Funding by NIH (grants R21 EB023106, R44 HL139248, and R01 HL126802), by Leducq foundation (project RHYTHM) and an American Heart Association Postdoctoral Fellowship (19POST34370122) are gratefully acknowledged.

<ol>
	<li>Ericsson, A. C., Crim, M. J., Franklin, C. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+brief+history+of+animal+modeling.">A brief history of animal modeling.</a> Missouri Medicine. 110 (3), 201-205 (2013).</li><li>Choudhary, A., Ibdah, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Animal+models+in+today's+translational+medicine+world.">Animal models in today's translational medicine world.</a> Missouri Medicine. 110 (3), 220-222 (2013).</li><li>Perlman, R. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mouse+models+of+human+disease:+An+evolutionary+perspective.">Mouse models of human disease: An evolutionary perspective.</a> Evolution, Medicine, and Public Health. 2016 (1), 170-176 (2016).</li><li>Milani-Nejad, N., Janssen, P. M. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Small+and+large+animal+models+in+cardiac+contraction+research:+advantages+and+disadvantages.">Small and large animal models in cardiac contraction research: advantages and disadvantages.</a> Pharmacology &amp; Therapeutics. 141 (3), 235-249 (2014).</li><li>Green, A. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Why+do+neuroprotective+drugs+that+are+so+promising+in+animals+fail+in+the+clinic?+An+industry+perspective.">Why do neuroprotective drugs that are so promising in animals fail in the clinic? An industry perspective.</a> Clinical and Experimental Pharmacology and Physiology. 29 (11), 1030-1034 (2002).</li><li>Shinnawi, R., Gepstein, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=iPCS+cell+modeling+of+inherited+cardiac+arrhythmias.">iPCS cell modeling of inherited cardiac arrhythmias.</a> Current Treatment Options in Cardiovascular Medicine. 16 (9), 331 (2014).</li><li>Morimoto, Y., Mori, S., Sakai, F., Takeuchi, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+induced+pluripotent+stem+cell-derived+fiber-shaped+cardiac+tissue+on+a+chip.">Human induced pluripotent stem cell-derived fiber-shaped cardiac tissue on a chip.</a> Lab on a Chip. 16 (12), 2295-2301 (2016).</li><li>Wang, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modeling+the+mitochondrial+cardiomyopathy+of+Barth+syndrome+with+induced+pluripotent+stem+cell+and+heart-on-chip+technologies.">Modeling the mitochondrial cardiomyopathy of Barth syndrome with induced pluripotent stem cell and heart-on-chip technologies.</a> Nature Medicine. 20 (6), 616-623 (2014).</li><li>Ben-Ari, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Developmental+changes+in+electrophysiological+characteristics+of+human-induced+pluripotent+stem+cell-derived+cardiomyocytes.">Developmental changes in electrophysiological characteristics of human-induced pluripotent stem cell-derived cardiomyocytes.</a> Heart Rhythm. 13 (12), 2379-2387 (2016).</li><li>Goversen, B., van der Heyden, M. A. G., van Veen, T. A. B., de Boer, T. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+immature+electrophysiological+phenotype+of+iPSC-CMs+still+hampers+in+vitro+drug+screening:+Special+focus+on+IK1.">The immature electrophysiological phenotype of iPSC-CMs still hampers in vitro drug screening: Special focus on IK1.</a> Pharmacology &amp; Therapeutics. 183, 127-136 (2018).</li><li>Zhang, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dedifferentiation+and+proliferation+of+mammalian+cardiomyocytes.">Dedifferentiation and proliferation of mammalian cardiomyocytes.</a> PloS One. 5 (9), 12559 (2010).</li><li>Watson, S. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biomimetic+electromechanical+stimulation+to+maintain+adult+myocardial+slices+in+vitro.">Biomimetic electromechanical stimulation to maintain adult myocardial slices in vitro.</a> Nature Communications. 10, 2168 (2019).</li><li>Fischer, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+functional+and+structural+preservation+of+precision-cut+human+myocardium+under+continuous+electromechanical+stimulation+in+vitro.">Long-term functional and structural preservation of precision-cut human myocardium under continuous electromechanical stimulation in vitro.</a> Nature Communications. 10, 117 (2019).</li><li>Ou, Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Physiological+Biomimetic+Culture+System+for+Pig+and+Human+Heart+Slices.">Physiological Biomimetic Culture System for Pig and Human Heart Slices.</a> Circulation Research. 125 (6), 628-642 (2019).</li><li>Qiao, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multiparametric+slice+culture+platform+for+the+investigation+of+human+cardiac+tissue+physiology.">Multiparametric slice culture platform for the investigation of human cardiac tissue physiology.</a> Progress in Biophysics and Molecular Biology 2. 144, 139-150 (2019).</li><li>Kang, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+Organotypic+Cultured+Cardiac+Slices:+New+Platform+For+High+Throughput+Preclinical+Human+Trials.">Human Organotypic Cultured Cardiac Slices: New Platform For High Throughput Preclinical Human Trials.