We thank Stefanie Perez-Feliz for excellent technical assistance, Dr. Jonas Wietek (Humboldt-University, Berlin, Germany) for providing the pUC57-GtACR1 plasmid, Prof. Dr. Michael Schupp (Charit&#233;- Universit&#228;tsmedizin Berlin, Institut f&#252;r Pharmakologie, Berlin) for the adenovirus production and Dr. Anastasia Khokhlova (Ural Federal University) for sharing her expertise to improve the cell isolation protocol and to re-design the pipette bending setup. The project was funded by the German Research Foundation (SPP1926: SCHN 1486/1-1; Emmy-Noether fellowship: SCHN1486/2-1) and the ERC Advanced Grant CardioNECT.

<ol>
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The authors have nothing to disclose.

Whereas optogenetic tools enable modulation of excitable cell electrophysiology in a non-invasive manner, they need thorough characterization in different cell types (e.g., CM) to allow one to choose the best available tool for a specific experimental design. The patch-clamp technique is a standard method for assessing cellular electrophysiology. In the whole-cell configuration, it allows one to record photo-activated currents across the plasma membrane or temporal changes in membrane voltage following light stimulation/inhibition. Optogenetic manipulation of electrical excitation also affects CM contractions. We use sarcomere tracking and carbon fiber-assisted force measurements to quantify the effects of optical interrogation on the mechanical activity of myocytes.
We describe a protocol to characterize the basic effects of a light-gated chloride channel, GtACR1, in CM. As model system, we chose rabbit CM, as their electrophysiological characteristics (e.g., AP shape and refractory period) resemble those observed in human CM more closely than rodent CM. Moreover, rabbit CM can be cultured for several days, long enough for adenoviral delivery and expression of GtACR1-eGFP. Notably, isolated CM change their structural properties in culture over time, including rounding of cell endings and gradual loss of cross-striation, T-tubular system and caveolae23,24. In line with this, functional alterations have been reported in cultured CM: depolarization of the resting membrane potential, prolongation of the AP and changes in cellular Ca2+ handling. For review of cellular adaptations in culture, please see Louch et al.25. Supplemental Figure 2 shows exemplary AP and contraction measurements of freshly isolated CM for comparison with those observed in cultured CM (Figure 6, Figure 7) using the here presented protocol.
Whole-cell patch-clamp recordings enable direct measurements of photocurrent properties (e.g., amplitudes and kinetics) and light-induced changes in membrane potential or AP characteristics at high temporal resolution. However, such recordings have several limitations: Firstly, the cytosol is replaced by the pipette solution in whole-cell recordings, which is advantageous to control ionic electrochemical gradients, but has the intrinsic disadvantage of washing-out cellular organelles, proteins and other compounds, thus potentially affecting cellular electrical responses. Secondly, side effects like activation of additional ion channels resulting from non-physiologically long depolarization (e.g., slow time constants of light-gated ion channels) are difficult to assess as our method only allows one to detect changes in APD, but not to conduct direct measurements of ionic concentrations in electrophysiologically relevant cell compartments. This could be done with fluorescent indicators (e.g., Ca2+ sensors) or ion-selective electrodes. Further characterization may include light intensity titrations, determination of pH-dependency, photocurrent kinetics at different membrane potentials, and recovery kinetics during repetitive light stimulation.
In contrast to patch-clamp recordings, single-cell force measurements enable analysis of cellular contractions of intact myocytes without affecting their intracellular milieu. Secondary effects on ion concentrations (e.g., Ca2+) can be indirectly assessed by determining generated force amplitude and dynamics (e.g., maximum velocity of contraction and relaxation; here not analyzed). Force measurements with the carbon fiber technique have an advantage over freely contracting cells as they provide direct information on passive and active forces in pre-loaded cells (i.e., in conditions that are more similar to the in situ or in vivo settings). Mechanical preloading is especially important when analyzing cellular contractility, as stretch affects force production and relaxation26,27.
Optogenetic approaches allow for spatiotemporally precise manipulation of the cellular membrane potential, both in single CM and intact cardiac tissue. Classically, ChR2, a light-gated cation non-selective channel, has been used for depolarization of the membrane potential, whereas light-driven proton and/or chloride pumps were used for membrane hyperpolarization. Both groups of optogenetic actuators require high expression levels, as ChR2 is characterized by an intrinsically low single-channel conductance28 and light-driven pumps maximally transport one ion per absorbed photon. Furthermore, prolonged activation of ChR2 in CM may lead to Na+ and/or Ca2+ overload, and light-driven pumps may change trans-sarcolemmal H+ or Cl- gradients29,30. In search for alternative tools for optogenetic control of CM activity, we recently tested the natural anion channelrhodopsin GtACR1, characterized by a superior single-channel conductance and higher light sensitivity compared to cation ChR such as ChR2. We found that GtACR1 activation depolarizes CM and can be used for optical pacing and inhibition, depending on the light pulse timing and duration. An additional advantage of using ACR instead of cation ChR might be the more negative reversal potential of Cl- compared to Na+, reducing artificially introduced ion currents. As we have previously shown, optical pacing with GtACR1 may lead to AP prolongation as a result of the slow component of GtACR1 channel closure, which could be overcome by using faster GtACR1 mutants19. However, AP prolongation is much less pronounced when using a lower, more physiological intracellular Cl- concentration (see Figure 6). Moreover, GtACR1-mediated inhibition by prolonged illumination results in profound membrane depolarization, which again could activate secondary Na+ and Ca2+ influx, thereby altering the activity of voltage-gated channels. In our measurements, we find that AP and contraction parameters recover to baseline within 40 s after a light-induced inhibition for 1 min (see Kopton et al. 2018, Figure 6, Figure 7). Light-gated K+ channels offer a potent alternative for silencing CM without affecting the CM resting membrane potential31.
In future we would like to quantitatively compare different optogenetic tools for their potential to inhibit cardiac activity. To this end, we test a variety of light-gated ion channels including ACR, ChR2 and red-shifted ChR variants32, as well as hyperpolarizing actuators such as halorhodopsin or the light gated adenylyl cyclase bPAC in combination with the potassium channel SthK (PAC-K)31.
The here presented protocol can be used for in-depth characterization of the electromechanical properties of CM. It is principally applicable also to CM from other species, and to CM isolated from diseased myocardium. Optical stimulation allows one to pace CM at different frequencies, and different preloads can be tested during carbon fiber contraction experiments. An interesting experiment would be to use low-intensity illumination for subthreshold depolarization, to mimic gradual increase in the resting membrane potential, as can be observed during the development of cardiac tissue remodeling during disease progression. Finally, functional measurements could be combined with Ca2+ imaging for further insight into excitation-contraction coupling, or with pharmacological interventions to evaluate the effects of different drugs on CM activity.

