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Andrew Grace

Molecular Pathogenesis of Cardiac Arrhythmias

Research Groupings: Cardiovascular science and medicine | Metabolic medicine, integrative and comparative physiology

Most of our research involves the characterisation of the molecular basis of the heart beat and the substrates that are responsible for cardiac arrhythmias. A central aim is to test the hypothesis that changes in ion channel function and/or expression are important in the pathogenesis of arrhythmias. Initially the studies have focused on monogenic ion channel disorders but have developed to include genetically complex cardiac disease.

Arrhythmias arise when the normal processes of cardiac excitation break down. They provide useful experimental insights into how the heart should function and are usually due to re-entrant waves of excitation, the conditions for which are favoured by slowed intraventricular conduction and delayed repolarization. These parameters are measured using computer-driven stimulation protocols derived from our clinical work applied in genetically modified (GM) animal models.

gene-targeted mice: in vivo models of ion channelopathiesThe work is highly integrated and moves from the identification and characterization of novel ion channel and receptor genes through functional analysis using gene-targeting to the invasive analysis of cardiac arrhythmia substrates in patients. The fact that measurements made in humans can be also be obtained in GM mice highlights the translational aspects of the approach. Our most recent work has described the mechanisms of cardiac arrhythmogenesis in a series of novel GM mice with targeted disruptions in respectively the potassium channel gene, KCNE1, and the sodium channel gene, Scn5a, with work in progress on the ryanodine receptor, RyR2. We have also initiated a large-scale genomics project looking at the genetic basis of sudden cardiac death with the Wellcome Trust Sanger Institute. In addition clinical trials of biophysical measurements from the human heart, 'fractionation', in patients at possible risk of sudden cardiac death continue across Europe. Together these provide the background to the refinement of the basic science programme leading to a much better understanding of the genetic basis of sudden cardiac death, its mechanisms, prediction and prevention.

Lab members
Yana Dautova, Nina Ghais, Iman Gurung, Parvez Hakim, Sandeep Hothi, Chris Huang, Matthew Killeen, Thomas Pedersen, Gary Tse, Yanmin Zhang, Yanhui Zhang

References

  1. Grace, A.A., Brady, P.A. & Shapiro, L.M. (2001) Risk management in Hypertrophic Cardiomyopathy. Lancet 357, 407-408.
  2. Papadatos, G.A, Wallerstein, P.M.R., Ratcliff, R., Head, C.E., Huang, C.L.H., Saumarez, R.C., Colledge, W.H. & Grace A.A. (2002) Slowed conduction and ventricular tachycardia following targeted disruption of the cardiac sodium channel Scn5a. Proc. Nat. Acad. Sci., USA 99, 6210-6215.
  3. Saumarez, R.C., Chojnowska, L., Derksen, R., Pytkowski, M., Sterlinski, M., Sadoul, N., Hauer, R.W.N., Ruzyllo, W. &, Grace, A.A. (2003) Sudden Death in Non-coronary Disease is Associated with Delayed Paced Ventricular Activation. Circulation 107, 2595-2600.

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