</a> Scientific Reports. 6, 28798 (2016).</li><li>Camelliti, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adult+human+heart+slices+are+a+multicellular+system+suitable+for+electrophysiological+and+pharmacological+studies.">Adult human heart slices are a multicellular system suitable for electrophysiological and pharmacological studies.</a> Journal of Molecular and Cellular Cardiology. 51 (3), 390-398 (2011).</li><li>Brandenburger, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Organotypic+slice+culture+from+human+adult+ventricular+myocardium.">Organotypic slice culture from human adult ventricular myocardium.</a> Cardiovascular Research. 93 (1), 50-59 (2012).</li><li>Watson, S. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preparation+of+viable+adult+ventricular+myocardial+slices+from+large+and+small+mammals.">Preparation of viable adult ventricular myocardial slices from large and small mammals.</a> Nature Protocols. 12 (12), 2623-2639 (2017).</li><li>Halbach, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ventricular+slices+of+adult+mouse+hearts+-+A+new+multicellular+in+vitro+model+for+electrophysiological+studies.">Ventricular slices of adult mouse hearts - A new multicellular in vitro model for electrophysiological studies.</a> Cellular Physiology and Biochemistry. 18 (1-3), 1-8 (2006).</li><li>Wang, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiac+tissue+slices:+preparation,+handling,+and+successful+optical+mapping.">Cardiac tissue slices: preparation, handling, and successful optical mapping.</a> American Journal of Physiology. Heart and Circulatory Physiology. 308 (9), 1112-1125 (2015).</li><li>Bussek, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiac+tissue+slices+with+prolonged+survival+for+in+vitro+drug+safety+screening.">Cardiac tissue slices with prolonged survival for in vitro drug safety screening.</a> Journal of Pharmacological and Toxicological Methods. 66 (2), 145-151 (2012).</li><li>Watson, S. A., Terracciano, C. M., Perbellini, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Myocardial+Slices:+an+Intermediate+Complexity+Platform+for+Translational+Cardiovascular+Research.">Myocardial Slices: an Intermediate Complexity Platform for Translational Cardiovascular Research.</a> Cardiovascular Drugs and Therapy. 33 (2), 239-244 (2019).</li><li>Rouwkema, J., Koopman, B. F. J. M., Blitterswijk, C. A. V., Dhert, W. J. A., Malda, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Supply+of+nutrients+to+cells+in+engineered+tissues.">Supply of nutrients to cells in engineered tissues.</a> Biotechnology and Genetic Engineering Reviews. 26 (1), 163-178 (2009).</li><li>Lang, D., Sulkin, M., Lou, Q., Efimov, I. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optical+mapping+of+action+potentials+and+calcium+transients+in+the+mouse+heart.">Optical mapping of action potentials and calcium transients in the mouse heart.</a> Journal of Visualized Experiments. (55), e3275 (2011).</li><li>Brianna, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Open-Source+Multiparametric+Optocardiography.">Open-Source Multiparametric Optocardiography.</a> Scientific Reports. 9, 721 (2019).</li><li>George, S. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modulating+cardiac+conduction+during+metabolic+ischemia+with+perfusate+sodium+and+calcium+in+guinea+pig+hearts.">Modulating cardiac conduction during metabolic ischemia with perfusate sodium and calcium in guinea pig hearts.</a> American Journal of Physiology - Heart and Circulatory Physiology. 316 (4), 849-861 (2019).</li><li>Kawara, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Activation+delay+after+premature+stimulation+in+chronically+diseased+human+myocardium+relates+to+the+architecture+of+interstitial+fibrosis.">Activation delay after premature stimulation in chronically diseased human myocardium relates to the architecture of interstitial fibrosis.</a> Circulation. 104 (25), 3069-3075 (2001).</li><li>Qu, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Action+potential+recording+and+pro-arrhythmia+risk+analysis+in+human+ventricular+trabeculae.">Action potential recording and pro-arrhythmia risk analysis in human ventricular trabeculae.</a> Frontiers in Physiology. 5 (8), 1109 (2018).</li><li>Franz, M. R., Swerdlow, C. D., Liem, L. B., Schaefer, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cycle+length+dependence+of+human+action+potential+duration+in+vivo.+Effects+of+single+extrastimuli,+sudden+sustained+rate+acceleration+and+deceleration,+and+different+steady-state+frequencies.">Cycle length dependence of human action potential duration in vivo. Effects of single extrastimuli, sudden sustained rate acceleration and deceleration, and different steady-state frequencies.</a> Journal of Clinical Investigation. 82 (3), 972-979 (1988).</li><li>Lou, Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transmural+heterogeneity+and+remodeling+of+ventricular+excitation-+contraction+coupling+in+human+heart+failure.">Transmural heterogeneity and remodeling of ventricular excitation- contraction coupling in human heart failure.</a> Circulation. 123 (17), 1881-1890 (2011).</li></ol>