ChR-mediated photocurrents were first recorded in the eyespot of unicellular green algae1,2. Soon after genetic cloning and heterologous expression of Chlamydomonas reinhardtii ChR1 and ChR2, ChR were used as tools to alter the membrane potential in Xenopus oocytes and mammalian cells by light3,4. Cation non-selective ChR depolarize the membrane of cells with a resting membrane potential that is negative to the reversal potential of ChR. They can thus be used to elicit AP in excitable cells, including neurons and CM, allowing optical pacing5,6.
Complementary to cation ChR, light-driven proton, chloride and sodium pumps7,8,9 have been used to inhibit neuronal activity10,11,12. However, the latter have limitations, requiring high light intensities and sustained illumination, as one ion is transported per absorbed photon. In 2014, two independent studies by Wietek et al. and Berndt et al. described the conversion of cation-conducting ChR into ACR via mutations in the channel pore13,14. One year later, natural ACR were discovered in the cryptophyte Guillardia theta (GtACR)15. As engineered ACR showed residual cation conductance, they were replaced by natural ACR, characterized by a large single-channel conductance and high light sensitivity15. GtACR were used to silence neuronal activity by polarizing the membrane potential towards the reversal potential of chloride16,17. Govorunova et al. applied GtACR1 to cultured rat ventricular CM and showed efficient photoinhibition at low light intensity levels that were not sufficient to activate previously available inhibition tools, such as the proton pump Arch18. Our group recently reported that GtACR1-mediated photoinhibition of CM is based on depolarization and that GtACR1 can also be used, therefore, for optical pacing of CM19.
Here, we present a protocol for studying the electrophysiological and mechanical effects of GtACR1 photoactivation on cultured rabbit ventricular CM. We first describe cell isolation, culturing and transduction. Electrophysiological effects are measured using whole-cell patch-clamp recordings. Light-mediated currents at a given membrane voltage are assessed in V-clamp mode. Membrane potential dynamics are measured while electrically or optically pacing CM (I-clamp mode). Optical inhibition of electrically triggered AP is tested using sustained light application. Mechanical effects are measured using carbon fibers in combination with imaging-based tracking of sarcomere length. To do so, optically paceable cells are mechanically preloaded by attaching two carbon fibers to the plasma membrane near opposite cell ends. Sarcomere length changes are recorded during optical or electrical pacing. Finally, photoinhibition is measured during electrical field stimulation of the cells, and generated forces are analyzed.
The protocol includes the following steps shown in the flowchart in Figure 1: rabbit deep anesthesia, thiopental overdose injection, heart excision, Langendorff-perfusion and tissue digestion, mechanical dissociation of the tissue to release cells, microscopic analysis of CM yield, culturing of CM, transduction with adenovirus type 5, followed by incubation and functional experiments.
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/60490/60490fig1a.jpg" /> 
Figure 1: Flowchart of the protocol used to obtain electrically and optically paceable CM. Hearts are excised from rabbits 9-10 weeks old, and cardiac tissue is digested while being perfused using a Langendorff setup. Cells are released by mechanical agitation. The CM yield is counted under a microscope. CM are cultured, transduced with adenovirus type 5 and functional experiments are performed 48-72 hours post-transduction. <a href="https://www.jove.com/files/ftp_upload/60490/60490fig1alarge.jpg" target="_blank">Please click here to view a larger version of this figure.</a>

