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Understanding how the atrial and ventricular chambers of the heart maintain their distinct identity is a prerequisite for treating chamber-specific diseases. Here, we selectively inactivated the transcription factor in the atrial working myocardium of the neonatal mouse heart to show that it is required to maintain atrial identity. Atrial inactivation downregulated highly chamber specific genes such as and , and conversely, increased the expression of ventricular identity genes including . Using combined single nucleus transcriptome and open chromatin profiling, we assessed genomic accessibility changes underlying the altered atrial identity expression program, identifying 1846 genomic loci with greater accessibility in control atrial cardiomyocytes compared to KO aCMs. 69% of the control-enriched ATAC regions were bound by TBX5, demonstrating a role for TBX5 in maintaining atrial genomic accessibility. These regions were associated with genes that had higher expression in control aCMs compared to KO aCMs, suggesting they act as TBX5-dependent enhancers. We tested this hypothesis by analyzing enhancer chromatin looping using HiChIP and found 510 chromatin loops that were sensitive to TBX5 dosage. Of the loops enriched in control aCMs, 73.7% contained anchors in control-enriched ATAC regions. Together, these data demonstrate a genomic role for TBX5 in maintaining the atrial gene expression program by binding to atrial enhancers and preserving tissue-specific chromatin architecture of atrial enhancers.
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http://dx.doi.org/10.1101/2023.04.21.537535 | DOI Listing |
There is evidence for a shared genetic basis of atrial septal defects (ASDs) and atrial fibrillation (AF), but it remains unclear how genetic susceptibility leads to these distinct human atrial diseases. Here, we used directed differentiation of human induced pluripotent stem cell to ventricular or atrial cardiomyocytes (CMs) to define gene regulatory networks (GRNs) of human ventricular or atrial CM identity. In ventricular, atrial, or both types of CMs, we uncovered accessible chromatin regions, transcription factor motifs and key regulatory nodes, including the transcription factor , which is linked to ASDs and AF in humans.
View Article and Find Full Text PDFJ Mol Cell Cardiol
August 2025
Center for Cardiovascular Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH 43205, USA; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43205, USA. Electronic address:
Establishment and maintenance of specialized CMs in the heart is critical for the proper cardiac structure and function. Conversely, loss or gain of their identities is associated with various heart diseases such as cardiac arrythmia and cardiomyopathy. CM identity is established during early heart development and continues to be maintained under normal physiological condition, and this is predominantly accomplished by gene regulation.
View Article and Find Full Text PDFCirculation
August 2025
Department of Cardiology, Boston Children's Hospital, MA (M.E.S., Y.Y.S., Jie Li, Jiajin Li, E.M.K., A.P., Q.M., C.P., M.A.T., Y.W., C.H., V.J.B., W.T.P.).
Background: Atrial fibrillation, the most common sustained arrhythmia, affects 59 million individuals worldwide. The transcription factor TBX5 (T-box 5) is essential for normal atrial rhythm. Its inactivation causes loss of atrial cardiomyocyte (aCM) enhancer accessibility, looping, transcriptional identity, and spontaneous atrial fibrillation.
View Article and Find Full Text PDFInt J Emerg Med
May 2025
Kaiser Permanente Northern California Division of Research, Pleasanton, CA, USA.
Background: Oral anticoagulation (OAC) reduces stroke and mortality risk in patients with non-valvular atrial fibrillation/flutter (AF). Patterns of OAC initiation upon discharge from US emergency departments (ED) are poorly understood. We sought to examine stroke prophylaxis actions upon, and shortly following, ED discharge of stroke-prone AF patients.
View Article and Find Full Text PDFJ Transl Med
May 2025
Department of Intensive Care Unit, The Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fujian Provincial Hospital South Branch, No. 516, Jinrong South, Fuzhou, Fujian Province, China.
Background: The optimal management strategy for new-onset atrial fibrillation (NOAF) in patients with sepsis remains unclear. This study aimed to investigate and compare the associations of rhythm control medications versus rate control medications with mortality outcomes in septic patients with NOAF.
Methods: This propensity score-matched cohort study utilized data from the Medical Information Mart in Intensive Care-IV database.