The authors have nothing to disclose.

Here, we present step-by-step methods to obtain viable cardiac slices from cardioplegically arrested human hearts and to functionally characterize the slices using dual optical mapping of transmembrane potential and intracellular calcium. With preserved extracellular environment and native cell-cell coupling, human cardiac slices can be used as an accurate model of the human heart for fundamental scientific discovery and for efficacy and cardiotoxicity testing of pharmacological agents and gene therapies. The technology ...

Animal models have been a valuable tool used for understanding the underlying mechanisms of human physiology and pathophysiology, as well as a platform for preliminary testing of therapies to treat various diseases1. Great strides have been taken in the field of biomedical research based on these animal studies2. However, significant interspecies differences exist between human and animal physiologies, including mice, rats, guinea pigs, rabbits, sheep, pigs, and dogs3,4. As a result, there have been numerous drug, gene, and cell therapies that showed promise during the animal testing stage but failed to live up to the results in clinical trials5. To bridge this gap, isolated cardiac myocytes and human induced pluripotent stem cells (iPSCs) were developed as models to test the response of human physiology to various drugs and diseases6. Stem cell-derived cardiomyocytes have been widely used in organ-on-a-chip systems as a surrogate of the heart6,7,8. However, the usefulness of iPSC-derived cardiomyocytes (iPSC-CMs) is impeded by their relatively immature phenotype and the lack of representation of the cardiomyocyte subpopulation; the mature myocardium is a complex structure comprised of several coexisting cell types such as fibroblasts, neurons, macrophages, and endothelial cells. On the other hand, isolated human cardiomyocytes are electrically mature, and different cardiomyocyte subpopulations can be obtained by altering culturing parameters9. Still, these myocytes generally exhibit altered action potential morphologies due to the lack of cell-cell coupling, rapid de-differentiation, and occurrence of proarrhythmic behavior in vitro10,11. Some of the limitations were addressed by 3D cell culture models of iPSC-CMs and cardiac myocytes. These models, which include spheroids, hydrogel scaffold encapsulated 3D cultures, engineered heart tissues (EHTs), and heart-on-a-chip systems, use multiple cardiac cell populations such as cardiomyocytes, fibroblasts, and endothelial cells. They either self-assemble or assemble along a scaffold to form 3D structures, and some even reproduce the complex anisotropic nature of the myocardium. These models have been reported to have cells of mature phenotypes, contractile properties, and molecular profiles similar to cardiac tissue. The heart-on-a-chip system also allows the study of systemic effects in drug testing and disease models. However, in vitro cell-based models lack the native extracellular matrix and therefore cannot accurately mimic organ level electrophysiology. Human cardiac slices, by contrast, have an intact extracellular matrix and native cell-to-cell contacts, making them useful for more accurately examining arrhythmogenic properties of the human myocardium.
Researchers have developed human cardiac organotypic slices as a physiological preclinical platform for acute and chronic drug testing and to study cardiac electrophysiology and cardiac disease progression12,13,14,15,16,17,18,19. When compared with iPSC-derived cardiomyocytes, human cardiac slices more faithfully replicate adult human cardiac electrophysiology with a mature cardiomyocyte phenotype. When compared with isolated human cardiomyocytes, cardiac slices exhibit physiological action potential durations because of the well-preserved cell-cell coupling and the intrinsic existence of their native intra- and extracellular environments.
This protocol describes the process of generating human cardiac slices from whole donor hearts, performing acute (i.e., hours-long) and chronic (i.e., days-long) studies to test cardiac electrophysiology parameters via optical mapping. While this protocol describes only the use of the left ventricular (LV) tissue, it has been successfully applied to other regions of the heart as well as other species such as mice, rats, guinea pigs, and pigs14,20,21,22. Our laboratory uses whole human donor hearts that have been rejected for transplantation for the last 5 years, but it is feasible for these same procedures to be carried out on any donor heart sample tissues obtained by alternative means (e.g., left ventricular assist device [LVAD] implantations, biopsies, myectomies) as long as the tissues have the ability to be sectioned into cubes. Optical mapping is employed for analysis in this study due to its capacity to simultaneously map optical action potentials and calcium transients with high spatial (100 x 100 pixels) and temporal (&#62;1,000 frames/s) resolution. Alternative methods can also be used, such as multielectrode arrays (MEAs) or microelectrodes, but these techniques are limited by their relatively low spatial resolutions. Additionally, MEAs were designed for use with cell cultures, and sharp microelectrodes are more easily managed for use with whole hearts or large tissue wedges.
The goal of the article is to enable more researchers to use human cardiac tissues for cardiac electrophysiology studies. It should be noted that the technology described in this article is relatively simple and beneficial for short-term studies (on the order of several hours to days). More physiological biomimetic culture for longer-term studies (on the order of weeks) has been discussed and described by a number of other studies12,18,23. Electrical stimulation, mechanical loading, and tissue stretching are advantageous conditioning mechanisms that can help limit the onset of in vitro tissue remodelling12,18,23.