<table fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Equipment - Cell isolation/Culturing/Transduction</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Adeno-X Adenoviral System 3 CMV</td>
			<td>TaKaRa, Clontech Laboratories, Inc., Mountain View, California, USA</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Aortic cannula</td>
			<td>Radnoti</td>
			<td></td>
			<td>4.8 OD x 3.6 ID x 8-9 L mm</td>
		</tr>
		<tr>
			<td>Coverslips &#248; 16 mm, Thickness No. 0</td>
			<td>VWR International GmbH, Leuven, Belgium</td>
			<td>631-0151</td>
			<td>Borosilicate Glass</td>
		</tr>
		<tr>
			<td>Griffin Silk, Black, 2 m Length, Size 3, 0.5 mm</td>
			<td>Samuel Findings, London, UK</td>
			<td>TSGBL3</td>
			<td></td>
		</tr>
		<tr>
			<td>Incubator</td>
			<td>New Brunswick, Eppendorf, Sch&#246;nenbuch, Switzerland</td>
			<td>Galaxy 170S</td>
			<td></td>
		</tr>
		<tr>
			<td>Langendorff-perfusion set-up</td>
			<td>Zitt-Thoma Laborbedarf Glasbl&#228;serei, Freiburg, Germany</td>
			<td></td>
			<td>Custom-made</td>
		</tr>
		<tr>
			<td>Langendorff-pump</td>
			<td>Ismatec, Labortechnik-Analytik, Glattbrugg-Z&#252;rich, Switzerland</td>
			<td>ISM444</td>
			<td></td>
		</tr>
		<tr>
			<td>Mesh: Nylon Monodur filter cloth</td>
			<td>Cadisch Precision Meshes Ltd</td>
			<td></td>
			<td>800 &#181;m holes, 1 m wide</td>
		</tr>
		<tr>
			<td>Neubauer chamber</td>
			<td>VWR International GmbH, Leuven, Belgium</td>
			<td>717806</td>
			<td></td>
		</tr>
		<tr>
			<td>Rabbit, New Zealand White</td>
			<td>Charles River</td>
			<td>Strain Code: 052</td>
			<td></td>
		</tr>
		<tr>
			<td>Scissors</td>
			<td>Aesculap AG, Tuttlingen, Germany</td>
			<td>BC774R</td>
			<td>Bauchdeckenschere ger. 18cm</td>
		</tr>
		<tr>
			<td>Sterile filter, 0.22 &#181;m</td>
			<td>Merck, Darmstadt, Germany</td>
			<td>SLGP033RB</td>
			<td></td>
		</tr>
		<tr>
			<td>Equipment - Patch-clamp</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Amplfier</td>
			<td>AxonInstruments, Union City, CA, United States</td>
			<td>Axopatch 200B</td>
			<td></td>
		</tr>
		<tr>
			<td>Coverslip &#248; 50 mm, Thickness No. 1</td>
			<td>VWR International GmbH, Leuven, Belgium</td>
			<td>631-0178</td>
			<td>Borosilicate Glass</td>
		</tr>
		<tr>
			<td>Digitizer Axon Digidata</td>
			<td>Molecular Devices, San Jos&#233;, CA, United States</td>
			<td>1550A</td>
			<td></td>
		</tr>
		<tr>
			<td>Filter (530/20)</td>
			<td>Leica Microsystems, Wetzlar, Germany</td>
			<td>11513878</td>
			<td>BZ:00</td>
		</tr>
		<tr>
			<td>Filter (630/20)</td>
			<td>Chroma Technology, Bellows Falls, Vermont, United States</td>
			<td>227155</td>
			<td></td>
		</tr>
		<tr>
			<td>Headstage</td>
			<td>AxonInstruments, Union City, CA, United States</td>
			<td>CV203BU</td>
			<td></td>
		</tr>
		<tr>
			<td>Interface</td>
			<td>Scientifica, Uckfield, UK</td>
			<td>1U Rack, 352036</td>
			<td></td>
		</tr>
		<tr>
			<td>LED 525 nm</td>
			<td>Luminus Devices, Sunnyvale, CA, United States</td>
			<td>PT-120-G</td>
			<td></td>
		</tr>
		<tr>
			<td>LED control software</td>
			<td>Essel Research and Development, Toronto, Canada</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>LED control system</td>
			<td>custom-made</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Micropipette Puller</td>
			<td>Narishige Co., Tokyo, Japan</td>
			<td>PP-830</td>
			<td></td>
		</tr>
		<tr>
			<td>Microscope inverted</td>
			<td>Leica Microsystems, Wetzlar, Germany</td>
			<td>DMI4000B</td>
			<td></td>
		</tr>
		<tr>
			<td>Motorised Micromanipulator</td>
			<td>Scientifica, Uckfield, UK</td>
			<td>PatchStar</td>
			<td></td>
		</tr>
		<tr>
			<td>Optical power meter</td>
			<td>Thorlabs, Newton, NJ, United States</td>
			<td>PM100D</td>
			<td></td>
		</tr>
		<tr>
			<td>Silicone Grease</td>
			<td>RS Components, Corby, UK</td>
			<td>494-124</td>
			<td></td>
		</tr>
		<tr>
			<td>Silver wire</td>
			<td>A-M Systems, Sequim, WA, United States</td>
			<td>787500</td>
			<td>Silver, Bare 0.015&#39;&#39;, Coated 0.0190&#39;&#39;, Length 25 Feet</td>
		</tr>
		<tr>
			<td>Soda lime glass capillaries</td>
			<td>Vitrex Medical A/S, Vasekaer, Denmark</td>
			<td>160213 BRIS, ISO12772</td>
			<td>1.55 OD x 1.15 ID x 75 L mm</td>
		</tr>
		<tr>
			<td>Software Axon pClamp</td>
			<td>Molecular Devices, San Jos&#233;, CA, United States</td>
			<td>Version 10.5</td>
			<td></td>
		</tr>
		<tr>
			<td>Software MatLab2017</td>
			<td>The MathWorks, Inc.</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Stage micrometer</td>
			<td>Graticules Optics LTD, Tonbridge, UK</td>
			<td>1 mm</td>
			<td></td>
		</tr>
		<tr>
			<td>Equipment - Carbon fiber</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Carbon fibers</td>
			<td>provided from Prof. Jean-Yves Le Guennec</td>
			<td></td>
			<td>BZ:00</td>
		</tr>
		<tr>
			<td>Digitizer Axon Digidata</td>
			<td>Molecular Devices, Sunnyvale, CA, United States</td>
			<td>1550B</td>
			<td></td>
		</tr>
		<tr>
			<td>Filter (530/20)</td>
			<td>Leica Microsystems, Wetzlar, Germany</td>
			<td>11513878</td>
			<td></td>
		</tr>
		<tr>
			<td>Filter (630/20)</td>
			<td>Chroma Technology, Bellows Falls, Vermont, United States</td>
			<td>227155</td>
			<td></td>
		</tr>
		<tr>
			<td>Fluorescence System Interface</td>
			<td>IonOptix, Milton, MA United States</td>
			<td>FSI-800</td>
			<td>2.0 OD x 1.16 ID x 100 L mm</td>
		</tr>
		<tr>
			<td>Force Transducer System</td>
			<td>Aurora Scientific Inc., Ontario, Canada</td>
			<td>406A</td>
			<td></td>
		</tr>
		<tr>
			<td>Glass capillaries for force measurements</td>
			<td>Harvard Apparatus, Holliston, Massachusetts, United States</td>
			<td>GC200F-10</td>
			<td></td>
		</tr>
		<tr>
			<td>Interface National Instruments</td>
			<td>National Instruments, Budapest, Hungary</td>
			<td>BNC-2110</td>
			<td></td>
		</tr>
		<tr>
			<td>LED 525 nm</td>
			<td>Luminus Devices, Sunnyvale, CA, United States</td>
			<td>PT-120-G</td>
			<td></td>
