
pmid: 40704959
pmc: PMC12471107
Microvascular rarefaction is a feature of heart failure with preserved ejection fraction (HFpEF) that may underlie associated rhythm disturbances. Angiotensin II (AngII) signaling has been implicated, but its role in sinoatrial (SA) node dysfunction remains unclear.The authors tested whether changes in SA node microvascular architecture contribute to pacemaker dysfunction in early HFpEF.Mice received a 28-day subcutaneous infusion of a sub-pressor dose of AngII. Electrocardiography, echocardiography, confocal imaging, spatial RNA detection, and optical mapping were used to assess SA node structure and function.Heart rate declined progressively during AngII infusion, with males falling from 605 ± 6 beats/min to 490 ± 6 beats/min and females from 646 ± 23 beats/min to 511 ± 10 beats/min by day 28. Bradycardia was accompanied by increased beat-to-beat variability: the percentage of consecutive heartbeats that differed in duration by >6 milliseconds increased from 3.5% ± 1.3% to 32.1% ± 4.5% in males and from 3.8% ± 1.1% to 27.7% ± 2.5% in females. These changes coincided with reduced microvessel density in the superior SA node (males: 6.1 ± 0.5 nm/μm3 to 3.9 ± 0.2 nm/μm3; females: 5.6 ± 0.4 to 2.8 ± 0.5 nm/μm3), whereas vessels in the inferior SA node remained unchanged. Despite preserved myocyte density, these changes were accompanied by up-regulation of oxidative stress and the hypoxia-inducible factor 1α and vascular endothelial growth factor signaling pathways.These findings highlight microvascular rarefaction in the superior SA node as a key early event in HFpEF pathology. The loss of redundant vascular loops compromises metabolic support for pacemaking, illustrating a broader principle: rarefaction can impair excitability in metabolically demanding excitable tissues.
Male, Angiotensin II (mesh), Inbred C57BL (mesh), sinoatrial node, Sinoatrial Node (mesh), Heart Disease (rcdc), 3208 Medical Physiology (for-2020), Article, vascular rarefaction, Mice, Electrocardiography, Heart Rate (mesh), Heart Rate, 1102 Cardiorespiratory Medicine and Haematology (for), 1103 Clinical Sciences (for), Animals (mesh), Electrocardiography (mesh), Animals, 32 Biomedical and Clinical Sciences (for-2020), Male (mesh), Microvessels (mesh), Sinoatrial Node, Heart Failure, Cardiovascular (hrcs-hc), Angiotensin II, Mice (mesh), 3201 Cardiovascular medicine and haematology (for-2020), Stroke Volume (mesh), Stroke Volume, 2.1 Biological and endogenous factors (hrcs-rac), 3202 Clinical sciences (for-2020), Heart Failure (mesh), HFpEF, Mice, Inbred C57BL, Female (mesh), Microvessels, Cardiovascular (rcdc), Female
Male, Angiotensin II (mesh), Inbred C57BL (mesh), sinoatrial node, Sinoatrial Node (mesh), Heart Disease (rcdc), 3208 Medical Physiology (for-2020), Article, vascular rarefaction, Mice, Electrocardiography, Heart Rate (mesh), Heart Rate, 1102 Cardiorespiratory Medicine and Haematology (for), 1103 Clinical Sciences (for), Animals (mesh), Electrocardiography (mesh), Animals, 32 Biomedical and Clinical Sciences (for-2020), Male (mesh), Microvessels (mesh), Sinoatrial Node, Heart Failure, Cardiovascular (hrcs-hc), Angiotensin II, Mice (mesh), 3201 Cardiovascular medicine and haematology (for-2020), Stroke Volume (mesh), Stroke Volume, 2.1 Biological and endogenous factors (hrcs-rac), 3202 Clinical sciences (for-2020), Heart Failure (mesh), HFpEF, Mice, Inbred C57BL, Female (mesh), Microvessels, Cardiovascular (rcdc), Female
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