Nonmyocytes as electrophysiological contributors to cardiac excitation and conduction

Am J Physiol Heart Circ Physiol. 2023 Sep 1;325(3):H475-H491. doi: 10.1152/ajpheart.00184.2023. Epub 2023 Jul 7.

Abstract

Although cardiac action potential (AP) generation and propagation have traditionally been attributed exclusively to cardiomyocytes (CM), other cell types in the heart are also capable of forming electrically conducting junctions. Interactions between CM and nonmyocytes (NM) enable and modulate each other's activity. This review provides an overview of the current understanding of heterocellular electrical communication in the heart. Although cardiac fibroblasts were initially thought to be electrical insulators, recent studies have demonstrated that they form functional electrical connections with CM in situ. Other NM, such as macrophages, have also been recognized as contributing to cardiac electrophysiology and arrhythmogenesis. Novel experimental tools have enabled the investigation of cell-specific activity patterns in native cardiac tissue, which is expected to yield exciting new insights into the development of novel or improved diagnostic and therapeutic strategies.

Keywords: cardiomyocyte; connexin-43; heterocellular coupling; nonmyocyte.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Action Potentials
  • Arrhythmias, Cardiac / metabolism
  • Electrophysiological Phenomena
  • Fibroblasts* / metabolism
  • Humans
  • Myocytes, Cardiac* / metabolism