		</tr>
		<tr>
			<td>LED control box</td>
			<td>Essel Research and Development, Toronto, Canada</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>LED control system</td>
			<td>custom-made</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Microcontroller</td>
			<td>Parallax Inc., Rocklin, California, United States</td>
			<td>Propeller</td>
			<td></td>
		</tr>
		<tr>
			<td>Micropipette Puller</td>
			<td>Narishige Co., Tokyo, Japan</td>
			<td>PC-10</td>
			<td></td>
		</tr>
		<tr>
			<td>Microscope inverted</td>
			<td>Leica Microsystems, Wetzlar, Germany</td>
			<td>DMI4000B</td>
			<td></td>
		</tr>
		<tr>
			<td>MyoCam-S camera</td>
			<td>IonOptix, Dublin, Ireland</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>MyoCam-S camera Power</td>
			<td>IonOptix, Milton, MA, United States</td>
			<td>MCS-100</td>
			<td></td>
		</tr>
		<tr>
			<td>MyoPacer Field Stimulator</td>
			<td>IonOptix Cooperation, Milton, MA, United States</td>
			<td>MYP100</td>
			<td></td>
		</tr>
		<tr>
			<td>Piezo Motor</td>
			<td>Physik Instrumente (PI) GmbH &#38; Co. KG, Karlsruhe, Germany</td>
			<td>E-501.00</td>
			<td></td>
		</tr>
		<tr>
			<td>Silicone Grease</td>
			<td>RS Components, Corby, UK</td>
			<td>494-124</td>
			<td></td>
		</tr>
		<tr>
			<td>Software Axon pClamp</td>
			<td>Molecular Devices, San Jos&#233;, CA, United States</td>
			<td>Version 10.5</td>
			<td></td>
		</tr>
		<tr>
			<td>Software IonWizard</td>
			<td>IonOptix, Dublin, Ireland</td>
			<td>Version 6.6.10.125</td>
			<td></td>
		</tr>
		<tr>
			<td>Software MatLab2017</td>
			<td>The MathWorks, Inc.</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Stage micrometer</td>
			<td>Graticules Optics LTD, Tonbridge, UK</td>
			<td>1 mm</td>
			<td></td>
		</tr>
		<tr>
			<td>Chemicals</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Adenosine</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>A9251-100G</td>
			<td></td>
		</tr>
		<tr>
			<td>Bovine serum albumin</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>A7030-50G</td>
			<td></td>
		</tr>
		<tr>
			<td>CaCl2</td>
			<td>Honeywell Fluka, Muskegon, MI, USA</td>
			<td>21114-1L</td>
			<td></td>
		</tr>
		<tr>
			<td>L-Carnitine hydrochloride</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>C9500-25G</td>
			<td></td>
		</tr>
		<tr>
			<td>Collagenase type 2, 315 U/mg</td>
			<td>Worthington, Lakewood, NJ, USA</td>
			<td>LS004177</td>
			<td></td>
		</tr>
		<tr>
			<td>Creatine</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>C0780-50G</td>
			<td></td>
		</tr>
		<tr>
			<td>Cytosine-&#946;-D-arabinofuranoside</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>C1768-100MG</td>
			<td></td>
		</tr>
		<tr>
			<td>EGTA</td>
			<td>Carl Roth GmbH + Co. KG, Karlsruhe, Germany</td>
			<td>3054.3</td>
			<td></td>
		</tr>
		<tr>
			<td>Esketamine hydrochloride, Ketanest S 25 mg/mL</td>
			<td>Pfizer Pharma PFE GmbH, Berlin, Germany</td>
			<td>PZN-07829486</td>
			<td></td>
		</tr>
		<tr>
			<td>Fetal Bovine Serum</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>F9665</td>
			<td></td>
		</tr>
		<tr>
			<td>Gentamycin 50 mg/mL</td>
			<td>Gibco, Life Technologies, Waltham, MA, USA</td>
			<td>15750-037</td>
			<td></td>
		</tr>
		<tr>
			<td>Glucose</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>G7021-1KG</td>
			<td></td>
		</tr>
		<tr>
			<td>Heparin-Sodium, 5,000 IU/mL</td>
			<td>Braun Melsungen AG, Melsungen, Germany</td>
			<td>PZN-03029843</td>
			<td></td>
		</tr>
		<tr>
			<td>HEPES</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>H3375-1KG</td>
			<td></td>
		</tr>
		<tr>
			<td>Insulin (bovine pancreas)</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>I6634-50MG</td>
			<td></td>
		</tr>
		<tr>
			<td>K-aspartate</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>A6558-25G</td>
			<td></td>
		</tr>
		<tr>
			<td>KCl</td>
			<td>VWR International GmbH, Leuven, Belgium</td>
			<td>26764.260</td>
			<td>1 mg/mL</td>
		</tr>
		<tr>
			<td>KOH</td>
			<td>Honeywell Fluka, Muskegon, MI, USA</td>
			<td>35113-1L</td>
			<td></td>
		</tr>
		<tr>
			<td>Laminin from Engelbreth-Holm-Swarm murine sarcoma basement membrane</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>L2020-1MG</td>
			<td></td>
		</tr>
		<tr>
			<td>M199-Medium</td>
			<td>Sigma-Aldirch, St. Louis, Missouri, United States</td>
			<td>M4530</td>
			<td></td>
		</tr>
		<tr>
			<td>Mg-ATP</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>A9187-1G</td>
			<td></td>
		</tr>
		<tr>
			<td>MgCl2</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>63069-500ML</td>
			<td></td>
		</tr>
		<tr>
			<td>NaCl</td>
			<td>Fisher Scientific, Loughborough, Leics., UK</td>
			<td>10428420</td>
			<td></td>
		</tr>
		<tr>
			<td>NaCl-Solution 0.9%, Isotone Kochsalz-L&#246;sung 0.9%</td>
			<td>Braun Melsungen AG, Melsungen, Germany</td>
			<td>3200950</td>
			<td></td>
		</tr>
		<tr>
			<td>NaOH</td>
			<td>AppliChem GmbH, Darmstadt, Germany</td>
			<td>A6579</td>
			<td>without Ca2+/Mg2+</td>
		</tr>
		<tr>
			<td>Na-pyruvat</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>P2256-100MG</td>
			<td></td>
		</tr>
		<tr>
			<td>Phosphate Buffered Saline</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>D1408-500ML</td>
			<td></td>
		</tr>
		<tr>
			<td>Poly(2-hydroxyethyl methacrylate)</td>
			<td>Sigma, Poole, UK</td>
			<td>192066</td>
			<td></td>
		</tr>
		<tr>
			<td>Protease XIV from Streptomyces griseus</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>P5147-1G</td>
			<td></td>
		</tr>
		<tr>
			<td>Taurine</td>
			<td>Sigma-Aldrich, St. Louis, Missouri, United States</td>
			<td>T0625-500G</td>
			<td></td>
		</tr>
		<tr>
			<td>Thiopental Inresa 0.5 g</td>
			<td>Inresa Arzneimittel GmbH, Freiburg, Germany</td>
			<td>PZN-11852249</td>
			<td></td>
		</tr>
		<tr>
			<td>Xylazine hydrochloride, Rompun 2%</td>
			<td>Bayer Vital GmbH, Leverkusen, Germany</td>
			<td>PZN-01320422</td>
			<td></td>
		</tr>
	</tbody>
</table>

