Skip to main content
Top
Published in: Endocrine 2/2019

01-08-2019 | Hyperthyroidism | Original Article

Alterations in atrial ion channels and tissue structure promote atrial fibrillation in hypothyroid rats

Authors: Jianqiang Li, Zhaorui Liu, Hongwei Zhao, Fengxiang Yun, Zhaoguang Liang, Dingyu Wang, Xinbo Zhao, Jiawei Zhang, Hai Cang, Yilun Zou, Yue Li

Published in: Endocrine | Issue 2/2019

Login to get access

Abstract

Purpose

It is well known that hyperthyroidism is associated with atrial fibrillation (AF); however, the relationship between hypothyroidism and AF remains controversial.

Methods

Hypothyroidism was established in rats by two methods: methimazole-induced (MMI) and thyroidectomy (TX). MMI model includes control (n = 10), MMI (n = 10), and MMI + L-thyroxine (T4, n = 10). Methimazole was given intragastrically in MMI and MMI + T4 for 12 weeks, and T4 was added intragastrically in MMI + T4 at week 5. TX model includes sham (n = 10), TX (n = 10), and TX + T4 (n = 10). Four weeks after surgery, rats in TX + T4 received T4 for 8 weeks. Triiodothyronine (T3), T4, and thyroid-stimulating hormone (TSH) were measured. Electrophysiology, tissue structure and function, and protein levels of potassium and L-type calcium channels were assessed in the atria.

Results

Severe changes in the atrial structure of hypothyroid rats were observed. Compared with euthyroid rats, atrial effective refractory period (AERP) in hypothyroid rats was significantly shortened; accordingly, inducibility and duration of AF were considerably increased. Protein levels of minK, Kv1.5, Kv4.2, Kv4.3, Kv7.1, and Cav1.2 were upregulated in hypothyroid rats, whereas there was only a tendency toward increased Kir2.1. Kv11.1 was statistically upregulated in the MMI model and had an increasing tendency in the TX model. Conversely, Kir3.1 and Kir3.4 were downregulated in hypothyroid rats. The above changes could be partially inhibited by T4 treatment.

