Skip to main content
Log in

Effects and pharmacological mechanism of Zhigancao Decoction on electrical and structural remodeling of the atrium of rabbits induced by rapid atrial pacing

  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Zhigancao decoction (ZD) has a long history in China as a traditional Chinese medicine compound for the treatment of tachyarrhythmias. This study mainly explored the pharmacological mechanism of Zhigancao Decoction in preventing atrial fibrillation by altering the electrical and structural remodeling of the atrial in rabbits.

Methods

In total, 30 male New Zealand white rabbits were randomly divided into 3 groups (ten rabbits for each). The first group was sham-operated (control group). The second group was intervened by the rapid right atrium pacing (RAP) to induce atrial fibrillation (AF group), while the third group was given ZD gavage and RAP (AF + ZD group). All rabbits were anesthetized before two monophasic action potential (MAP) catheters were sequentially inserted into the right atrium. After 8 h of rapid right atrial pacing, the electrophysiological indexes and the induction rate of atrial fibrillation were observed in the three groups of rabbits, and the left atrial myocardium samples were taken to observe the ultrastructure. Single atrial myocytes were separated by enzymolysis, and the L-type calcium current (ICa-L) of atrial myocytes in different experimental groups was observed by whole-cell patch clamp technique. The fluorescence intensity of Ca2+ in atrial myocytes was observed after Fluo-3/AM fluorescent staining. The main components of ZD were identified by liquid chromatography-mass spectrometry-mass spectrometry (LC–MS/MS) method.

Results

Compared with the AF group, the maximum ascent rate (Max dV/dt) and plateau potential were significantly reduced in the ZD group, the action potential duration at 10% and 20% (APD10, APD20) were significantly shortened (P < 0.01), action potential duration at 50%, 70%, and 90% (APD50, APD70, APD90) were significantly prolonged, and atrial effective refractory period (AERP) was significantly prolonged (P < 0.01) in the ZD group. In the ZD group, the ICa-L amplitudes of rabbit atrial myocytes under each clamping voltage were significantly smaller than those in the AF group (P < 0.01) and the control group (P < 0.05). The Ca2+ fluorescence intensity in the rabbit atrial myocytes in the ZD group was significantly weaker than that in the AF group (P < 0.01) and the control group (P < 0.05). Electron microscopy displayed that the control group had neatly arranged atrial tissue myofilaments and intact mitochondria. However, the ultrastructural damage of the AF group was severe compared with that of the ZD group. LC–MS/MS analysis confirmed that ZD contained several antiarrhythmic compounds including ginsenoside, isoliensinine, catalpol, glycyrrhizinate and hesperetin.

Conclusion

Rapid atrial pacing (RAP) could cause the electrical and structural remodeling of rabbit atrial myocytes. ZD might reverse the atrial electrical remodeling but could have little effect on structural remodeling, which might be the mechanism of ZD treatment on atrial fibrillation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Haim M, Hoshen M, Reges O, et al. Prospective national study of the prevalence, incidence, management and outcome of a large contemporary cohort of patients with incident non-valvular atrial fibrillation. J Am Heart Assoc. 2015;4(1):e001486. https://doi.org/10.1161/JAHA.114.001486.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Sibley S, Muscedere J. New-onset atrial fibrillation in critically ill patients. Can Respir J. 2015;22(3):179–82. https://doi.org/10.1155/2015/394961.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014;129(8):837–47. https://doi.org/10.1161/CIRCULATIONAHA.113.005119.

    Article  PubMed  Google Scholar 

  4. Burstein B, Nattel S. Atrial fibrosis: mechanisms and clinical relevance in atrial fibrillation. J Am Coll Cardiol. 2008;51(8):802–9. https://doi.org/10.1016/j.jacc.2007.09.064.

    Article  CAS  PubMed  Google Scholar 

  5. Casaclang-Verzosa G, Gersh BJ, Tsang TS. Structural and functional remodeling of the left atrium: clinical and therapeutic implications for atrial fibrillation. J Am Coll Cardiol. 2008;51(1):1–11. https://doi.org/10.1016/j.jacc.2007.09.026.

    Article  PubMed  Google Scholar 

  6. Thomas L, Abhayaratna WP. Left atrial reverse remodeling: mechanisms, evaluation, and clinical significance. JACC Cardiovasc Imag. 2017;10(1):65–77. https://doi.org/10.1016/j.jcmg.2016.11.003.

    Article  Google Scholar 

  7. Liu W, Xiong X, Feng B, et al. Classic herbal formula Zhigancao Decoction for the treatment of premature ventricular contractions (PVCs): a systematic review of randomized controlled trials. Complement Ther Med. 2015;23(1):100–15. https://doi.org/10.1016/j.ctim.2014.12.008.

    Article  CAS  PubMed  Google Scholar 

  8. Xiong XJ. Exploration on connotation of Zhigancao Decoction formula syndrome from the perspective of modern pathophysiology and severe cases of critical care and its clinical efficacy on cardioversion, maintenance of sinus rhythm, hemostasis, increasing platelets count, and tonifying deficiency. Zhongguo Zhong Yao Za Zhi. 2019;44(18):3842–60. https://doi.org/10.19540/j.cnki.cjcmm.20190416.501.