electromechanical assessment of optogenetically modulated cardiomyocyte activity

Over the past two decades, optogenetic tools have been established as potent means to modulate cell-type specific activity in excitable tissues, including the heart. While Channelrhodopsin-2 (ChR2) is a common tool to depolarize the membrane potential in cardiomyocytes (CM), potentially eliciting action potentials (AP), an effective tool for reliable silencing of CM activity has been missing. It has been suggested to use anion channelrhodopsins (ACR) for optogenetic inhibition. Here, we describe a protocol to assess the effects of activating the natural ACR GtACR1 from Guillardia theta in cultured rabbit CM. Primary readouts are electrophysiological patch-clamp recordings and optical tracking of CM contractions, both performed while applying different patterns of light stimulation. The protocol includes CM isolation from rabbit heart, seeding and culturing of the cells for up to 4 days, transduction via adenovirus coding for the light-gated chloride channel, preparation of patch-clamp and carbon fiber setups, data collection and analysis. Using the patch-clamp technique in whole-cell configuration allows one to record light-activated currents (in voltage-clamp mode, V-clamp) and AP (current-clamp mode, I-clamp) in real time. In addition to patch-clamp experiments, we conduct contractility measurements for functional assessment of CM activity without disturbing the intracellular milieu. To do so, cells are mechanically preloaded using carbon fibers and contractions are recorded by tracking changes in sarcomere length and carbon fiber distance. Data analysis includes assessment of AP duration from I-clamp recordings, peak currents from V-clamp recordings and force calculation from carbon fiber measurements. The described protocol can be applied to the testing of biophysical effects of different optogenetic actuators on CM activity, a prerequisite for the development of a mechanistic understanding of optogenetic experiments in cardiac tissue and whole hearts.

GtACR1-eGFP was expressed in cultured rabbit CM (Figure 6 insert) and photocurrents were measured with the patch-clamp technique. Photoactivation of GtACR1 shows large inward directed currents at -74 mV. In Figure 6A peak current (IP) at 4 mW/mm2 is 245 pA. AP were triggered either electrically (Figure 6B) or optically (Figure 6C) with current injections 1.5 times the threshold, or short depolarizing light pulses of 10 ms, respectively. Analyzing APD values, electrically paced CM show an APD 20 of 0.24 &#177; 0.08 s and an APD 90 of 0.75 &#177; 0.17 s, whereas optically paced CM show an APD 20 of 0.31 &#177; 0.08 s and an APD 90 of 0.81 &#177; 0.19 s (SE, n = 5, N = 2, in the here presented example APD 20electrical = 0.17 s; APD 20optical = 0.27 s and APD 90electrical = 0.61 s; APD 90optical = 0.68 s; Figure 6D). Optically paced CM show a slower AP onset (Figure 6D). CM activation was inhibited upon sustained illumination (for 64 s, 4 mW/mm2) by polarizing the membrane potential towards the reversal potential of chloride, here -58 mV (Figure 6E). Higher current injections than 1.5 times the threshold do not elicit AP generation (Figure 6F). Generated peak forces were determined from carbon fiber bending (Figure 7B,C,E). The CM generated 232 &#181;N/mm2 upon electrical pacing (Figure 7B) and 261 &#181;N/mm2 following optical pacing (Figure 7C). Prolonged green-light pulses inhibit contractions (Figure 7E). Following optical inhibition for 64 s, reoccurring contractions generate a lower contractile force, and force values recover towards baseline after ~10 contractions (pacing at 0.25 Hz, Figure 7D) in keeping with diastolic calcium loss from rabbit CM.
<img alt="Figure 6" class="xfigimg" src="/files/ftp_upload/60490/60490fig6a.jpg" /> 
Figure 6: Representative patch-clamp recordings of electrically and optically paced/inhibited CM. (A) Representative photocurrent at -74 mV using a light pulse of 300 ms, 4 mW/mm2. IP indicates the peak current. The insert shows a GtACR1-eGFP positive cell. (B) Representative AP recording at 0 pA using a current ramp of 10 ms, 0.6 nA to electrically pace the CM. (C) Representative AP recording at 0 pA using light pulses of 10 ms, 0.4 mW/mm2. (D) Top graph shows the overlay of the 10th AP of electrically (blue) and optically (green) activated CM. AP were aligned by the maximum change in membrane potential (dV/dt max). Bottom graph shows the difference of membrane potential between optically and electrically triggered AP (Eoptical-Eelectrical). (E) Electrically triggered AP were inhibited under sustained light of 64 s, 4 mW/mm2. (F) AP are inhibited by higher current injections than 1.5 times the threshold (from 0.7 nA in steps of 0.1 nA to 2.2 nA) under sustained light. <a href="https://www.jove.com/files/ftp_upload/60490/60490fig6alarge.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Figure 7" class="xfigimg" src="/files/ftp_upload/60490/60490fig7a.jpg" /> 
Figure 7: Representative data from carbon fiber recordings of optically and electrically paced/inhibited CM. (A) Display in the data acquisition software. Image (I) shows the measured CM with the window for calculating sarcomere length. Cell width is labelled in orange. (1) Range of relevant frequencies. (2) FFT power spectrum shows the frequency of the sarcomere spacing on the cell. The average sarcomere length is calculated from the peak frequency. (3) Sarcomere length tracking window. (4) Intensity trace. (5) The intensity trace multiplied by a Hamming window is the windowed intensity trace. Scheme (II) shows the elliptical cross-section of the cell. Width in orange and thickness in dashed blue. Image (III) shows the position of the carbon fibers with the respective detection boxes, left in red and right in green. (6) Intensity trace. (7) First derivative of intensity trace (see data acquisition software manual). (B) Representative trace of electrically elicited contractions. Panel (I) shows the sarcomere length shortening, panel (II) the distance between the two carbon fibers. (C) Representative trace of optically elicited contractions (525 nm, 0.25 Hz, 10 ms, 6 mW/mm2). Panel (I) shows the sarcomere length shortening, panel (II) the distance between the two carbon fibers. (D) Generated peak force from contraction 1 to 11 after a pause caused by inhibition of AP generation. (E) Representative trace of optical inhibition of contractions under sustained illumination (525 nm, 64 s, 6 mW/mm2). Panel (I) shows the sarcomere length shortening, panel (II) the length between the two carbon fibers. <a href="https://www.jove.com/files/ftp_upload/60490/60490fig7alarge.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<table border="1" fo:keep-together.within-page="1">
	<tbody>
		<tr>
			<td>A</td>
			<td>area</td>
		</tr>
		<tr>
			<td>ACR</td>
			<td>anion channelrhodopsin</td>
		</tr>
		<tr>
			<td>AP</td>
			<td>action potential</td>
		</tr>
		<tr>
			<td>APD</td>
			<td>action potential duration</td>
		</tr>
		<tr>
			<td>CFU</td>
			<td>colony forming unit</td>
		</tr>
		<tr>
			<td>ChR</td>
			<td>channelrhodopsin</td>
		</tr>
		<tr>
			<td>CM</td>
			<td>cardiomyocyte</td>
		</tr>
		<tr>
			<td>eGFP</td>
			<td>enhanced green fluorescent protein</td>
		</tr>
		<tr>
			<td>ESD</td>
			<td>end systolic cell deformation</td>
		</tr>
		<tr>
			<td>EU</td>
			<td>endotoxin units</td>
		</tr>
		<tr>
			<td>F</td>
			<td>force</td>
		</tr>
		<tr>
			<td>FFT</td>
			<td>fast Fourier transform</td>
		</tr>
		<tr>
			<td>GtACR</td>
			<td>Guillardia theta anion channelrhodopsin</td>
		</tr>
		<tr>
			<td>GUI</td>
			<td>graphical user interface</td>
		</tr>
		<tr>
			<td>I-clamp</td>
			<td>current-clamp</td>
		</tr>
		<tr>
			<td>IU</td>
			<td>international units</td>
		</tr>
		<tr>
			<td>MOI</td>
			<td>multiplicity of infection</td>
		</tr>
		<tr>
			<td>poly-HEMA</td>
			<td>poly(2-hydroxyethyl methacrylate)</td>
		</tr>
		<tr>
			<td>V-clamp</td>
			<td>voltage-clamp</td>
		</tr>
	</tbody>
</table>
Table 5: List of abbreviations.
<img alt="Supplemental Figure 1" src="/files/ftp_upload/60490/60490suppfig1a.jpg" /> 
Supplemental Figure 1: Light intensity measurements with optical power meter. (A) Measurement of 10 ms light pulses at 4 mW/mm2. (B) Measurement of sustained illumination of 64 s at 4 mW/mm2. <a href="https://www.jove.com/files/ftp_upload/60490/60490suppfig1alarge.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Supplemental Figure 2" src="/files/ftp_upload/60490/60490suppfig2a.jpg" /> 
Supplemental Figure 2: Properties of freshly isolated CM and their structural adaptation in culture. (A) AP recording of a freshly isolated CM (APD 20 of 1.11 &#177; 0.34 s, APD 90 of 1.96 &#177; 0.32 s, n = 7, N = 2). Mean resting membrane potential of -79.3 &#177; 0.8 mV (n = 7, N = 2). (B) Carbon fiber recording of an electrically paced freshly isolated CM. Mean peak force of 205 &#177; 78 &#181;N/mm2 (n = 7, N = 2). (C) Confocal images of a freshly isolated CM (I); untransduced (II) and transduced (III) CM after 48 hours in culture. <a href="https://www.jove.com/files/ftp_upload/60490/60490suppfig2alarge.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
Supplemental Material: MatLab script to determine APD and resting membrane potential. <a href="https://www.jove.com/files/ftp_upload/60490/SupplementalMaterial.zip" target="_blank">Please click here to download this file.</a>