<table>
	<tbody>
		<tr>
			<td>1mL BD Syringe</td>
			<td>Thomas Scientific</td>
			<td>309597</td>
			<td></td>
		</tr>
		<tr>
			<td>2,3-butanedione monoxime</td>
			<td>Sigma-Aldrich</td>
			<td>B0753</td>
			<td></td>
		</tr>
		<tr>
			<td>6 well culture plates</td>
			<td>Corning</td>
			<td>3516</td>
			<td></td>
		</tr>
		<tr>
			<td>Biosafety cabinet</td>
			<td>ThermoFisher Scientific</td>
			<td>1377</td>
			<td></td>
		</tr>
		<tr>
			<td>Blebbistatin</td>
			<td>Cayman</td>
			<td>13186</td>
			<td></td>
		</tr>
		<tr>
			<td>Bubble Trap</td>
			<td>Radnoti</td>
			<td>130149</td>
			<td></td>
		</tr>
		<tr>
			<td>Calcium chloride</td>
			<td>Sigma-Aldrich</td>
			<td>C1016</td>
			<td></td>
		</tr>
		<tr>
			<td>Corning Cell Strainers</td>
			<td>Fisher Scientific</td>
			<td>07-201-432</td>
			<td></td>
		</tr>
		<tr>
			<td>Di-4-ANEPPS</td>
			<td>Biotium</td>
			<td></td>
			<td>stock solution at 1.25 mg/mL in DMSO</td>
		</tr>
		<tr>
			<td>DMSO</td>
			<td>Sigma-Aldrich</td>
			<td>D2650</td>
			<td></td>
		</tr>
		<tr>
			<td>Dumont #3c Forceps</td>
			<td>Fine Science Tools</td>
			<td>11231-20</td>
			<td></td>
		</tr>
		<tr>
			<td>Emission dichroic mirror</td>
			<td>Chroma</td>
			<td>T630LPXR-UF1</td>
			<td></td>
		</tr>
		<tr>
			<td>Emission filter (RH237)</td>
			<td>Chroma</td>
			<td>ET690/50m</td>
			<td></td>
		</tr>
		<tr>
			<td>Emission Filter (Rhod2AM)</td>
			<td>Chroma</td>
			<td>ET590/33m</td>
			<td></td>
		</tr>
		<tr>
			<td>Excitation dichroic mirror</td>
			<td>Chroma</td>
			<td>T550LPXR-UF1</td>
			<td></td>
		</tr>
		<tr>
			<td>Excitation Filter</td>
			<td>Chroma</td>
			<td>ET500/40x</td>
			<td></td>
		</tr>
		<tr>
			<td>Falcon 50mL Conical Centrifuge Tubes</td>
			<td>Fisher Scientific</td>
			<td>14-959-49A</td>
			<td></td>
		</tr>
		<tr>
			<td>Glucose</td>
			<td>Sigma-Aldrich</td>
			<td>G8270</td>
			<td></td>
		</tr>
		<tr>
			<td>Heat exchanger</td>
			<td>Radnoti</td>
			<td>158821</td>
			<td></td>
		</tr>
		<tr>
			<td>HEPES</td>
			<td>Sigma-Aldrich</td>
			<td>H3375</td>
			<td></td>
		</tr>
		<tr>
			<td>Incubator</td>
			<td>ThermoFisher Scientific</td>
			<td>50145502</td>
			<td></td>
		</tr>
		<tr>
			<td>Insulin Transferrin Selenium (ITS)</td>
			<td>Sigma-Aldrich</td>
			<td>I3146</td>
			<td></td>
		</tr>
		<tr>
			<td>LED excitation light source</td>
			<td>Prizmatix</td>
			<td>UHP-Mic-LED-520</td>
			<td></td>
		</tr>
		<tr>
			<td>Magnessium chloride hexahydrate</td>
			<td>Sigma-Aldrich</td>
			<td>M9272</td>
			<td></td>
		</tr>
		<tr>
			<td>Medium 199</td>
			<td>ThermoFisher Scientific</td>
			<td>11150059</td>
			<td></td>
		</tr>
		<tr>
			<td>Micam Ultima L type CMOS camera</td>
			<td>Scimedia</td>
			<td>N/A</td>
			<td></td>
		</tr>
		<tr>
			<td>Minutien Pins</td>
			<td>Fine Science Tools</td>
			<td>26002-10</td>
			<td></td>
		</tr>
		<tr>
			<td>Pennicillin-Streptomycin</td>
			<td>Sigma-Aldrich</td>
			<td>P4333</td>
			<td></td>
		</tr>
		<tr>
			<td>Peristaltic Pump</td>
			<td>Cole Parmer</td>
			<td>EW-07522-20</td>
			<td></td>
		</tr>
		<tr>
			<td>Platinum pacing wire</td>
			<td>Alfa Aesar</td>
			<td>43275</td>
			<td></td>
		</tr>
		<tr>
			<td>Pluronic F127</td>
			<td>ThermoFisher Scientific</td>
			<td>P6867</td>
			<td>nonionic, surfactant polyol</td>
		</tr>
		<tr>
			<td>Potassium chloride</td>
			<td>Sigma-Aldrich</td>
			<td>P3911</td>
			<td></td>
		</tr>
		<tr>
			<td>Powerlab data acquisition and stimulator</td>
			<td>AD Instruments</td>
			<td>Powerlab 4/26</td>
			<td></td>
		</tr>
		<tr>
			<td>RH237</td>
			<td>Biotium</td>
			<td>61018</td>
			<td></td>
		</tr>
		<tr>
			<td>Rhod2AM</td>
			<td>ThermoFisher Scientific</td>
			<td>R1245MP</td>
			<td></td>
		</tr>
		<tr>
			<td>Rhod-2AM</td>
			<td>Invitrogen, Carlsbad, CA</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sodium bicarbonate</td>
			<td>Sigma-Aldrich</td>
			<td>S6014</td>
			<td></td>
		</tr>
		<tr>
			<td>Sodium chloride</td>
			<td>Sigma-Aldrich</td>
			<td>S9625</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterilizer, dry bead</td>
			<td>Sigma-Aldrich</td>
			<td>Z378550</td>
			<td></td>
		</tr>
		<tr>
			<td>Stone Oxygen Diffuser</td>
			<td>Waterwood</td>
			<td>B00O0NUVM0</td>
			<td></td>
		</tr>
		<tr>
			<td>TissueSeal - Histoacryl Topical Skin Adhesive</td>
			<td>gobiomed</td>
			<td>AESCULAP</td>
			<td></td>
		</tr>
		<tr>
			<td>UltraPure Low Melting Point Agarose</td>
			<td>Thermo Fisher Scientific</td>
			<td>16520100</td>
			<td></td>
		</tr>
		<tr>
			<td>Ultrasound sonicator</td>
			<td></td>
			<td>Branson 1800</td>
			<td></td>
		</tr>
		<tr>
			<td>Vibratome</td>
			<td>Campden Instruments</td>
			<td>7000 smz</td>
			<td></td>
		</tr>
	</tbody>
</table>

