van Rinsum, A. | Search bioRxiv

bioRxiv2025

Dual effects of nicotinamide on aging-related arrhythmia: protective at low dose, proarrhythmic at high doses

BackgroundCardiac arrhythmia and dysfunction progressively increase with age, both of which are closely associated with a decline in NAD+. Supplementation with nicotinamide (NAM), a critical NAD+ precursor, has shown protection in experimental models of aging-related cardiac diseases, including atrial fibrillation (AF) and heart failure, especially heart failure with preserved ejection fraction. With the potential rise of NAM in treatment of various cardiometabolic diseases, its dose-dependent cardiac-specific adverse effects and underlying mechanisms warrant investigation. MethodsThe effects of NAM on aging-related arrhythmia and cardiac dysfunction were assessed using ex vivo Langendorff mouse hearts and adult Drosophila heart preparations. Different doses of NAM (10-100 mM) were tested for their impact on the contractility of HL-1 cardiomyocytes, lifespan and cardiac function of Drosophila, as well as arrhythmia susceptibility of ex vivo mouse hearts. Acetylation of sarcoplasmic/endoplasmic reticulum Ca{superscript 2} ATPase 2a (SERCA2a) was measured by immunoprecipitation followed by Western blotting. ResultsAcute perfusion with 10 mM NAM had limited influence on aging-related AF susceptibility in ex vivo mouse hearts. Short-term dietary intervention with 10 mM NAM in late-life protected against aging-induced cardiac arrhythmia and contractile dysfunction exclusively in male Drosophila. In contrast, life-long exposure or NAM concentrations above 20 mM led to dose-dependent adverse cardiac effects, including impaired contractility in HL-1 cardiomyocyte and shortened lifespan in Drosophila, with increased arrhythmia observed in both models. In ex vivo mouse hearts, 100 mM NAM increased SERCA2a acetylation, suggesting inhibition of sirtuin1 and impaired calcium handling, which likely underlies the observed effects of high-dose NAM on arrhythmia and cardiac dysfunction. ConclusionsNAM exhibits a narrow therapeutic window in aging-related cardiac dysfunction and arrhythmia, with its efficacy highly dependent on dose, duration, and biological context. While a moderate dose in late-life may be protective, chronic or excessive intake of NAM can induce arrythmia and impair cardiac function, likely through disruption of the SERCA2a activity. These findings underscore the importance of cautious and context-specific application of NAM in clinical settings.

physiology↗

bioRxiv2024

A novel and robust method for assessing mitochondrial (dys)function in healthy and diseased frozen cardiac tissue

Cardiovascular diseases are often associated with impairment in mitochondrial function detected by reduced mitochondrial oxygen consumption using high-resolution respirometry. However, existing respirometry protocols are limited by the necessity for fresh tissue samples. This study developed a method with tailored substrate-inhibitor titration (TSIT) of mitochondrial electron transport complexes (ETC) to measure mitochondrial function in frozen cardiac samples using high-resolution respirometry. Briefly, acetyl-CoA was added to fuel the tricarboxylic acid (TCA) cycle for NADH production, enabling complex I (CI)-linked respiratory assessment. NADH was then added to measure maximum CI-linked respiratory capacity, followed by rotenone and succinate to assess complex II (CII)-linked respiratory capacity. TSIT detected mitochondrial functional differences between frozen atrial and ventricular tissue, with comparable results as measured in fresh samples. It also detected cardiac mitochondrial dysfunction across various (patho)physiological mouse models (including aging, ischemia reperfusion, obesity, and CI deficiency) as well as in frozen human donor samples, highlighting its clinical potential. Furthermore, we showed the first evidence for supercomplexes (SCs) formation between ETC-SCs and the TCA cycle metabolon, underpinning TSIT feasibility. In conclusion, we established a novel, robust, sensitive and translational method (TSIT) for assessing mitochondrial (dys)function in frozen cardiac samples from various species, enabling flexible analysis of mitochondrial function in both laboratory and clinical settings.

physiology↗