Electrocardiographic Characterization of Cardiac Hypertrophy in Mice that Overexpress the ErbB2 Receptor Tyrosine Kinase

Electrocardiography is an important method for evaluation and risk stratification of patients with cardiac hypertrophy. We hypothesized that the recently developed transgenic mouse model of cardiac hypertrophy (ErbB2^tg) will display distinct ECG features, enabling WT (wild type) mice to be distinguished from transgenic mice without using conventional PCR genotyping. We evaluated more than 2000 mice and developed specific criteria for genotype determination by using cageside ECG, during which unanesthetized mice were manually restrained for less than 1 min. Compared with those from WT counterparts, the ECG recordings of ErbB2^tg mice were characterized by higher P- and R-wave amplitudes, broader QRS complexes, inverted T waves, and ST interval depression. Pearson''s correlation matrix analysis of combined WT and ErbB2^tg data revealed significant correlation between heart weight and the ECG parameters of QT interval (corrected for heart rate), QRS interval, ST height, R amplitude, P amplitude, and PR interval. In addition, the left ventricular posterior wall thickness as determined by echocardiography correlated with ECG-determined ST height, R amplitude, QRS interval; echocardiographic left ventricular mass correlated with ECG-determined ST height and PR interval. In summary, we have determined phenotypic ECG criteria to differentiate ErbB2^tg from WT genotypes in 98.8% of mice. This inexpensive and time-efficient ECG-based phenotypic method might be applied to differentiate between genotypes in other rodent models of cardiac hypertrophy. Furthermore, with appropriate modifications, this method might be translated for use in other species.Abbreviations: HCM, hypertrophic cardiomyopathy; LV, left ventricle; QT_c, QT interval corrected for heart rateElectrocardiography is an important method used in human patients for evaluation of cardiac hypertrophy, for example, hypertrophic cardiomyopathy (HCM).^30,35 Although echocardiography is considered to be the ‘gold standard’ in HCM diagnostics, ECG evaluation may provide additional information needed for diagnosis.³⁰ In some patients with HCM, ECG changes precede echocardiographic changes;^30,36 therefore the 2 modalities are often used together to screen family members of patients with HCM. Similarly, there are reports of athletes who suddenly die during training, in whom HCM was confirmed at autopsy and in whom ECG abnormalities were recorded in the absence of overt clinical signs.²³ In contrast, although developed before echocardiography, ECG is often underutilized in the characterization of mouse models of cardiac disease.The first reports on mouse ECG were published in the 1950s^15,40 and were followed by the rapid development of rodent ECG methods, recording, and analysis.¹⁶ Several approaches support the recording and analysis of mouse ECG, including 12-lead ECG,^7,51 open-chest models,^7,51 telemetry using radiofrequency transmitters,¹⁶ and recording in anesthetized mice.^7,51 All of these methods provide information on cardiac electrophysiology, yet each has its specific advantages and limitations.⁵¹ Further use of ECG in mouse models of cardiac disease could improve our understanding of the electrophysiologic remodeling in these diseases.Several mouse models of HCM (due to genetic modifications of genes related to human HCM^18,21,50 or to lysosomal storage disease-related cardiomyopathies^2,4,6,46) were developed to study these hypertrophic conditions and the resulting electrical disturbances in the myocardium. However, despite carrying the same genetic alterations that cause human disease, many mouse models do not have phenotypic ECG changes or even hypertrophy.^18,21,50 Therefore the development of a small animal model of cardiac hypertrophy with ECG features similar to those in human patients is of particular interest. We recently developed a mouse model with cardiac hypertrophy and pathologic features compatible with HCM⁴⁷ and hypothesized that various electrocardiographic features could enable us to distinguish between wildtype (WT) mice and transgenic littermates after weaning. In the current study, we established an ECG method that identifies the hypertrophic phenotype and thus assists in determining the genotype of mice. This ECG method thus reduced laboratory costs and the time necessary to isolate and analyze DNA for genotyping.