preclinical cardiac electrophysiology assessment by dual voltage and calcium optical mapping of human organotypic cardiac slices

Human cardiac slice preparations have recently been developed as a platform for human physiology studies and therapy testing to bridge the gap between animal and clinical trials. Numerous animal and cell models have been used to examine the effects of drugs, yet these responses often differ in humans. Human cardiac slices offer an advantage for drug testing in that they are directly derived from viable human hearts. In addition to having preserved multicellular structures, cell-cell coupling, and extracellular matrix environments, human cardiac tissue slices can be used to directly test the effect of innumerable drugs on adult human cardiac physiology. What distinguishes this model from other heart preparations, such as whole hearts or wedges, is that slices can be subjected to longer-term culture. As such, cardiac slices allow for studying the acute as well as chronic effects of drugs. Furthermore, the ability to collect several hundred to a thousand slices from a single heart makes this a high-throughput model to test several drugs at varying concentrations and combinations with other drugs at the same time. Slices can be prepared from any given region of the heart. In this protocol, we describe the preparation of left ventricular slices by isolating tissue cubes from the left ventricular free wall and sectioning them into slices using a high precision vibrating microtome. These slices can then either be subjected to acute experiments to measure baseline cardiac electrophysiological function or cultured for chronic drug studies. This protocol also describes dual optical mapping of cardiac slices for simultaneous recordings of transmembrane potentials and intracellular calcium dynamics to determine the effects of the drugs being investigated.

Human organotypic slices were collected from the left ventricle of a donor human heart according to the protocol detailed above and illustrated in Figure 1. A dual camera optical mapping system like that in Figure 2 was used in the upright imaging configuration to perform simultaneous optical mapping of voltage and calcium about 1 h after the completion of the slicing protocol. Data were analyzed using RHYTHM1.2 (Figure 3), an open ...

Watch this Scientific Journal Video about Preclinical Cardiac Electrophysiology Assessment by Dual Voltage and Calcium Optical Mapping of Human Organotypic Cardiac Slices at JoVE.com

Preclinical Cardiac Electrophysiology Assessment by Dual Voltage and Calcium Optical Mapping of Human Organotypic Cardiac Slices

This protocol describes the procedure for sectioning and culturing human cardiac slices for preclinical drug testing and details the use of optical mapping for recording transmembrane voltage and intracellular calcium signals simultaneously from these slices.

Human cardiac slice preparations have recently been developed as a platform for human physiology studies and therapy testing to bridge the gap between ...

preclinical-cardiac-electrophysiology-assessment-dual-voltage-calcium

Research

JoVE Journal

Bioengineering

9.6K Views.  The George Washington University. This protocol describes the procedure for sectioning and culturing human cardiac slices for preclinical drug testing and details the use of optical mapping for recording transmembrane voltage and intracellular calcium signals simultaneously from these slices.

Video: Preclinical Cardiac Electrophysiology Assessment by Dual Voltage and Calcium Optical Mapping of Human Organotypic Cardiac Slices

Optical Mapping of Action Potentials and Calcium Transients in the Mouse Heart

The mouse heart is a popular model for cardiovascular studies due to the existence of low cost technology for genetic engineering in this species. Cardiovascular physiological phenotyping of the mouse heart can be easily done using fluorescence imaging employing various probes for transmembrane potential (Vm), calcium transients (CaT), and other parameters. Excitation-contraction coupling is characterized by action potential and intracellular calcium dynamics; therefore, it is critically important to map both Vm and CaT simultaneously from the same location on the heart1-4. Simultaneous optical mapping from Langendorff perfused mouse hearts has the potential to elucidate mechanisms underlying heart failure, arrhythmias, metabolic disease, and other heart diseases. Visualization of activation, conduction velocity, action potential duration, and other parameters at a myriad of sites cannot be achieved from cellular level investigation but is well solved by optical mapping1,5,6. In this paper we present the instrumentation setup and experimental conditions for simultaneous optical mapping of Vm and CaT in mouse hearts with high spatio-temporal resolution using state-of-the-art CMOS imaging technology. Consistent optical recordings obtained with this method illustrate that simultaneous optical mapping of Langendorff perfused mouse hearts is both feasible and reliable.

This paper details the dissection procedure, instrumental setup, and experimental conditions during optical mapping of transmembrane potential (Vm) and intracellular calcium transient (CaT) in intact isolated Langendorff perfused mouse hearts.