Conclusions

AERP shortening due to altered protein levels of ion channels and atrial structural changes increased the susceptibility to AF in hypothyroidism. Thyroid replacement therapy could prevent electrical and structural remodeling under hypothyroid condition.
Literature
1.
go back to reference H. Vargas-Uricoechea, A. Bonelo-Perdomo, C.H. Sierra-Torres, Effects of thyroid hormones on the heart. Clin. Investig. Arterioscler. 26, 296–309 (2014)PubMed H. Vargas-Uricoechea, A. Bonelo-Perdomo, C.H. Sierra-Torres, Effects of thyroid hormones on the heart. Clin. Investig. Arterioscler. 26, 296–309 (2014)PubMed
2.
3.
go back to reference E.J. Kim, A. Lyass, N. Wang, J.M. Massaro, C.S. Fox, E.J. Benjamin, J.W. Magnani, Relation of hypothyroidism and incident atrial fibrillation (from the Framingham Heart Study). Am. Heart J. 167, 123–126 (2014)CrossRefPubMed E.J. Kim, A. Lyass, N. Wang, J.M. Massaro, C.S. Fox, E.J. Benjamin, J.W. Magnani, Relation of hypothyroidism and incident atrial fibrillation (from the Framingham Heart Study). Am. Heart J. 167, 123–126 (2014)CrossRefPubMed
4.
go back to reference C. Baumgartner, B.R. da Costa, T.H. Collet, M. Feller, C. Floriani, D.C. Bauer, A.R. Cappola, S.R. Heckbert, G. Ceresini, J. Gussekloo, W.P.J. den Elzen, R.P. Peeters, R. Luben, H. Völzke, M. Dörr, J.P. Walsh, A. Bremner, M. Iacoviello, P. Macfarlane, J. Heeringa, D.J. Stott, R.G.J. Westendorp, K.T. Khaw, J.W. Magnani, D. Aujesky, N. Rodondi, Thyroid function within the normal range, subclinical hypothyroidism, and the risk of atrial fibrillation. Circulation 136, 2100–2116 (2017)CrossRefPubMedPubMedCentral C. Baumgartner, B.R. da Costa, T.H. Collet, M. Feller, C. Floriani, D.C. Bauer, A.R. Cappola, S.R. Heckbert, G. Ceresini, J. Gussekloo, W.P.J. den Elzen, R.P. Peeters, R. Luben, H. Völzke, M. Dörr, J.P. Walsh, A. Bremner, M. Iacoviello, P. Macfarlane, J. Heeringa, D.J. Stott, R.G.J. Westendorp, K.T. Khaw, J.W. Magnani, D. Aujesky, N. Rodondi, Thyroid function within the normal range, subclinical hypothyroidism, and the risk of atrial fibrillation. Circulation 136, 2100–2116 (2017)CrossRefPubMedPubMedCentral
5.
go back to reference C. Selmer, J.B. Olesen, M.L. Hansen, J. Lindhardsen, A.M. Olsen, J.C. Madsen, J. Faber, P.R. Hansen, O.D. Pedersen, C. Torp-Pedersen, G.H. Gislason, The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study. BMJ. 345, e7895 (2012)CrossRefPubMedPubMedCentral C. Selmer, J.B. Olesen, M.L. Hansen, J. Lindhardsen, A.M. Olsen, J.C. Madsen, J. Faber, P.R. Hansen, O.D. Pedersen, C. Torp-Pedersen, G.H. Gislason, The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study. BMJ. 345, e7895 (2012)CrossRefPubMedPubMedCentral
6.
go back to reference B. Worku, A.J. Tortolani, I. Gulkarov, O.W. Isom, I. Klein, Preoperative hypothyroidism is a risk factor for postoperative atrial fibrillation in cardiac surgical patients. J. Card. Surg. 30, 307–312 (2015)CrossRefPubMed B. Worku, A.J. Tortolani, I. Gulkarov, O.W. Isom, I. Klein, Preoperative hypothyroidism is a risk factor for postoperative atrial fibrillation in cardiac surgical patients. J. Card. Surg. 30, 307–312 (2015)CrossRefPubMed
7.
go back to reference J. Martínez-Comendador, J.M. Marcos-Vidal, J. Gualis, C.E. Martin, E. Martin, J. Otero, M. Castaño, Subclinical hypothyroidism might increase the risk of postoperative atrial fibrillation after aortic valve replacement. Thorac. Cardiovasc. Surg. 64, 427–433 (2016)PubMed J. Martínez-Comendador, J.M. Marcos-Vidal, J. Gualis, C.E. Martin, E. Martin, J. Otero, M. Castaño, Subclinical hypothyroidism might increase the risk of postoperative atrial fibrillation after aortic valve replacement. Thorac. Cardiovasc. Surg. 64, 427–433 (2016)PubMed
