Early Impact of Proton Beam Therapy on Electrophysiological Characteristics in a Porcine Model.

Autor:	Imamura K; Translational Interventional Electrophysiology Laboratory, Mayo Clinic/St. Mary's Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)., Deisher AJ; Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN., Dickow J; Translational Interventional Electrophysiology Laboratory, Mayo Clinic/St. Mary's Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)., Rettmann ME; Translational Interventional Electrophysiology Laboratory, Mayo Clinic/St. Mary's Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)., Yasin OZ; Translational Interventional Electrophysiology Laboratory, Mayo Clinic/St. Mary's Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)., Pepin MD; Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN., Hohmann S; Translational Interventional Electrophysiology Laboratory, Mayo Clinic/St. Mary's Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)., Konishi H; Translational Interventional Electrophysiology Laboratory, Mayo Clinic/St. Mary's Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)., Suzuki A; Translational Interventional Electrophysiology Laboratory, Mayo Clinic/St. Mary's Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)., Newman LK; Translational Interventional Electrophysiology Laboratory, Mayo Clinic/St. Mary's Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)., Sun X; Department of Cardiovascular Medicine (X.S.), Mayo Clinic, Rochester, MN., Kruse JJ; Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN., Merrell KW; Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN., Herman MG; Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN., Foote RL; Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN., Packer DL; Translational Interventional Electrophysiology Laboratory, Mayo Clinic/St. Mary's Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.).
Jazyk:	angličtina
Zdroj:	Circulation. Arrhythmia and electrophysiology [Circ Arrhythm Electrophysiol] 2023 Jun; Vol. 16 (6), pp. e011179. Date of Electronic Publication: 2023 May 15.
DOI:	10.1161/CIRCEP.122.011179
Abstrakt:	Background: Particle therapy is a noninvasive, catheter-free modality for cardiac ablation. We previously demonstrated the efficacy for creating ablation lesions in the porcine heart. Despite several earlier studies, the exact mechanism of early biophysical effects of proton and photon beam delivery on the myocardium remain incompletely resolved. Methods: Ten normal and 9 infarcted in situ porcine hearts received proton beam irradiation (40 Gy) delivered to the left ventricular myocardium with follow-up for 8 weeks. High-resolution electroanatomical mapping of the left ventricular was performed at baseline and follow-up. Bipolar voltage amplitude, conduction velocity, and connexin-43 were determined within the irradiated and nonirradiated areas. Results: The irradiated area in normal hearts showed a significant reduction of bipolar voltage amplitude (10.1±4.9 mV versus 5.7±3.2, P <0.0001) and conduction velocity (85±26 versus 55±13 cm/s, P =0.03) beginning at 4 weeks after irradiation. In infarcted myocardium after irradiation, bipolar voltage amplitude of the infarct scar (2.0±2.9 versus 0.8±0.7 mV, P =0.008) was significantly reduced as well as the conduction velocity in the infarcted heart (43.7±15.7 versus 26.3±11.4 cm/s, P =0.02). There were no significant changes in bipolar voltage amplitude and conduction velocity in nonirradiated myocardium. Myocytolysis, capillary hyperplasia, and dilation were seen in the irradiated myocardium 8 weeks after irradiation. Active caspase-3 and reduction of connexin-43 expression began in irradiated myocardium 1 week after irradiation and decreased over 8 weeks. Conclusions: Irradiation of the myocardium with proton beams reduce connexin-43 expression, conduction velocity, and bipolar conducted electrogram amplitude in a large porcine model. The changes in biomarkers preceded electrophysiological changes after proton beam therapy. Competing Interests: Disclosures Dr Packer in the past 12 months has provided consulting services for Abbott, ArtFix, Biosense Webster Inc, External Beam Ablation Med (EBAmed), Maxwell Biomed, MediaSphere Medical, LLC, MedLumics, Medtronic, St. Jude Medical, Siemens, Sanofi, Thermedical, and Wave Strategy. Dr Packer received no personal compensation for these consulting activities unless noted. Dr Packer receives research funding from the Abbott, Biosense Webster, Boston Scientific/EPT, CardioInsight, EBAmed, Medtronic Inc, Siemens, St. Jude Medical Inc, Thermedical Inc, National Institutes of Health (NIH), Robertson Foundation, Vital Project Funds Inc, Mr and Mrs J. Michael Cook/Fund. Mayo Clinic and Dr Packer have a financial interest in Analyze-AVW technology that may have been used to analyze some of the heart images in this research. In accordance with the Bayh-Dole Act, this technology has been licensed to commercial entities, and both Mayo Clinic and Dr Packer have received royalties less than $10 000, the federal threshold for significant financial interest. In addition, Mayo Clinic holds an equity position in the company to which the AVW technology has been licensed. Dr Packer and Mayo Clinic jointly have equity in a privately held company, EBAmed, and has received stock options from Neutrace, ArtFix Ltd, and Xenter Inc. Dr Packer has a licensing agreement with the American Heart Association and Medtronic Inc, for the Mayo Atrial Fibrillation Symptom Inventory (MAFSI) Survey and has contractual rights to receive future royalties under this license. Royalties from Wiley & Sons, Oxford, and St. Jude Medical. The other authors report no conflicts.
Databáze:	MEDLINE
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