    Article  PubMed  Google Scholar 

  9. Scott L Jr, Fender AC, Saljic A, et al. NLRP3 inflammasome is a key driver of obesity-induced atrial arrhythmias. Cardiovasc Res. 2021;117(7):1746–59. https://doi.org/10.1093/cvr/cvab024.

    Article  CAS  PubMed  Google Scholar 

  10. Sun J, Wugeti N, Mahemuti A. Reversal effect of Zhigancao decoction on myocardial fibrosis in a rapid pacing-induced atrial fibrillation model in New Zealand rabbits. J Int Med Res. 2019;47(2):884–92. https://doi.org/10.1177/0300060518799819.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Fei YD, Chen M, Guo S, et al. Simultaneous activation of the small conductance calcium-activated potassium current by acetylcholine and inhibition of sodium current by ajmaline cause J-wave syndrome in Langendorff-perfused rabbit ventricles. Heart Rhythm. 2021;18(1):98–108. https://doi.org/10.1016/j.hrthm.2020.07.036.

    Article  PubMed  Google Scholar 

  12. Rouet R, Worou ME, Puddu PE, et al. Nifedipine blocks ondansetron electrophysiological effects in rabbit Purkinje fibers and decreases early after depolarization incidence. Curr Clin Pharmacol. 2012;7(1):41–8. https://doi.org/10.2174/157488412799218789.

    Article  CAS  PubMed  Google Scholar 

  13. Fan YY, Xu F, Zhu C, et al. Effects of febuxostat on atrial remodeling in a rabbit model of atrial fibrillation induced by rapid atrial pacing. J Geriatr Cardiol. 2019;16(7):540–51. https://doi.org/10.11909/j.issn.1671-5411.2019.07.003.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Jiang W, Zeng M, Cao Z, et al. Icariin, a novel blocker of sodium and calcium channels, eliminates early and delayed afterdepolarizations, as well as triggered activity, in rabbit cardiomyocytes. Front Physiol. 2017;8:342. https://doi.org/10.3389/fphys.2017.00342.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Wu CY, Zhang DL, Zhou CZ, et al. Effect of zhigancao decoction on atrial monophasic action potential in rabbits. New Chin Med. 2013;45(03):173–5. https://doi.org/10.13457/j.cnki.jncm.2013.03.077.

    Article  Google Scholar 

  16. Wijesurendra RS, Casadei B. Mechanisms of atrial fibrillation. Heart. 2019;105(24):1860–7. https://doi.org/10.1136/heartjnl-2018-314267.

    Article  CAS  PubMed  Google Scholar 

  17. Heijman J, Voigt N, Nattel S, et al. Cellular and molecular electrophysiology of atrial fibrillation initiation, maintenance, and progression. Circ Res. 2014;114(9):1483–99. https://doi.org/10.1161/CIRCRESAHA.114.302226.

    Article  CAS  PubMed  Google Scholar 

  18. Chang CJ, Chen YC, Lin YK, et al. Rivaroxaban modulates electrical and mechanical characteristics of left atrium. J Biomed Sci. 2013;20(1):17. https://doi.org/10.1186/1423-0127-20-17.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Allessie M, Ausma J, Schotten U. Electrical, contractile and structural remodeling during atrial fibrillation. Cardiovasc Res. 2002;54(2):230–46. https://doi.org/10.1016/s0008-6363(02)00258-4.

    Article  CAS  PubMed  Google Scholar 

  20. Moore-Morris T, Guimarães-Camboa N, Banerjee I, et al. Resident fibroblast lineages mediate pressure overload-induced cardiac fibrosis. J Clin Invest. 2014;124(7):2921–34. https://doi.org/10.1172/JCI74783.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Jalife J, Kaur K. Atrial remodeling, fibrosis, and atrial fibrillation. Trends Cardiovasc Med. 2015;25(6):475–84. https://doi.org/10.1016/j.tcm.2014.12.015.

    Article  CAS  PubMed  Google Scholar 

  22. Wijffels MC, Kirchhof CJ, Dorland R, et al. Atrial fibrillation begets atrial fibrillation A study in awake chronically instrumented goats. Circulation. 1995;92(7):1954–68. https://doi.org/10.1161/01.cir.92.7.1954.

    Article  CAS  PubMed  Google Scholar 

  23. Wakili R, Voigt N, Kääb S, et al. Recent advances in the molecular pathophysiology of atrial fibrillation. J Clin Invest. 2011;121(8):2955–68. https://doi.org/10.1172/JCI46315.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Yue L, Feng J, Gaspo R, et al. Ionic remodeling underlying action potential changes in a canine model of atrial fibrillation. Circ Res. 1997;81(4):512–25. https://doi.org/10.1161/01.res.81.4.512.

    Article  CAS  PubMed  Google Scholar 

  25. Pandit SV, Berenfeld O, Anumonwo JM, et al. Ionic determinants of functional reentry in a 2-D model of human atrial cells during simulated chronic atrial fibrillation. Biophys J. 2005;88(6):3806–21. https://doi.org/10.1529/biophysj.105.060459.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Tong YQ, Sun M, Hu CJ, et al. Changes of QT dispersion in hemodialysis patients after administrating zhigancao decoction (). Chin J Integr Med. 2018;24(8):627–31. https://doi.org/10.1007/s11655-016-2599-6.

    Article  PubMed  Google Scholar 

  27. Sun J, Lu Y, Yan H, et al. Application of the myocardial tissue/silicon substrate microelectrode array technology on detecting the effection of Zhigancao Decoction medicated serum on cardiac electrophysiology. Int J Clin Exp Med. 2015;8(2):2017–23.

    PubMed  PubMed Central  Google Scholar 

  28. Zhang XY, Xu AW, Ma JW, et al. Electrophysiological effects of zhigancao decoction on guinea pigs with ischemia-hypoxia-induced arrhythmia [J]. Tradit Chin Drug Res Clin Pharmacol. 2008;19(2):102–5. https://doi.org/10.19378/j.issn.1003-9783.2008.02.008.

    Article  Google Scholar 

  29. Qi XY, Huang H, Ordog B, et al. Fibroblast inward-rectifier potassium current upregulation in profibrillatory atrial remodeling. Circ Res. 2015;116(5):836–45. https://doi.org/10.1161/CIRCRESAHA.116.305326.

    Article  CAS  PubMed  Google Scholar 

  30. Yang L, Deng N, He J, et al. Calcineurin Aβ gene knockdown inhibits transient outward potassium current ion channel remodeling in hypertrophic ventricular myocyte. Open Life Sci. 2021;16(1):1010–21. https://doi.org/10.1515/biol-2021-0107.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Wu L, Ma J, Li H, et al. Late sodium current contributes to the reverse rate-dependent effect of IKr inhibition on ventricular repolarization. Circulation. 2011;123(16):1713–20. https://doi.org/10.1161/CIRCULATIONAHA.110.000661.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Gan TY, Qiao W, Xu GJ, et al. Aging-associated changes in L-type calcium channels in the left atria of dogs. Exp Ther Med. 2013;6(4):919–24. https://doi.org/10.3892/etm.2013.1266.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Zhao Z, Liu M, Zhang Y, et al. Cardioprotective effect of monoammonium glycyrrhizinate injection against myocardial ischemic injury in vivo and in vitro: involvement of inhibiting oxidative stress and regulating Ca2+ homeostasis by L-type calcium channels. Drug Des Devel Ther. 2020;14:331–46. https://doi.org/10.2147/DDDT.S232130.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Liu Z, Song L, Zhang P, et al. Ginsenoside Rb1 exerts antiarrhythmic effects by inhibiting INa and ICaL in rabbit ventricular myocytes. Sci Rep. 2019;9(1):20425. https://doi.org/10.1038/s41598-019-57010-9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Zhang J, Luo D, Li F, et al. Ginsenoside Rg3 alleviates antithyroid cancer drug vandetanib-induced QT interval prolongation. Oxid Med Cell Longev. 2021;2021:3520034. https://doi.org/10.1155/2021/3520034.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Liu Z, Hu L, Zhang Z, et al. Isoliensinine eliminates afterdepolarizations through inhibiting late sodium current and L-type calcium current. Cardiovasc Toxicol. 2021;21(1):67–78. https://doi.org/10.1007/s12012-020-09597-z.

    Article  CAS  PubMed  Google Scholar 

  37. Huang C, Cui Y, Ji L, et al. Catalpol decreases peroxynitrite formation and consequently exerts cardioprotective effects against ischemia/reperfusion insult. Pharm Biol. 2013;51(4):463–73. https://doi.org/10.3109/13880209.2012.740052.

    Article  CAS  PubMed  Google Scholar 

  38. Liu P, Li J, Liu M, et al. Hesperetin modulates the Sirt1/Nrf2 signaling pathway in counteracting myocardial ischemia through suppression of oxidative stress, inflammation, and apoptosis. Biomed Pharmacother. 2021;139:111552. https://doi.org/10.1016/j.biopha.2021.111552.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge all the staff at Cardiac Electrophysiology Laboratory of Wuhan University for their tireless work and professionalism.

Funding

This study was supported by the Hubei Provincial Health Committee of Traditional Chinese Medicine and Integrated Traditional Chinese and Western Medicine Research Guidance Project (2013Z-B01).

Author information

Authors and Affiliations

Authors

Contributions

Sheng Guo and Yao-jun Xue are first co-authors and contributed equally to this study.

Corresponding author

Correspondence to Bo Yang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest regarding the publication of this paper.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Guo, S., Xue, Yj., Zhu, X. et al. Effects and pharmacological mechanism of Zhigancao Decoction on electrical and structural remodeling of the atrium of rabbits induced by rapid atrial pacing. J Interv Card Electrophysiol 66, 597–609 (2023). https://doi.org/10.1007/s10840-022-01356-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10840-022-01356-0

Keywords

Navigation