8.
go back to reference M.C. Jaimes, L.A.A. Torrado, N.F.S. Reyes, J.C. Mackenzie, J.P.U. Mallarino, Hypothyroidism is a risk factor for atrial fibrillation after coronary artery bypass graft. Braz. J. Cardiovasc. Surg. 32, 475–480 (2017)PubMedPubMedCentral M.C. Jaimes, L.A.A. Torrado, N.F.S. Reyes, J.C. Mackenzie, J.P.U. Mallarino, Hypothyroidism is a risk factor for atrial fibrillation after coronary artery bypass graft. Braz. J. Cardiovasc. Surg. 32, 475–480 (2017)PubMedPubMedCentral
9.
go back to reference Y. Zhang, E.I. Dedkov, D. Teplitsky, N.Y. Weltman, C.J. Pol, V. Rajagopalan, B. Lee, A.M. Gerdes, Both hypothyroidism and hyperthyroidism increase atrial fibrillation inducibility in rats. Circ. Arrhythm. Electrophysiol. 6, 952–959 (2013)CrossRefPubMedPubMedCentral Y. Zhang, E.I. Dedkov, D. Teplitsky, N.Y. Weltman, C.J. Pol, V. Rajagopalan, B. Lee, A.M. Gerdes, Both hypothyroidism and hyperthyroidism increase atrial fibrillation inducibility in rats. Circ. Arrhythm. Electrophysiol. 6, 952–959 (2013)CrossRefPubMedPubMedCentral
10.
go back to reference Y. Zhang, E.I. Dedkov, B. Lee, Y. Li, K. Pun, A.M. Gerdes, Thyroid hormone replacement therapy attenuates atrial remodeling and reduces atrial fibrillation inducibility in a rat myocardial infarction-heart failure model. J. Card. Fail. 20, 1012–1019 (2014)CrossRefPubMedPubMedCentral Y. Zhang, E.I. Dedkov, B. Lee, Y. Li, K. Pun, A.M. Gerdes, Thyroid hormone replacement therapy attenuates atrial remodeling and reduces atrial fibrillation inducibility in a rat myocardial infarction-heart failure model. J. Card. Fail. 20, 1012–1019 (2014)CrossRefPubMedPubMedCentral
11.
go back to reference H. Watanabe, M. Ma, T. Washizuka, S. Komura, T. Yoshida, Y. Hosaka, K. Hatada, M. Chinushi, T. Yamamoto, K. Watanabe, Y. Aizawa, Thyroid hormone regulates mRNA expression and currents of ion channels in rat atrium. Biochem. Biophys. Res. Commun. 308, 439–444 (2003)CrossRefPubMed H. Watanabe, M. Ma, T. Washizuka, S. Komura, T. Yoshida, Y. Hosaka, K. Hatada, M. Chinushi, T. Yamamoto, K. Watanabe, Y. Aizawa, Thyroid hormone regulates mRNA expression and currents of ion channels in rat atrium. Biochem. Biophys. Res. Commun. 308, 439–444 (2003)CrossRefPubMed
12.
go back to reference M.L. Ma, K. Watanabe, H. Watanabe, Y. Hosaka, S. Komura, Y. Aizawa, T. Yamamoto, Different gene expression of potassium channels by thyroid hormone and an antithyroid drug between the atrium and ventricle of rats. Jpn. Heart J. 44, 101–110 (2003)CrossRefPubMed M.L. Ma, K. Watanabe, H. Watanabe, Y. Hosaka, S. Komura, Y. Aizawa, T. Yamamoto, Different gene expression of potassium channels by thyroid hormone and an antithyroid drug between the atrium and ventricle of rats. Jpn. Heart J. 44, 101–110 (2003)CrossRefPubMed
13.
go back to reference Z.Q. Sun, K. Ojamaa, W.A. Coetzee, M. Artman, I. Klein, Effects of thyroid hormone on action potential and repolarizing currents in rat ventricular myocytes. Am. J. Physiol. Endocrinol. Metab. 278, E302–E307 (2000)CrossRefPubMed Z.Q. Sun, K. Ojamaa, W.A. Coetzee, M. Artman, I. Klein, Effects of thyroid hormone on action potential and repolarizing currents in rat ventricular myocytes. Am. J. Physiol. Endocrinol. Metab. 278, E302–E307 (2000)CrossRefPubMed
14.
go back to reference A. Mansén, C. Tiselius, P. Sand, J. Fauconnier, H. Westerblad, B. Rydqvist, B. Vennström, Thyroid hormone receptor alpha can control action potential duration in mouse ventricular myocytes through the KCNE1 ion channel subunit. Acta Physiol. (Oxf). 198, 133–142 (2010)CrossRefPubMed A. Mansén, C. Tiselius, P. Sand, J. Fauconnier, H. Westerblad, B. Rydqvist, B. Vennström, Thyroid hormone receptor alpha can control action potential duration in mouse ventricular myocytes through the KCNE1 ion channel subunit. Acta Physiol. (Oxf). 198, 133–142 (2010)CrossRefPubMed
