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Article . 2025
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Microvascular Rarefaction in the Sinoatrial Node: A Potential Mechanism for Pacemaker Dysfunction in Early HFpEF.

Authors: Manning, Declan; Rivera, Ernesto J; Rhana, Paula; Matsumoto, Collin; Fong, Zhihui; Thai, Phung N; Muñoz, Manuel F; +6 Authors

Microvascular Rarefaction in the Sinoatrial Node: A Potential Mechanism for Pacemaker Dysfunction in Early HFpEF.

Abstract

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.

Country
United States
Keywords

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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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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