Watch this Scientific Journal Video about Electromechanical Assessment of Optogenetically Modulated Cardiomyocyte Activity at JoVE.com

Electromechanical Assessment of Optogenetically Modulated Cardiomyocyte Activity

We present a protocol for evaluating the electromechanical effects of GtACR1 activation in rabbit cardiomyocytes. We provide detailed information on cell isolation, culturing and adenoviral transduction, and on functional experiments with the patch-clamp and carbon-fiber techniques.

Over the past two decades, optogenetic tools have been established as potent means to modulate cell-type specific activity in excitable tissues, including ...

electromechanical-assessment-optogenetically-modulated-cardiomyocyte

Research

JoVE Journal

Medicine

7.9K Views.  Medical Center-University of Freiburg. We present a protocol for evaluating the electromechanical effects of GtACR1 activation in rabbit cardiomyocytes. We provide detailed information on cell isolation, culturing and adenoviral transduction, and on functional experiments with the patch-clamp and carbon-fiber techniques.

Video: Electromechanical Assessment of Optogenetically Modulated Cardiomyocyte Activity

Isolation of Cardiomyocyte Nuclei from Post-mortem Tissue

Identification of cardiomyocyte nuclei has been challenging in tissue sections as most strategies rely only on cytoplasmic marker proteins1. Rare events in cardiac myocytes such as proliferation and apoptosis require an accurate identification of cardiac myocyte nuclei to analyze cellular renewal in homeostasis and in pathological conditions2. Here, we provide a method to isolate cardiomyocyte nuclei from post mortem tissue by density sedimentation and immunolabeling with antibodies against pericentriolar material 1 (PCM-1) and subsequent flow cytometry sorting. This strategy allows a high throughput analysis and isolation with the advantage of working equally well on fresh tissue and frozen archival material. This makes it possible to study material already collected in biobanks. This technique is applicable and tested in a wide range of species and suitable for multiple downstream applications such as carbon-14 dating3, cell-cycle analysis4, visualization of thymidine analogues (e.g. BrdU and IdU)4, transcriptome and epigenetic analysis.

Cardiac nuclei are isolated via density sedimentation and immunolabeled with antibodies against pericentriolar material 1 (PCM-1) to identify and sort cardiomyocyte nuclei by flow cytometry.

Identification of cardiomyocyte nuclei has been challenging in tissue sections as most strategies rely only on cytoplasmic marker proteins1. Rare events ...

A Novel Application of Musculoskeletal Ultrasound Imaging

Ultrasound is an attractive modality for imaging muscle and tendon motion during dynamic tasks and can provide a complementary methodological approach for biomechanical studies in a clinical or laboratory setting. Towards this goal, methods for quantification of muscle kinematics from ultrasound imagery are being developed based on image processing. The temporal resolution of these methods is typically not sufficient for highly dynamic tasks, such as drop-landing. We propose a new approach that utilizes a Doppler method for quantifying muscle kinematics. We have developed a novel vector tissue Doppler imaging (vTDI) technique that can be used to measure musculoskeletal contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities using ultrasound. The goal of this preliminary study was to investigate the repeatability and potential applicability of the vTDI technique in measuring musculoskeletal velocities during a drop-landing task, in healthy subjects. The vTDI measurements can be performed concurrently with other biomechanical techniques, such as 3D motion capture for joint kinematics and kinetics, electromyography for timing of muscle activation and force plates for ground reaction force. Integration of these complementary techniques could lead to a better understanding of dynamic muscle function and dysfunction underlying the pathogenesis and pathophysiology of musculoskeletal disorders.