15.
go back to reference H. Alonso, J. Fernández-Ruocco, M. Gallego, L.L. Malagueta-Vieira, A. Rodríguez-de-Yurre, E. Medei, O. Casis, Thyroid stimulating hormone directly modulates cardiac electrical activity. J. Mol. Cell Cardiol. 89, 280–286 (2015)CrossRefPubMed H. Alonso, J. Fernández-Ruocco, M. Gallego, L.L. Malagueta-Vieira, A. Rodríguez-de-Yurre, E. Medei, O. Casis, Thyroid stimulating hormone directly modulates cardiac electrical activity. J. Mol. Cell Cardiol. 89, 280–286 (2015)CrossRefPubMed
16.
go back to reference H. Bruere, L. Fauchier, A. Bernard Brunet, B. Pierre, E. Simeon, D. Babuty, N. Clementy, History of thyroid disorders in relation to clinical outcomes in atrial fibrillation. Am. J. Med. 128, 30–37 (2015)CrossRefPubMed H. Bruere, L. Fauchier, A. Bernard Brunet, B. Pierre, E. Simeon, D. Babuty, N. Clementy, History of thyroid disorders in relation to clinical outcomes in atrial fibrillation. Am. J. Med. 128, 30–37 (2015)CrossRefPubMed
17.
go back to reference I. Morishima, K. Okumura, Y. Morita, Y. Kanzaki, K. Takagi, R. Yoshida, H. Nagai, Y. Ikai, K. Furui, N. Yoshioka, H. Tsuboi, T. Murohara, High normal thyroid stimulating hormone shows a potential causal association with arrhythmia recurrence after catheter ablation of atrial fibrillation. J. Am. Heart Assoc. 7, e009158 (2018)CrossRefPubMedPubMedCentral I. Morishima, K. Okumura, Y. Morita, Y. Kanzaki, K. Takagi, R. Yoshida, H. Nagai, Y. Ikai, K. Furui, N. Yoshioka, H. Tsuboi, T. Murohara, High normal thyroid stimulating hormone shows a potential causal association with arrhythmia recurrence after catheter ablation of atrial fibrillation. J. Am. Heart Assoc. 7, e009158 (2018)CrossRefPubMedPubMedCentral
18.
go back to reference F. Guerra, M. Brambatti, R. Nieuwlaat, M. Marcucci, E. Dudink, H.J.G.M. Crijns, M.V. Matassini, A. Capucci, Symptomatic atrial fibrillation and risk of cardiovascular events: data from the Euro Heart Survey. Europace 19, 1922–1929 (2017)CrossRefPubMed F. Guerra, M. Brambatti, R. Nieuwlaat, M. Marcucci, E. Dudink, H.J.G.M. Crijns, M.V. Matassini, A. Capucci, Symptomatic atrial fibrillation and risk of cardiovascular events: data from the Euro Heart Survey. Europace 19, 1922–1929 (2017)CrossRefPubMed
19.
go back to reference M.C. Wijffels, C.J. Kirchhof, R. Dorland, M.A. Allessie, Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation 92, 1954–1968 (1995)CrossRefPubMed M.C. Wijffels, C.J. Kirchhof, R. Dorland, M.A. Allessie, Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation 92, 1954–1968 (1995)CrossRefPubMed
20.
go back to reference U. Ravens, E. Cerbai, Role of potassium currents in cardiac arrhythmias. Europace 10, 1133–1137 (2008)CrossRefPubMed U. Ravens, E. Cerbai, Role of potassium currents in cardiac arrhythmias. Europace 10, 1133–1137 (2008)CrossRefPubMed
21.
go back to reference N. Schmitt, M. Grunnet, S.P. Olesen, Cardiac potassium channel subtypes: new roles in repolarization and arrhythmia. Physiol. Rev. 94, 609–653 (2014)CrossRefPubMed N. Schmitt, M. Grunnet, S.P. Olesen, Cardiac potassium channel subtypes: new roles in repolarization and arrhythmia. Physiol. Rev. 94, 609–653 (2014)CrossRefPubMed
22.
go back to reference J.R. Ehrlich, Inward rectifier potassium currents as a target for atrial fibrillation therapy. J. Cardiovasc. Pharmacol. 52, 129–135 (2008)CrossRefPubMed J.R. Ehrlich, Inward rectifier potassium currents as a target for atrial fibrillation therapy. J. Cardiovasc. Pharmacol. 52, 129–135 (2008)CrossRefPubMed