The mouse heart is a popular model for cardiovascular studies due to the existence of low cost technology for genetic engineering in this species. ...

Construction of Defined Human Engineered Cardiac Tissues to Study Mechanisms of Cardiac Cell Therapy

Human cardiac tissue engineering can fundamentally impact therapeutic discovery through the development of new species-specific screening systems that replicate the biofidelity of three-dimensional native human myocardium, while also enabling a controlled level of biological complexity, and allowing non-destructive longitudinal monitoring of tissue contractile function. Initially, human engineered cardiac tissues (hECT) were created using the entire cell population obtained from directed differentiation of human pluripotent stem cells, which typically yielded less than 50% cardiomyocytes. However, to create reliable predictive models of human myocardium, and to elucidate mechanisms of heterocellular interaction, it is essential to accurately control the biological composition in engineered tissues. 
To address this limitation, we utilize live cell sorting for the cardiac surface marker SIRP&#945; and the fibroblast marker CD90 to create tissues containing a 3:1 ratio of these cell types, respectively, that are then mixed together and added to a collagen-based matrix solution. Resulting hECTs are, thus, completely defined in both their cellular and extracellular matrix composition.
Here we describe the construction of defined hECTs as a model system to understand mechanisms of cell-cell interactions in cell therapies, using an example of human bone marrow-derived mesenchymal stem cells (hMSC) that are currently being used in human clinical trials. The defined tissue composition is imperative to understand how the hMSCs may be interacting with the endogenous cardiac cell types to enhance tissue function. A bioreactor system is also described that simultaneously cultures six hECTs in parallel, permitting more efficient use of the cells after sorting.

This manuscript describes the creation of defined engineered cardiac tissues using surface marker expression and cell sorting. The defined tissues can then be used in a multi-tissue bioreactor to investigate mechanisms of cardiac cell therapy in order to provide a functional, yet controlled, model system of the human heart.

Human cardiac tissue engineering can fundamentally impact therapeutic discovery through the development of new species-specific screening systems that ...

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

The use of Micro-Computed Tomography (MicroCT) for in vivo studies of small animals as models of human disease has risen tremendously due to the fact that MicroCT provides quantitative high-resolution three-dimensional (3D) anatomical data non-destructively and longitudinally. Most importantly, with the development of a novel preclinical iodinated contrast agent called eXIA160, functional and metabolic assessment of the heart became possible. However, prior to the advent of commercial MicroCT scanners equipped with X-ray flat-panel detector technology and easy-to-use cardio-respiratory gating, preclinical studies of cardiovascular disease (CVD) in small animals required a MicroCT technologist with advanced skills, and thus were impractical for widespread implementation. The goal of this work is to provide a practical guide to the use of the high-speed Quantum FX MicroCT system for comprehensive determination of myocardial global and regional function along with assessment of myocardial perfusion, metabolism and viability in healthy mice and in a cardiac ischemia mouse model induced by permanent occlusion of the left anterior descending coronary artery (LAD).

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

This method outlines the use of Quantum Micro-Computed Tomography (MicroCT) to assess cardiac morphology, function, perfusion, metabolism and viability with iodinated contrast agent in mice with experimentally-induced myocardial ischemia. The technique can be applied for non-destructive high-throughput longitudinal in vivo imaging of various animal models of human heart disease.

The use of Micro-Computed Tomography (MicroCT) for in vivo studies of small animals as models of human disease has risen tremendously due to the fact that ...

Using Extraordinary Optical Transmission to Quantify Cardiac Biomarkers in Human Serum

For a biosensing platform to have clinical relevance in point-of-care (POC) settings, assay sensitivity, reproducibility, and ability to reliably monitor analytes against the background of human serum are crucial.
Nanoimprinting lithography (NIL) was used to fabricate, at a low cost, sensing areas as large as 1.5 mm x 1.5 mm. The sensing surface was made of high-fidelity arrays of nanoholes, each with an area of about 140 nm2. The great reproducibility of NIL made it possible to employ a one-chip, one-measurement strategy on 12 individually manufactured surfaces, with minimal chip-to-chip variation. These nanoimprinted localized surface plasmon resonance (LSPR) chips were extensively tested on their ability to reliably measure a bioanalyte at concentrations varying from 2.5 to 75 ng/mL amidst the background of a complex biofluid-in this case, human serum. The high fidelity of NIL enables the generation of large sensing areas, which in turn eliminates the need for a microscope, as this biosensor can be easily interfaced with a commonly available laboratory light source. These biosensors can detect cardiac troponin in serum with a high sensitivity, at a limit of detection (LOD) of 0.55 ng/mL, which is clinically relevant. They also show low chip-to-chip variance (due to the high quality of the fabrication process). The results are commensurable with widely used enzyme-linked immunosorbent assay (ELISA)-based assays, but the technique retains the advantages of an LSPR-based sensing platform (i.e., amenability to miniaturization and multiplexing, making it more feasible for POC applications).

This work describes a nanoimprinting lithography method to fabricate high-quality sensing arrays that work on the principle of extraordinary optical transmission. The biosensor is low-cost, robust, easy to use, and can detect cardiac troponin I in serum at clinically relevant concentrations (99th percentile cutoff &#8764;10-400 pg/mL, depending on the assay).

