Anna Gams published a new paper in JACC: CEP that describes the molecular and functional remodeling of cardiac pacemakers during heart failure

Previously we reported that a mammalian heart has two cardiac pacemakers: superior and inferior sinoatrial nodes: sSAN and iSAN. Regional isolation of sSAN and iSAN has been already considered for the treatment of inappropriate sinus tachycardia. Now we reported the loss of one of the pacemakers, preferentially iSAN, during end-stage heart failure due to significant remodeling of the transcriptome. RNA sequencing allowed for the comprehensive investigation of changes in gene expression between anatomically distinct pacemaking regions in healthy and failing rat hearts. This study provides a deeper understanding of the molecular signatures that are distinct between active and inactive pacemaking regions of the heart and changes in gene expression between healthy and failing hearts. Future studies should implement spatially resolved genomic sequencing to identify gene expression patterns in distinct anatomical regions of the SAN, particularly the areas of transition outside the relatively small anatomical borders of the functional sSAN and iSAN. Because this study was performed in rat hearts, future studies in the human heart are also necessary to establish the clinical relevance of our findings.             

Link: https://www.jacc.org/doi/full/10.1016/j.jacep.2022.08.003