23.
go back to reference B. Burstein, S. Nattel, Atrial fibrosis: mechanisms and clinical relevance in atrial fibrillation. J. Am. Coll. Cardiol. 51, 802–809 (2008)CrossRefPubMed B. Burstein, S. Nattel, Atrial fibrosis: mechanisms and clinical relevance in atrial fibrillation. J. Am. Coll. Cardiol. 51, 802–809 (2008)CrossRefPubMed
24.
go back to reference N.F. Marrouche, D. Wilber, G. Hindricks, P. Jais, N. Akoum, F. Marchlinski, E. Kholmovski, N. Burgon, N. Hu, L. Mont, T. Deneke, M. Duytschaever, T. Neumann, M. Mansour, C. Mahnkopf, B. Herweg, E. Daoud, E. Wissner, P. Bansmann, J. Brachmann, Association of atrial tissue fibrosis identified by delayed enhancement MRI and atrial fibrillation catheter ablation: the DECAAF study. JAMA. 311, 498–506 (2014)CrossRefPubMed N.F. Marrouche, D. Wilber, G. Hindricks, P. Jais, N. Akoum, F. Marchlinski, E. Kholmovski, N. Burgon, N. Hu, L. Mont, T. Deneke, M. Duytschaever, T. Neumann, M. Mansour, C. Mahnkopf, B. Herweg, E. Daoud, E. Wissner, P. Bansmann, J. Brachmann, Association of atrial tissue fibrosis identified by delayed enhancement MRI and atrial fibrillation catheter ablation: the DECAAF study. JAMA. 311, 498–506 (2014)CrossRefPubMed
25.
go back to reference P. Kong, P. Christia, N.G. Frangogiannis, The pathogenesis of cardiac fibrosis. Cell Mol. Life Sci. 71, 549–574 (2014)CrossRefPubMed P. Kong, P. Christia, N.G. Frangogiannis, The pathogenesis of cardiac fibrosis. Cell Mol. Life Sci. 71, 549–574 (2014)CrossRefPubMed
26.
go back to reference W.J. Chen, K.H. Lin, Y.S. Lee, Molecular characterization of myocardial fibrosis during hypothyroidism: evidence for negative regulation of the pro-alpha1(I) collagen gene expression by thyroid hormone receptor. Mol. Cell Endocrinol. 162, 45–55 (2000)CrossRefPubMed W.J. Chen, K.H. Lin, Y.S. Lee, Molecular characterization of myocardial fibrosis during hypothyroidism: evidence for negative regulation of the pro-alpha1(I) collagen gene expression by thyroid hormone receptor. Mol. Cell Endocrinol. 162, 45–55 (2000)CrossRefPubMed
27.
go back to reference E. Cano-Europa, V. Blas-Valdivia, M. Franco-Colin, C.A. Gallardo-Casas, R. Ortiz-Butrón, Methimazole-induced hypothyroidism causes cellular damage in the spleen, heart, liver, lung and kidney. Acta Histochem. 113, 1–5 (2011)CrossRefPubMed E. Cano-Europa, V. Blas-Valdivia, M. Franco-Colin, C.A. Gallardo-Casas, R. Ortiz-Butrón, Methimazole-induced hypothyroidism causes cellular damage in the spleen, heart, liver, lung and kidney. Acta Histochem. 113, 1–5 (2011)CrossRefPubMed
28.
go back to reference L. Lu, X. Yu, W. Teng, Z. Shan, Treatment with levothyroxine in pregnant rats with subclinical hypothyroidism improves cell migration in the developing brain of the progeny. J. Endocrinol. Invest. 35, 490–496 (2012)PubMed L. Lu, X. Yu, W. Teng, Z. Shan, Treatment with levothyroxine in pregnant rats with subclinical hypothyroidism improves cell migration in the developing brain of the progeny. J. Endocrinol. Invest. 35, 490–496 (2012)PubMed
Metadata
Title
Alterations in atrial ion channels and tissue structure promote atrial fibrillation in hypothyroid rats
Authors
Jianqiang Li
Zhaorui Liu
Hongwei Zhao
Fengxiang Yun
Zhaoguang Liang
Dingyu Wang
Xinbo Zhao
Jiawei Zhang
Hai Cang
Yilun Zou
Yue Li
Publication date
01-08-2019
Publisher
Springer US
Published in
Endocrine / Issue 2/2019
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-019-01968-z

Other articles of this Issue 2/2019

Endocrine 2/2019 Go to the issue