For a biosensing platform to have clinical relevance in point-of-care (POC) settings, assay sensitivity, reproducibility, and ability to reliably monitor ...

Assessing Collagen and Elastin Pressure-dependent Microarchitectures in Live, Human Resistance Arteries by Label-free Fluorescence Microscopy

The pathogenic contribution of resistance artery remodeling is documented in essential hypertension, diabetes and the metabolic syndrome. Investigations and development of microstructurally motivated mathematical models for understanding the mechanical properties of human resistance arteries in health and disease have the potential to aid understanding how disease and medical treatments affect the human microcirculation. To develop these mathematical models, it is essential to decipher the relationship between the mechanical and microarchitectural properties of the microvascular wall. In this work, we describe an ex vivo method for passive mechanical testing and simultaneous label-free three-dimensional imaging of the microarchitecture of elastin and collagen in the arterial wall of isolated human resistance arteries. The imaging protocol can be applied to resistance arteries of any species of interest. Image analyses are described for quantifying i) pressure-induced changes in internal elastic lamina branching angles and adventitial collagen straightness using Fiji and ii) collagen and elastin volume densities determined using Ilastik software. Preferably all mechanical and imaging measurements are performed on live, perfused arteries, however, an alternative approach using standard video-microscopy pressure myography in combination with post-fixation imaging of re-pressurized vessels is discussed. This alternative method provides users with different options for analysis approaches. The inclusion of the mechanical and imaging data in mathematical models of the arterial wall mechanics is discussed, and future development and additions to the protocol are proposed.

We describe simultaneous mechanical testing and 3D-imaging of the arterial wall of isolated, live human resistance arteries, and Fiji and Ilastik image analyses for the quantification of elastin and collagen spatial organization and volume densities. We discuss the use of these data in mathematical models of arterial wall mechanics.

The pathogenic contribution of resistance artery remodeling is documented in essential hypertension, diabetes and the metabolic syndrome. Investigations ...

Protocol for MicroRNA Transfer into Adult Bone Marrow-derived Hematopoietic Stem Cells to Enable Cell Engineering Combined with Magnetic Targeting

While CD133+ hematopoietic stem cells (SCs) have been proven to provide high potential in the field of regenerative medicine, their low retention rates after injection into injured tissues as well as the observed massive cell death rates lead to very restricted therapeutic effects. To overcome these limitations, we sought to establish a non-viral based protocol for suitable cell engineering prior to their administration. The modification of human CD133+ expressing SCs using microRNA (miR) loaded magnetic polyplexes was addressed with respect to uptake efficiency and safety as well as the targeting potential of the cells. Relying on our protocol, we can achieve high miR uptake rates of 80&#8211;90% while the CD133+ stem cell properties remain unaffected. Moreover, these modified cells offer the option of magnetic targeting. We describe here a safe and highly efficient procedure for the modification of CD133+ SCs. We expect this approach to provide a standard technology for optimization of therapeutic stem cell effects and for monitoring of the administered cell product via magnetic resonance imaging (MRI).

This protocol illustrates a safe and efficient procedure to modify CD133+ hematopoietic stem cells. The presented non-viral, magnetic polyplex-based approach may provide a basis for the optimization of therapeutic stem cell effects as well as for monitoring the administered cell product via magnetic resonance imaging.

While CD133+ hematopoietic stem cells (SCs) have been proven to provide high potential in the field of regenerative medicine, their low retention rates ...

A Net Mold-based Method of Scaffold-free Three-Dimensional Cardiac Tissue Creation

This protocol describes a novel and easy net mold-based method to create three-dimensional (3-D) cardiac tissues without additional scaffold material. Human-induced pluripotent stem-cell-derived cardiomyocytes (iPSC-CMs), human cardiac fibroblasts (HCFs), and human umbilical vein endothelial cells (HUVECs) are isolated and used to generate a cell suspension with 70% iPSC-CMs, 15% HCFs, and 15% HUVECs. They are co-cultured in an ultra-low attachment "hanging drop" system, which contains micropores for condensing hundreds of spheroids at one time. The cells aggregate and spontaneously form beating spheroids after 3 days of co-culture. The spheroids are harvested, seeded into a novel mold cavity, and cultured on a shaker in the incubator. The spheroids become a mature functional tissue approximately 7 days after seeding. The resultant multilayered tissues consist of fused spheroids with satisfactory structural integrity and synchronous beating behavior. This new method has promising potential as a reproducible and cost-effective method to create engineered tissues for the treatment of heart failure in the future.

This protocol describes a net mold-based method to create three-dimensional scaffold-free cardiac tissues with satisfactory structural integrity and synchronous beating behavior.

This protocol describes a novel and easy net mold-based method to create three-dimensional (3-D) cardiac tissues without additional scaffold material. ...