We describe a new ultrasound-based vector tissue Doppler imaging technique to measure muscle contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities. This approach provides complementary measurements of dynamic muscle function and could lead to a better understanding of mechanisms underlying musculoskeletal disorders.

Ultrasound is an attractive modality for imaging muscle and tendon  motion during dynamic tasks and can provide a complementary methodological  approach ...

Ultrasonic Assessment of Myocardial Microstructure

Echocardiography is a widely accessible imaging modality that is commonly used to noninvasively characterize and quantify changes in cardiac structure and function. Ultrasonic assessments of cardiac tissue can include analyses of backscatter signal intensity within a given region of interest. Previously established techniques have relied predominantly on the integrated or mean value of backscatter signal intensities, which may be susceptible to variability from aliased data from low frame rates and time delays for algorithms based on cyclic variation. Herein, we describe an ultrasound-based imaging algorithm that extends from previous methods, can be applied to a single image frame&#160;and accounts for the full distribution of signal intensity values derived from a given myocardial sample. When applied to representative mouse and human imaging data, the algorithm distinguishes between subjects with and without exposure to chronic afterload resistance. The algorithm offers an enhanced surrogate measure of myocardial microstructure and can be performed using open-access image analysis software.

Echocardiography is commonly used to noninvasively characterize and quantify changes in cardiac structure and function. We describe an ultrasound-based imaging algorithm that offers an enhanced surrogate measure of myocardial microstructure and can be performed using open-access image analysis software.

Echocardiography is a widely accessible imaging modality that is commonly used to noninvasively characterize and quantify changes in cardiac structure and ...

Contractions of Human-iPSC-derived Cardiomyocyte Syncytia Measured with a Ca-sensitive Fluorescent Dye in Temperature-controlled 384-well Plates

Spontaneously contracting syncytia of cardiomyocytes derived from human-induced pluripotent stem cells (hiPSC-CM) are a useful model of human cardiac physiology and pharmacology. Various methods have been proposed to record this spontaneous activity and to evaluate drug effects, but many of these methods suffer from limited throughput and/or physiological relevance. We developed a high-throughput screening system to quantify the effects of exogenous compounds on hiPSC-CM's beating frequency, using a Ca-sensitive fluorescent dye and a temperature-controlled imaging multi-well plate reader. We describe how to prepare the cell plates and the compound plates and how to run the automated assay to achieve high sensitivity and reproducibility. We also describe how to transform and analyze the fluorescence data to provide reliable measures of drug effects on spontaneous rhythm. This assay can be used in drug discovery programs to guide chemical optimization away from, or toward, compounds affecting human cardiac function.

Spontaneously contracting syncytia of cardiomyocytes derived from human-induced pluripotent stem cells are useful models of human cardiac physiology and pharmacology. Here we present a high-throughput screening system to quantify the effects of exogenous compounds on beating frequency, using a Ca-sensitive fluorescent dye and a temperature-controlled imaging multi-well plate reader.

Spontaneously contracting syncytia of cardiomyocytes derived from human-induced pluripotent stem cells (hiPSC-CM) are a useful model of human cardiac ...

Non-invasive Assessment of Dorsiflexor Muscle Function in Mice

Assessment of skeletal muscle contractile function is an important measurement for both clinical and research purposes. Numerous conditions can negatively affect skeletal muscle. This can result in a loss of muscle mass (atrophy) and/or loss of muscle quality (reduced force per unit of muscle mass), both of which are prevalent in chronic disease, muscle-specific disease, immobilization, and aging (sarcopenia). Skeletal muscle function in animals can be evaluated by a range of different tests. All tests have limitations related to the physiological testing environment, and the selection of a specific test often depends on the nature of the experiments. Here, we describe an in vivo, non-invasive technique involving a helpful and easy assessment of force frequency-curve (FFC) in mice that can be performed on the same animal over time. This permits monitoring of disease progression and/or efficacy&#160;of a potential therapeutic treatment.

Measurement of rodent skeletal muscle contractile function is a useful tool that can be used to track disease progression as well as efficacy of therapeutic intervention. We describe here the non-invasive, in vivo assessment of the dorsiflexor muscles that can be repeated over time in the same mouse.

Assessment of skeletal muscle contractile function is an important measurement for both clinical and research purposes. Numerous conditions can negatively ...

Ultrasonographic Assessment During Cardiopulmonary Resuscitation

The US-CAB (Ultrasound, Circulation/Airway/Breathing) protocol integrates several sonographic techniques into a structured assessment of the circulation, airway, and breathing status of a patient during cardiopulmonary resuscitation (CPR) in an advanced life support-compliant manner. US-C provides a subxiphoid view of the heart, to look for potentially reversible causes of disease, such as pericardial effusion, pulmonary embolism, hypovolemia, and acute coronary thrombosis. Sonographic cardiac activity during CPR not only helps differentiate pseudo-pulseless electrical activity (PEA) from true PEA but also represents a higher chance of the return of spontaneous circulation (ROSC) and survival. Evaluation of the inferior vena cava (IVC) shows the fluid status of the patient and indicates the best methods to use for fluid resuscitation. If aortic dissection is suspected, a subxiphoid view of the aorta is suggested for identifying an intimal flap. Once intubation is done, tracheal ultrasound (US-A) at the suprasternal notch helps differentiate endotracheal intubation (one air-mucosal interface with one comet-tail) from esophageal intubation (double tract sign). Immediately following US-A, bilateral lung US (US-B) should be done to confirm proper bilateral ventilation using the lung sliding sign. In addition, US-C can be serially followed to see the dynamic changes in the cardiac chambers and IVC, or any cardiac contraction suggestive of ROSC. US-B can also detect coexisting lung or pleural pathologies without interfering with the performance of CPR. The main concern when implementing this method is maintaining high-quality CPR without delays in chest compressions when performing US-CAB. Rigorous training and continued practice are key to minimize any interruptions during resuscitation.

Here, we present a US-CAB (Ultrasound, Circulation/Airway/Breathing) protocol for use during cardiopulmonary resuscitation (CPR). US-C evaluates the subxiphoid view of the heart and inferior vena cava. After intubation, tracheal US (US-A) and lung US (US-B) help confirm endotracheal intubation and proper ventilation.

