérée lors de l’HG. Nos travaux montrent que la régulation de ces adaptations gestationnelles fait intervenir le RM au niveau de la morphologie, de la relation métabolisme/fonctionnement contractile et de la repolarisation. En faisant avancer les connaissances sur l’hypertrophie de la grossesse, ces travaux vont permettre d’améliorer la compréhension des complications cardiovasculaires gestationnelles. / Pregnancy is characterized by marked hemodynamic and metabolic changes, which have consequences on the heart. The adaptation of the heart to this physiological situation requires a remodeling of its structure, and consequently functioning adjustments. Mechanisms responsible for these adaptations are largely unknown. However, this knowledge is essential for the understanding of cardiovascular complications, such as gestational hypertension (GH), which represents a risk for the mother and the fœtus. To characterize cardiac adaptations to pregnancy, our experimental approach consisted in studying this remodelling at the level of left ventricle cardiomyocytes. Therefore, our first objective was to determine structural and functional modifications of cardiomyocytes in pregnant rats to be able to identify their variations in GH. In pregnant rats, structural remodelling of cardiomyocytes was characterized by a proportional volume expansion. GH was induced by a high sodium supplement (0.9% NaCl). In hypertensive rats, we observe significant cell volume shrinkage. The study of functional modifications elicited a strong relationship between metabolic adaptations and cell contractility. According to our results, in pregnant rats cardiomyocyte contractility was increased in presence of energy substrates lactate and pyruvate. This effect was weaker in the cells from hypertensive rats. This suggested modifications of the excitation-contraction coupling, in which L-type calcium currents (ICa-L) play an important role. Unexpectedly, lactate and pyruvate induced a significant increase in ICa-L only in hypertensive rats. In pathological conditions, mineralocorticoid receptors (MR) have been shown to mediate structural as well as functional remodelling of the heart. Our study is the first to investigate MR involvement in cardiac remodelling during pregnancy. Thus, our second objective was to determine MR involvement in cardiomyocyte remodelling. For this study, pregnant rats were treated with potassium canrenoate of (20 mg / kg / day), a MR antagonist. Our results revealed that MR inhibition during the pregnancy elicited a significant decrease of cell volume. MR inhibition has also affected metabolism and cellular functioning relationship. Indeed, plasma concentration of lactate was lower, which was in correlation with its blunted effect on cell contractility. In women, pregnancy-induced hypertrophy is associated with changes in electrical properties of the heart. Indeed, repolarisation is prolonged, which is characterised by a longer duration of QTc interval on the electrocardiogram. Regulation mechanisms involved in this adaptation are still largely unknown. Our third objective was therefore to determine the role of MR in the adaptation of repolarisation to pregnancy. Pregnancy induced a prolongation in QTc interval, which correlates with a decrease in potassium currents Ito and IK1. MR inhibition prevented QTc interval prolongation and the lowering of Ito. Our study gives a new insight of pregnancy-induced cardiac hypertrophy, which is provided by investigations at the cellular level. Our results demonstrate that pregnancy and GH are characterised by opposite remodellings. Moreover, in pregnancy the contractile function is dependent on metabolic adaptations. This is all the more glaring in GH as metabolic alterations induced modifications of electric properties to maintain contractile functioning. Furthermore, our work reveals MR involvement in the regulation of morphology, metabolism/contractility relationship, and repolarisation. By improving the knowledge of hypertrophy during pregnancy, this work contributes to improve the understanding of pregnancy-induced cardiac complications.

La fibrillation auriculaire (FA) est l’arythmie cardiaque la plus fréquente et elle peut entraîner des complications médicales sévères, notamment des accidents vasculaires cérébraux. On observe des différences sexuelles importantes dans la présentation clinique de la FA. Son incidence est 1,5 à 2 fois plus élevée chez les hommes, tandis que les femmes tendent à développer de la FA plus tardivement et plus sévèrement. Malheureusement, on ignore toujours les causes de ces différences sexuelles. La FA est une pathologie multifactorielle généralement causée par un débalancement des propriétés électrophysiologiques et/ou structurelles des oreillettes favorisant l’initiation et/ou le maintien de cette arythmie. Le but de ce projet est de déterminer s’il existe des différences sexuelles parmi les mécanismes impliqués dans la pathogenèse de la FA chez la souris. Sachant que les hormones sexuelles peuvent avoir un impact considérable sur l’électrophysiologie cardiaque, un objectif complémentaire de ce projet est de déterminer la contribution des hormones sexuelles dans les différences observées. Au cours de ce projet, nous avons découvert que la prédisposition masculine à la FA est également retrouvée chez la souris mâle. Nous avons identifié des différences sexuelles dans la régulation du calcium intracellulaire favorisant l’initiation de la FA chez les mâles. Celles-ci sont reliées à une expression et une activité plus élevée de l’échangeur Na+-Ca2+ chez les mâles. Nous avons également observé que le maintien de la FA était favorisé par des oreillettes de plus grande taille et par une latéralisation plus prononcée des connexines chez les mâles. L’orchiectomie réduit la susceptibilité des mâles à la FA en diminuant la latéralisation des connexines ainsi que la taille des cardiomyocytes auriculaires, suggérant un rôle des androgènes. À terme, ce projet permettra de mieux comprendre les mécanismes impliqués dans les différences sexuelles dans la pathogenèse de la FA. Une meilleure compréhension de ces mécanismes pourrait mener à une approche thérapeutique mieux adaptée au sexe des patients, pour une meilleure prise en charge de ceux-ci. / Atrial fibrillation (AF) is the most common type of cardiac arrhythmia, and it can lead to severe medical complications, including stroke. There are significant sex differences in the clinical presentation of AF. Its incidence is 1.5- to 2-fold higher in men, whereas women tend to develop AF later and more severely. Unfortunately, the mechanisms underlying these sex differences remain unknown. AF is a multifactorial pathology generally caused by an imbalance in electrophysiological and/or structural properties of the atria that promote AF initiation and/or maintenance. The aim of this project is to determine whether there are sex differences among the mechanisms involved in the pathogenesis of AF in mice.. Knowing that sex hormones can have a considerable impact on cardiac electrophysiology, a complementary objective of this project was to explore the contribution of sex hormones in the sex differences we observed. We first discovered that the male predisposition to AF is also found in mice. We have identified major sex differences in the regulation of intracellular calcium that promote AF initiation in males. These differences are related to a higher Na+-Ca2+ exchanger expression and function in males. We have also observed that AF maintenance was favoured by larger atria and more pronounced lateralization of connexins in males. Orchiectomy reduced AF susceptibility of males by reducing connexin lateralization and the dimensions of atrial myocytes, suggesting a role for androgens. Ultimately, this project will provide a better understanding of the mechanisms underlying sex differences in the pathogenesis of AF. This information could lead to a therapeutic approach better adapted to the sex of the patients, for a better management of AF.