Optical Imaging of Isolated Murine Ventricular Myocytes

The ability to isolate adult cardiac myocytes has permitted researchers to study a variety of cardiac pathologies at the single cell level. While advances in calcium sensitive dyes have permitted the robust optical recording of single cell calcium dynamics, recording of robust transmembrane optical voltage signals has remained difficult. Arguably, this is because of the low single to noise ratio, phototoxicity, and photobleaching of traditional potentiometric dyes. Therefore, single cell voltage measurements have long been confined to the patch clamp technique which while the gold standard, is technically demanding and low throughput. However, with the development of novel potentiometric dyes, large, fast optical responses to changes in voltage can be obtained with little to no phototoxicity and photobleaching. This protocol describes in detail how to isolate adult murine myocytes which can be used for cellular shortening, calcium, and optical voltage measurements. Specifically, the protocol describes how to use a ratiometric calcium dye, a single-excitation calcium dye, and a single excitation voltage dye. This approach can be used to assess the cardiotoxicity and arrhythmogenicity of various chemical agents. While phototoxicity is still an issue at the single cell level, methodology is discussed on how to reduce it.

We present the methodology for the isolation of murine myocytes and how to obtain voltage or calcium traces simultaneously with sarcomere shortening traces using fluorescence photometry with simultaneous digital cell geometry measurements.

The ability to isolate adult cardiac myocytes has permitted researchers to study a variety of cardiac pathologies at the single cell level. While advances ...

Fabrication of 3D Cardiac Microtissue Arrays using Human iPSC-Derived Cardiomyocytes, Cardiac Fibroblasts, and Endothelial Cells

Generation of human cardiomyocytes (CMs), cardiac fibroblasts (CFs), and endothelial cells (ECs) from induced pluripotent stem cells (iPSCs) has provided a unique opportunity to study the complex interplay among different cardiovascular cell types that drives tissue development and disease. In the area of cardiac tissue models, several sophisticated three-dimensional (3D) approaches use induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) to mimic physiological relevance and native tissue environment with a combination of extracellular matrices and crosslinkers. However, these systems are complex to fabricate without microfabrication expertise and require several weeks to self-assemble. Most importantly, many of these systems lack vascular cells and cardiac fibroblasts that make up over 60% of the nonmyocytes in the human heart. Here we describe the derivation of all three cardiac cell types from iPSCs to fabricate cardiac microtissues. This facile replica molding technique allows cardiac microtissue culture in standard multi-well cell culture plates for several weeks. The platform allows user-defined control over microtissue sizes based on initial seeding density and requires less than 3 days for self-assembly to achieve observable cardiac microtissue contractions. Furthermore, the cardiac microtissues can be easily digested while maintaining high cell viability for single-cell interrogation with the use of flow cytometry and single-cell RNA sequencing (scRNA-seq). We envision that this in vitro model of cardiac microtissues will help accelerate validation studies in drug discovery and disease modeling.

Here, we describe an easy-to-use methodology to generate 3D self-assembled cardiac microtissue arrays composed of pre-differentiated human-induced pluripotent stem cell-derived cardiomyocytes, cardiac fibroblasts, and endothelial cells. This user-friendly and low cell requiring technique to generate cardiac microtissues can be implemented for disease modeling and early stages of drug development.

Generation of human cardiomyocytes (CMs), cardiac fibroblasts (CFs), and endothelial cells (ECs) from induced pluripotent stem cells (iPSCs) has provided ...

Developing 3D Organized Human Cardiac Tissue within a Microfluidic Platform

The leading cause of death worldwide persists as cardiovascular disease (CVD). However, modeling the physiological and biological complexity of the heart muscle, the myocardium, is notoriously difficult to accomplish in vitro. Mainly, obstacles lie in the need for human cardiomyocytes (CMs) that are either adult or exhibit adult-like phenotypes and can successfully replicate the myocardium&#39;s cellular complexity and intricate 3D architecture. Unfortunately, due to ethical concerns and lack of available primary patient-derived human cardiac tissue, combined with the minimal proliferation of CMs, the sourcing of viable human CMs has been a limiting step for cardiac tissue engineering. To this end, most research has transitioned toward cardiac differentiation of human induced pluripotent stem cells (hiPSCs) as the primary source of human CMs, resulting in the wide incorporation of hiPSC-CMs within in vitro assays for cardiac tissue modeling.
Here in this work, we demonstrate a protocol for developing a 3D mature stem cell-derived human cardiac tissue within a microfluidic device. We specifically explain and visually demonstrate the production of a 3D in vitro anisotropic cardiac tissue-on-a-chip model from hiPSC-derived CMs. We primarily describe a purification protocol to select for CMs, the co-culture of cells with a defined ratio via mixing CMs with human CFs (hCFs), and suspension of this co-culture within the collagen-based hydrogel. We further demonstrate the injection of the cell-laden hydrogel within our well-defined microfluidic device, embedded with staggered elliptical microposts that serve as surface topography to induce a high degree of alignment of the surrounding cells and the hydrogel matrix, mimicking the architecture of the native myocardium. We envision that the proposed 3D anisotropic cardiac tissue-on-chip model is suitable for fundamental biology studies, disease modeling, and, through its use as a screening tool, pharmaceutical testing.

The goal of this protocol is to explain and demonstrate the development of a three-dimensional (3D) microfluidic model of highly aligned human cardiac tissue, composed of stem cell-derived cardiomyocytes co-cultured with cardiac fibroblasts (CFs) within a biomimetic, collagen-based hydrogel, for applications in cardiac tissue engineering, drug screening, and disease modeling.

The leading cause of death worldwide persists as cardiovascular disease (CVD). However, modeling the physiological and biological complexity of the heart ...