The US-CAB (Ultrasound, Circulation/Airway/Breathing) protocol integrates several sonographic techniques into a structured assessment of the circulation, ...

Model of Ischemic Heart Disease and Video-Based Comparison of Cardiomyocyte Contraction Using hiPSC-Derived Cardiomyocytes

Ischemic heart disease is a significant cause of death worldwide. It has therefore been the subject of a tremendous amount of research, often with small-animal models such as rodents. However, the physiology of the human heart differs significantly from that of the rodent heart, underscoring the need for clinically relevant models to study heart disease. Here, we present a protocol to model ischemic heart disease using cardiomyocytes differentiated from human induced pluripotent stem cells (hiPS-CMs) and to quantify the damage and functional impairment of the ischemic cardiomyocytes. Exposure to 2% oxygen without glucose and serum increases the percentage of injured cells, which is indicated by staining of the nucleus with propidium iodide, and decreases cellular viability. These conditions also decrease the contractility of hiPS-CMs as confirmed by displacement vector field analysis of microscopic video images. This protocol may furthermore provide a convenient method for personalized drug screening by facilitating the use of hiPS cells from individual patients. Therefore, this model of ischemic heart disease, based on iPS-CMs of human origin, can provide a useful platform for drug screening and further research on ischemic heart disease.

We present a model of ischemic heart disease using cardiomyocytes derived from human induced pluripotent stem cells, together with a method for quantitative evaluation of tissue damage caused by ischemia. This model can provide a useful platform for drug screening and further research on ischemic heart disease.

Ischemic heart disease is a significant cause of death worldwide. It has therefore been the subject of a tremendous amount of research, often with ...

Ultrasound-Guided Induced Pluripotent Stem Cell-Derived Cardiomyocyte Implantation in Myocardial Infarcted Mice

The key objective of cell therapy after myocardial infarction (MI) is to effectively enhance the cell grafted rate, and human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are a promising cell source for cardiac repair after ischemic damage. However, a low grafted rate is a significant obstacle for effective cardiac tissue regeneration after transplantation. This protocol shows that multiple hiPSC-CM ultrasound-guided percutaneous injections into an MI area effectively increase cell transplantation rates. The study also describes the entire hiPSC-CM culture process, pretreatment, and ultrasound-guided percutaneous delivery methods. In addition, the use of human mitochondrial DNA help detect the absence of hiPSC-CMs in other mouse organs. Lastly, this paper describes the changes in cardiac function, angiogenesis, cell size, and apoptosis at the infarcted border zone in mice 4 weeks after cell delivery. It can be concluded that echocardiography-guided percutaneous injection of the left ventricular myocardium is a feasible, relatively invasive, satisfactory, repeatable, and effective cellular therapy.

Ultrasound-guided cell delivery around the site of myocardial infarction in mice is a safe, effective, and convenient way of cell transplantation.

The key objective of cell therapy after myocardial infarction (MI) is to effectively enhance the cell grafted rate, and human induced pluripotent stem ...

Providing Visual Biofeedback Using Brightness Mode Ultrasound During a Golf Swing

Using ultrasound biofeedback in conjunction with verbal cueing can increase muscle thickness more than verbal cueing alone and may augment traditional rehabilitation techniques in an athletic, physically active population. Brightness mode (B-mode) ultrasound can be applied using frame-by-frame analysis synchronized with video to understand muscle thickness changes during these dynamic tasks. Visual biofeedback with ultrasound has been established in static positions for the muscles of the lateral abdominal wall. However, by securing the transducer to the abdomen using an elastic belt and foam block, biofeedback can be applied during more specific tasks prevalent in lifetime sports, such as golf. To analyze muscle activity during a golf swing, muscle thickness changes can be compared. The thickness must increase throughout the task, indicating that the muscle is more active. This methodology allows clinicians to immediately replay ultrasound videos for patients as a visual tool to instruct proper activity of the muscles of interest. For example, ultrasound can be used to target the external and internal obliques, which play an important role in swinging a golf club or any other rotational sport or activity. This methodology aims to increase oblique muscle thickness during the golf swing. Additionally, the timing of muscle contraction can be targeted by instructing the patient to contract the abdominal muscles at specific time points, such as the beginning of the downswing, with the goal of improving muscle firing patterns during tasks.

Brightness mode ultrasound can be used to provide visual biofeedback of the muscles of the lateral abdominal wall during a golf swing. Post-swing visual and verbal instruction can increase the muscle activation and timing of the external and internal obliques.

Using ultrasound biofeedback in conjunction with verbal cueing can increase muscle thickness more than verbal cueing alone and may augment traditional ...

Muscle Function Obtained with Motion Mode Ultrasound and Surface Electromyography during Core Endurance Exercise

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured between fascial borders at a given time point during an exercise. This selected time point produces a one-dimensional image resulting in real-time, live observation of anatomy. Ultrasound used during functional movement can be referred to as dynamic ultrasound; this is feasible and reliable with the use of a linear transducer, elastic belt, and foam block to secure consistent transducer placement. The lateral abdominal wall is commonly investigated using ultrasound due to the overlapping nature of the muscles. Surface electromyography (sEMG) can complement M-mode ultrasound imaging because it measures the electrical representation of muscle activation. There is minimal evidence using M-mode ultrasound and sEMG simultaneously during core exercise. Exercises that challenge the core musculature involve both isometric holds (e.g., side plank), as well as oscillatory extremity movements (e.g., dead bug). In this study, both instruments will be used simultaneously to measure core muscle function during exercise. Ultrasound measurements will be obtained using a linear transducer and ultrasound unit, and sEMG measurements will be acquired from a wireless sEMG system. To make comparisons between participants and exercises, normalization methods using static, exercise starting positions for both instruments will be used. An activation ratio will be used for ultrasound and calculated by dividing the contracted thickness (thickness during a time point of exercise) by the rested (starting position) thickness. Muscle thickness will be measured in centimeters from the superior inferior fascial border to inferior superior fascial border. These methods aim to offer an innovative and practical measurement of muscle function with M-mode ultrasound and sEMG during core endurance exercises.

This protocol uses motion mode ultrasound and surface electromyography simultaneously to measure muscle function of the core. Muscle thickness and activation of the local stabilizers (e.g., transverse abdominis, internal oblique) and global movers (e.g., external oblique) is achievable during specific time points of the side plank and dead bug exercises.

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured ...