In silico investigation of a KCNQ1 mutation associated with short QT syndrome

Adeniran, I ORCID: https://orcid.org/0000-0002-9775-3249, Whittaker, DG, El Harchi, A, Hancox, JC and Zhang, H (2017) In silico investigation of a KCNQ1 mutation associated with short QT syndrome. Scientific Reports, 7 (1). ISSN 2045-2322

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Abstract

Short QT syndrome (SQTS) is a rare condition characterized by abnormally 'short' QT intervals on the ECG and increased susceptibility to cardiac arrhythmias and sudden death. This simulation study investigated arrhythmia dynamics in multi-scale human ventricle models associated with the SQT2-related V307L KCNQ1 'gain-of-function' mutation, which increases slow-delayed rectifier potassium current (I ). A Markov chain (MC) model recapitulating wild type (WT) and V307L mutant I kinetics was incorporated into a model of the human ventricular action potential (AP) for investigation of QT interval changes and arrhythmia substrates. In addition, the degree of simulated I inhibition necessary to normalize the QT interval and terminate re-entry in SQT2 conditions was quantified. The developed MC model accurately reproduced AP shortening and reduced effective refractory period associated with altered I kinetics in homozygous (V307L) and heterozygous (WT-V307L) mutation conditions, which increased the lifespan and dominant frequency of re-entry in 3D human ventricle models. I reductions of 58% and 65% were sufficient to terminate re-entry in WT-V307L and V307L conditions, respectively. This study further substantiates a causal link between the V307L KCNQ1 mutation and pro-arrhythmia in human ventricles, and establishes partial inhibition of I as a potential anti-arrhythmic strategy in SQT2.