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Frontiers in Physiology

○ Frontiers Media SA

Preprints posted in the last 90 days, ranked by how well they match Frontiers in Physiology's content profile, based on 106 papers previously published here. The average preprint has a 0.10% match score for this journal, so anything above that is already an above-average fit.

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Shape Analysis of Coronary Flow Waveforms using Singular Value Decomposition

Sturgess, V. E.; Schenk, N. A.; Ziegele, J. W.; Essajee, S. I.; Tune, J. D.; Rajapakse, I.; Figueroa, C. A.; Beard, D. A.

2026-08-31 physiology 10.64898/2026.08.26.743980 medRxiv
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Coronary flow waveforms have a distinct diastolic-dominant shape with periods of low or retrograde flow during systole. While the general waveform shape has been attributed to complex interactions between cardiac and vascular mechanics, there is limited research into the variability in coronary flow waveforms and what this variability may reveal about cardiac function. This work presents a shape analysis of left anterior descending artery (LAD) flow waveforms using Fourier transforms and Singular Value Decomposition (SVD) performed on baseline data collected from 32 pigs. Pigs included in the study reflect two breeds (Ossabaw and Yorkshire) and three different experimental conditions (lean-control, lean-paced, and obese-paced). Fourier transforms were used to decompose the waveforms into 15 harmonics for each pig. An SVD analysis is then used to extract temporal patterns of the waveforms. Correlations between pig-specific coefficients for the SVD modes and clinical metrics were used to investigate physiological explanations of LAD waveform variability. Temporal LAD flow patterns of the second SVD mode are significantly correlated with heart rate. The third SVD mode significantly correlates with mean blood pressure and maximum hyperemic flow. Furthermore, the fourth SVD mode is weakly correlated with left-ventricular end diastolic pressure and endocardial-epicardial flow ratios. This work demonstrates that LAD flow waveforms can be broken down into temporal patterns that correlate with physiological features. Furthermore, this shape-analysis method allows for waveform reconstruction and simplifies visualization of the temporal patterns identified using SVD, an advantage over existing methods that focus on characterizing flow waveforms by points of interest.

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Lognormal Neural Point Process Models for Interpretable Heartbeat Dynamics

Kumar, B. R.; Ramsundar, B.; Subramanian, S.

2026-08-20 physiology 10.64898/2026.08.12.744524 medRxiv
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Neural temporal point processes (NTPPs) are powerful tools for modeling sequences of timestamped events with statistical temporal structure. Density-based NTPPs, in particular, are an interesting opportunity to merge the universal function approximation capability of neural networks with a defined statistical model in a way that has many potential applications. We demonstrate one such application to heartbeat dynamics, a physiologic point process. We specifically apply a lognormal mixture NTPP to compute instantaneous estimates of the mean and standard deviation of beat-to-beat intervals. We compare our results to the state of art (Barbieri et al.) point process model for heartbeat dynamics, which uses a more physiologically rigorous inverse Gaussian model. We find that the NTPP model maintains reasonable accuracy while improving upon robustness to noise.

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Precision Insulin-Pump Calibration and Optimal Insulin Delivery to Improve Blood Glucose Levels

Aganj, I.; Bryant, N.; (Morgan) Panaro, L.; Caravan, P. D.; Gaglia, J. L.; Fischl, B. R.

2026-07-28 endocrinology 10.64898/2026.07.27.26359073 medRxiv
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The successful management of type-1 diabetes (T1D) and insulin-dependent type-2 diabetes depends on the ability to accurately calibrate bolus and basal insulin doses, and minimize the time spent with high postprandial blood glucose (BG) levels while avoiding dangerously low hypoglycemic excursions. Precise calibration of the insulin pump helps with successful disease management; however, people with T1D may still experience prolonged, potentially damaging BG levels due to postprandial highs. Insulin pumps offer large, currently underexploited degrees of freedom in insulin delivery, which can have a dramatic impact on average postprandial BG levels. Building on existing models of the glucose-insulin system, we first propose a simple, automated, and individualized insulin-pump calibration system based on a series of measures taken before and a few hours after carbohydrate ingestion. We then modulate the shape of pre-meal insulin dosing to explicitly reduce postprandial BG levels while minimizing the likelihood of dangerously low BG. Such an optimal insulin delivery time course can potentially improve postprandial BG levels and rapidly bring BG to the target level. We evaluated our methods in 20 patients over 4 days, with BG levels sampled frequently.

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Computational Evaluation of a Turbulence-like Electrical Activity Hypothesis in Atrial Fibrillation: Substrate Remodeling, Critical Wavelength Transition, and Multi-wavelet Maintenance

Chu, X.; Qiao, Q.; Xu, J.; Wang, X.; Li, M.-M.; Jiang, C.-X.; Tang, R.-B.; Liu, T.; Zhao, X.; Ye, H.; Xu, Z.; Han, K.; Fu, B.; Long, D.-Y.

2026-08-10 cardiovascular medicine 10.64898/2026.08.08.26360016 medRxiv
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BACKGROUND: Atrial fibrillation (AF) remains difficult to explain using a single focal driver or rotor-centered mechanism across disease stages. We tested whether progressive atrial substrate remodeling can drive a critical transition toward turbulence-like, decentralized multi wavelet electrical activity. METHODS: We constructed a controlled two-dimensional atrial reaction-diffusion model with six graded substrate-remodeling stages. We evaluated effective wavelength, theoretical wavelet capacity, AF inducibility, vulnerable-window dynamics, spatial randomness, temporal memory, spectral dispersion, nonlinear indices, virtual ablation response and ERP-prolongation reverse mechanistic testing. RESULTS: Progressive remodeling shortened effective wavelength from 12.0 to 2.4 cm and increased theoretical wavelet capacity from 0.69 to 17.36. Inducibility rose sigmoidally as wavelength shortened, with a model-derived transition near lambda50=4.5 cm. Advanced substrates showed increased wavebreak, spatial randomness, short-memory dynamics, broad spectral dispersion, positive nonlinear indices and resistance to random local ablation. Culprit atrial premature beats within the vulnerable window efficiently triggered AF, whereas counter pacing at 20 to 35 ms reduced inducibility from 52% to 11% in stage 2. CONCLUSIONS: In this controlled model, AF initiation and maintenance were linked to substrate-dependent wavelength, wavelet capacity and vulnerable-window triggering. The model-derived transition provides a testable framework for future high-density mapping, patient30 specific modeling and device-based studies. Key Words atrial fibrillation; turbulence-like electrical activity; substrate remodeling; critical wavelength; multi-wavelet re-entry; vulnerable window; culprit premature atrial beat; counter pacing

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A Computational Model of Oxidative Stress in a Human Ventricular Myocyte

Zukowski, H. M.; Hernandez Hernandez, G.; Yang, P.-C.; Clancy, C. E.

2026-09-23 physiology 10.64898/2026.09.17.752441 medRxiv
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Mitochondrial reactive oxygen species (ROS) are implicated in cardiac dysfunction, but complex dynamic interactions between ROS, intracellular calcium, and electrophysiology make it difficult to resolve mechanisms experimentally. We developed the Zukowski excitation-contraction-mitochondrial-ROS (ECM-ROS) model, a computational model that couples human ventricular electrophysiology with mitochondrial calcium handling, energetics, ROS production, and ROS dependent modulation of the ryanodine receptor, SERCA, L-type calcium current, and late sodium current. Model predictions were evaluated against independent experimental measurements of ROS induced changes in action potential duration and intracellular calcium. We then used the model to characterize ROS calcium feedback across physiological pacing rates and applied it to doxorubicin induced oxidative stress. Increasing cytosolic calcium produced nonlinear amplification of mitochondrial activity and cytosolic ROS, with greater amplification at faster pacing rates. Moderate ROS elevation initially enhanced calcium release, whereas greater oxidative stress depleted sarcoplasmic reticulum calcium stores. During simulated doxorubicin exposure, faster pacing lowered the level of oxidative stress required to produce calcium dysregulation and action potential prolongation. Mitochondrial ROS and calcium accumulation preceded detectable electrophysiological remodeling. In populations incorporating variability in ion channel expression, neither doxorubicin induced oxidative stress nor subtle pharmacological IKr block alone produced early afterdepolarizations. However, early afterdepolarizations were predicted to emerge with combined perturbations. These findings establish a computational framework for investigating bidirectional coupling among mitochondrial function, ROS, calcium handling, and human cardiac electrophysiology. The model generates testable predictions regarding the early detection of oxidative cardiac injury and the physiological conditions that increase susceptibility to arrhythmia.

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Muse 2 forehead photoplethysmography agrees with Polar H10 for heart rate but overestimates ultra-short RMSSD

Griadhi, I. P. A.; Suadnyana, I. A. A.; Wahyuni, N.

2026-10-08 sports medicine 10.64898/2026.10.05.26364782 medRxiv
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The Muse 2 EEG headset also records forehead photoplethysmography (PPG). We tested whether its pulse intervals can replace Polar H10 RR intervals for ultra-short heart-rate variability in 28 seated recordings (60 s eyes open, then 60 s eyes closed), using fixed processing, no exclusions and eleven sensitivity analyses. Mean heart rate agreed almost perfectly (ICC [≥] 0.999; bias -0.22 and 0.00 beats min-1). SDNN agreement was good to excellent (ICC 0.86 and 0.91; bias +8.6 and +8.2 ms). RMSSD agreement was moderate (ICC 0.60): Muse exceeded Polar in at least 27 of 28 sessions (bias +19.2 and +18.5 ms; about 1.9-fold), and the ratio bias fell as RMSSD rose. Interval differences (SD 23 ms) implied about 16 ms of independent timing error per pulse, which reproduced the RMSSD bias; without ECG, sensor jitter could not be separated from variation in pulse transit time. Tracking of the eyes-closed change in ln RMSSD was not demonstrated ({rho} = 0.35, 95% CI -0.07 to 0.67; detectable {rho} [≥] 0.51). Muse 2 PPG can supply mean heart rate and, with a stated bias, SDNN; its ultra-short RMSSD is not interchangeable with Polar RMSSD and should be reported as pulse-rate variability.

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Evaluating Temporal Orders for Local Non-Stationary Biological Signals Analysis: A Python Framework and Simulation Study

Mlynczak, M.; Rosol, M.; Korzeniewski, K.; Gasior, J. S.

2026-07-29 physiology 10.64898/2026.07.26.740785 medRxiv
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Background and ObjectiveAccurately parameterizing dynamic, time-varying interactions in physiological systems is a methodological challenge, as global causal discovery methods may obscure transient, local fluctuations. This study introduces tempord, an open-source Python library designed to estimate local temporal orders and evaluate the short-term stability, directionality, and strength of causal links in non-stationary biological signals. MethodsThe algorithm estimates temporal relationships by keeping one signal stationary while iteratively shifting another one within a sliding window. To parameterize optimal inter-signal shifts (causal vector, CV), the framework utilizes linear modeling or time series distance metrics. The methodology was validated through a simulation study on synthetic bivariate signals with mathematically imposed dynamic phase delays, under both deterministic and noisy conditions. Furthermore, in-vivo capabilities were demonstrated by evaluating cardiorespiratory coupling dynamics across spontaneous and music-induced relaxation breathing states. ResultsThe simulation study demonstrated that the extracted CV trajectories precisely aligned with ground-truth temporal delays, assessed using mean absolute error and root mean square error for both noise-free and noisy synthetic data. In-vivo application demonstrated dynamic temporal stability and the detection of minor step changes during autonomic nervous system state transitions. ConclusionsThe tempord Python package bridges the gap between global causal discovery and local beat-by-beat statistical parameterization. It provides a robust "bottom-up" analytical instrument for investigating the transient mechanisms governing complex biological networks.

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Sympathetic activation and the force-frequency relationship in heart failure with reduced ejection fraction

Straw, S.; Gupta, A.; Bretheron, B.; Cole, C. A.; Brown, O. I.; Kamalathasan, S.; Drozd, M.; Lowry, J. E.; Corrigan, J.; Paton, M. F.; Burgess, R.; Kearney, M. T.; Cubbon, R. M.; Witte, K. K.; Gierula, J.

2026-09-01 physiology 10.64898/2026.08.24.746885 medRxiv
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Background Limited heart rate rise contributes to reduced exercise tolerance for people who have heart failure with reduced ejection fraction (HFrEF), yet rate-adaptive pacing does not improve functional capacity due to an attenuated force-frequency relationship (FFR). How the FFR relates to total peripheral resistance and sympathetic tone in HFrEF is unknown. Methods In a prospective, observational study, participants with HFrEF and controls underwent an incremental pacing protocol, during which heart rate was increased from 50 to 140 beats per minute. At each heart rate increment LV contractility was measured by echocardiography to determine the FFR, as well as continuous beat-to-beat measurement of systolic and diastolic blood pressures with a plethysmography device to determine cardiac output, total peripheral resistance and blood pressure variability (BPV). A microneurography study was then conducted to measure muscle sympathetic nerve activity (MSNA) during incremental pacing. Results A total of 157 participants with HFrEF and 55 controls (mean age 71.1{+/-}1.4 years, 172 (81.1%) male) underwent the pacing protocol. We observed single units in seven of 11 participants who participated in the microneurography study. In both groups, LV contractility and cardiac output increased until the peak of the FFR, after which these declined. We observed a reduction in total peripheral resistance, blood pressure variability, MSNA frequency and incidence coinciding with the peak of the FFR, beyond which these increased. Whilst these relationships were present in both groups, they were more evident in participants with HFrEF. Conclusions For people with HFrEF there is a bidirectional relationship between heart rate and sympathetic activation, with a nadir of sympathetic tone occurring at the peak of the FFR. Both excessively low and high heart rates are accompanied by greater sympathetic activation. Taken together, these data suggest that optimal heart rate targets for HFrEF are likely to be individual.

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Thoracoabdominal pressure transmission during prone and supine cardiopulmonary resuscitation in fresh-frozen human cadavers

Smith, Z.; Lust, R.; Falyar, C.; Swanson, M.; Akintade, B.; Bolin, L.

2026-09-29 physiology 10.64898/2026.09.22.753658 medRxiv
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Background: Prone cardiopulmonary resuscitation (CPR) may be necessary when turning a prone patient supine would delay chest compressions. Although prone compressions can generate arterial pressures comparable with or greater than supine CPR, the pathway of pressure transmission is uncertain. We examined synchronized intrathoracic, intra-abdominal, and central arterial pressures in both supine and prone positions. Methods: Two thawed fresh-frozen adult cadavers underwent three, 2-minute mechanical CPR trials per position in a counterbalanced crossover sequence. Solid-state catheters recorded pleural, peritoneal, and central arterial pressures simultaneously. Trial-level outcomes included peak pressure, mean pressure, pressure-time area, and the mean peritoneal-to-pleural pressure gradient. Exploratory fixed-effects models included position, cadaver, and their interaction. Results: Prone CPR increased peak intrathoracic pressure by 7.04 mmHg, peak intra-abdominal pressure by 21.69 mmHg, and peak arterial pressure by 15.40 mmHg. Mean intra-abdominal and arterial pressures increased by 16.22 and 9.90 mmHg, respectively. The mean peritoneal-to-pleural gradient reversed direction from -8.46 mmHg supine to 4.85 mmHg prone. Intrathoracic pressure-time area increased 3.4-fold, from 1.62 to 5.46 mmHg{middle dot}s, and arterial pressure-time area increased 2.2-fold, from 2.96 to 6.42 mmHg{middle dot}s. Conclusions: Compared to supine, prone mechanical CPR generated higher arterial pressures and reversed the pressure relationship across the thoracoabdominal boundary in both cadavers. Higher abdominal pressure coincided with a larger intrathoracic pressure-time area, a pattern compatible with reduced caudal pressure dissipation.

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Temple PPG Morphology Demonstrates a Stronger Cardiovascular Age Signal Than Wrist Sites

Liu, D.; Dutta, A.; Nadig, S.

2026-08-24 physiology 10.64898/2026.08.19.745616 medRxiv
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The features of the PPG (photoplethysmography) morphology are known to reflect age-related cardiac and vascular changes. In most contemporary wearables, PPG signals are acquired from distal sites such as the wrist and finger. The superficial temporal artery (STA), accessible at the temple region, is reached via a shorter arterial path from the aortic root than the radial circulation, and may therefore carry hemodynamic and aging information with less distance-dependent attenuation. We hypothesized that the morphology of the PPG at temple region (STA) would show stronger and more numerous age correlates than the PPG at the wrist. To test this, we extracted a common set of 89 pulse-morphology features, spanning raw-waveform timing/amplitude/area measures, ratios among them, derivative-based ratios, and spectral harmonic-ratio features. We compared an in-house temple-worn device which has PPG as one of the sensors, with a publicly available Microsoft Aurora-BP wrist-worn PPG dataset, and tested each feature's association with age. We identified 14 robust age correlates at the temple region, compared to 3 at the wrist. The temple's correlates spanned multiple morphological categories and showed a larger age-association than at the wrist. These results support the hypothesis that the temple region may be a more robust PPG measurement site than the wrist to extract age-related cardiovascular information, which motivates further investigation of temple-based cardiovascular sensing.

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CADENCE: Open-source software for signal conditioning, feature extraction, visualization and analysis of cardiac optical mapping data

Aras, K.; Pandey, S.; Adelakun, A.; Minnella, E.; Lichtenberger, A.; Qadus, N.; Barnhart, L.

2026-10-08 physiology 10.64898/2026.09.30.755844 medRxiv
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Optical mapping is a fundamental tool for cardiac electrophysiology research. Processing of these signals can be non-trivial, requiring multiple pre- and post-processing steps to limit interpretation errors. Existing software packages have features siloed across platforms and require users to combine several packages for in-depth analysis. To address this, we developed CADENCE, an open-source MATLAB-based application combining feature breadth (e.g., SVD denoising, conduction velocity, alternans, annotated rotors) and depth (e.g., 15 independent alternans features across both voltage and calcium modalities) in an end-to-end pipeline including data conversion, signal conditioning, feature extraction, and signal analysis. We demonstrate CADENCE's capabilities across datasets spanning four species (rat, rabbit, pig, and human), three tissue preparations (slices, wedge, and whole heart), and three camera configurations (single, dual, and panoramic). CADENCE was validated against three blinded expert observers (15 hearts) and demonstrated agreement comparable to inter-observer variability (SD ratios 1.07/0.95/0.89 for APD80, activation, CaTD80). Dominant frequency was recovered with a median error of 0.03% across 84 of 88 paced recordings with 1:1 capture. CADENCE's code is publicly available and distributed as a compiled standalone application that the end-user can install and run without a MATLAB license to encourage adoption and standardization across laboratories.

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Plethysmometry: an automated cuff-based method for estimating ranges of systolic, diastolic and mean arterial pressures

Gangadharan, N.; Baskaran, B.; Manavalan, A.; Praveenkumar, M.; Anandhakumar, M.; Jebaraj, B.; Devasahayam, S.; Subramani, S.

2026-10-02 cardiovascular medicine 10.64898/2026.10.01.26364471 medRxiv
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Abstract Background: Conventional cuff based methods report single systolic and diastolic pressure values and depend either on Korotkoff sounds or on empirical oscillometric algorithms. Methods: We developed a patented cuff based method, termed plethysmometry, that simultaneously records cuff pressure and finger photoplethysmograms from the cuffed and contralateral arms. The contralateral photoplethysmogram serves as an internal physiological reference for pulse amplitude. Following an initial pressure ramp, 16 cuff pressure plateaus are applied. Absolute and normalized pulse amplitudes in the cuffed arm are related to cuff pressure to estimate lower and upper systolic and diastolic pressures. Mean arterial pressure is estimated independently from cuff pressure oscillation amplitude. The estimations are done by automated algorithms developed in MATLAB. Results: The method reports lower and upper systolic, diastolic and mean arterial pressure ranges (during the recording period), together with their average values. Average pulse pressure is also reported. Graphs are provided for reference to check the accuracy of reported pressures. Conclusion: Plethysmometry provides an objective digital record of the cuff pressure and pulse traces and estimates systolic and diastolic pressure ranges from the pulse response of the individual subject to graded cuff pressure. It also reports mean arterial pressure. Comparison of plethysmometric systolic and diastolic pressures with sphygmomanometrically derived pressures and diagnostic agreement are reported in a companion paper.

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Prediction of Obstructive Sleep Apnea Using Variational Autoencoder-Derived Features From 12-Lead ECG

Harvey, C.; Gupta, A.; Halder, B.; Thompson, J.; Mishra, S.; Gratton, M. K.; Stevens, D.; Noheria, A.; Mazzotti, D. R.

2026-09-23 cardiovascular medicine 10.64898/2026.09.22.26363710 medRxiv
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BackgroundObstructive sleep apnea (OSA) is a highly prevalent sleep disorder. Major risk factors include obesity, older age, and male sex. Given the well-established association between OSA and cardiovascular disease, markers of cardiovascular health derived from electrocardiography (ECG) may help identify individuals with undiagnosed OSA. This study evaluated whether 12-lead ECG features improve machine learning-based prediction of OSA beyond established clinical factors. MethodsWe conducted a retrospective cohort study of individuals who underwent diagnostic sleep studies at the University of Kansas Health System Sleep Disorders Center (2004-2025) and had a 12-lead ECG acquired within one year. Standard ECG features (intervals, amplitudes, voltage-time integrals, morphology descriptors) were extracted from the representative beat. Latent representations were derived using two variational autoencoder (VAE) models pretrained on >1 million ECGs: a 30-dimensional representative-beat VAE and a 90-dimensional full 10-second ECG VAE. Three LightGBM models were trained: clinical factors only (age, sex, weight, height, body mass index [BMI], Epworth sleepiness scale [ESS]), ECG features only, and a combined model. Feature selection and hyperparameter tuning were performed separately for each model within a 5-fold cross-validation scheme. The outcome was moderate-to-severe OSA (AHI[≥]15 events/h), evaluated by AUROC (bootstrapped 95% CI) in a 10% holdout test set. ResultsThe dataset included 7,699 individuals (52.2% women, mean age 58.0 {+/-} 14.2 years, BMI 33.6{+/-}8.2 kg/m{superscript 2}, ESS 8.8{+/-}5.1; 36.4% with moderate-to-severe OSA) Training AUROC (95% CI) was 0.71 (0.66-0.76) for the combined model, versus 0.65 (0.59-0.70) for the clinical-only model and 0.66 (0.61-0.72) for the ECG-only model. Holdout test AUROC was 0.78 (combined), 0.69 (clinical-only), and 0.71 (ECG-only). Feature importance identified age, BMI, weight, ECG VAE latent variables, height, sex, and P-wave voltage-time integral as relevant contributor to the predictions. ConclusionsLatent ECG features extracted by VAE improve prediction of moderate-to-severe OSA when combined with clinical factors.

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A multiscale analysis of liver lobule fibrosis and its impact on drug propagation and metabolism - a DLA approach

Coombe, D.; Rezania, V.; Tuszynski, J.

2026-09-03 physiology 10.64898/2026.08.28.747748 medRxiv
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Employing DLA methods, this paper explores the self-assembly of collagen fibers and resulting fibrosis at three scales up to the scale of regular lobule models. This allows a mechanistic exploration of the effects of collagen on drug transport (flow and diffusion) and metabolism. In addition, this method permits an analysis of fiber growth characteristics. First, variations of the DLA method of Parkinson et al (1994) will be used to generate multiple explicit collagen microfibril self-assembly using DLA particles in one dimension using cubic grid blocks of (4 mm)3 in a 240 x 20 x 20 grid model. The second stage will be to assess the consequences of various densities of these fibers in three dimensions on flow reductions at a higher scale. Here we utilize DLA methods in cubic grid blocks of (80 nm)3 to mimic 3D collagen self-assembly of fibrils. We then apply a pressure gradient or specified flow rates across a spatially gridded version of these models to quantify flow effects. This region represents a local zone of liver tissue affected by fibrosis. Analytic models of fibrotic effects on flow are employed for comparison. A third stage explores the implications of fibrosis in a liver lobule model using multiple grid blocks of size 3200 mm to represent the lobule tissue. Here, a continuum model of fiber density is employed, based on the previous two scales. The model also includes the effects of additional grid blocks representing sinusoidal flow paths found in the lobule. We contrast and quantify drug propagation and metabolism of molecular dissolved versus nanoparticle delivery vehicles in fibrotic media, achieved by upscaling explicit collagen distributions to appropriate average values.

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Cholesterol-Mediated Modulation of Collecting Lymphatic Vessel Contractility: Exploring Cholesterol Depletion as a Therapeutic Alternative to Improve Lymphatic Function in Hypercholesterolemia

Keane, K.; Castorena-Gonzalez, J. A.

2026-08-10 physiology 10.64898/2026.08.04.742795 medRxiv
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Globally, hypercholesterolemia affects over 20% of the population; and while many studies have examined its impact on cardiovascular health, little is known about its effects on the lymphatic system. In mice, hypercholesterolemia has been linked to multiple aspects of lymphatic dysfunction; and a recent study demonstrated that cholesterol depletion by cyclodextrins promoted lymphatic vessel regeneration and restored lymphatic drainage in mouse models of lymphedema. Collecting lymphatic vessels rely on the spontaneous and highly entrained contractions of lymphatic muscle cells (LMCs) and competent unidirectional on-way valves to propel lymph forward. Critical to lymphatic pacemaking and contractility is the proper functioning of ion channels, which are known to be modulated by the cholesterol content in the plasma membrane. Therefore, we sought to understand the role cholesterol plays in regulating lymphatic contractility. The effects of cholesterol depletion by the cyclodextrins M{beta}CD and HP{beta}CD were assessed in cannulated and pressurized inguinal-axillary collecting lymphatic vessels (CLVs) from C57BL6/J (WT) mice. Noteworthy, studies have shown that HP{beta}CD is safe for human use, and in fact, it is commonly used as a drug excipient. Acute treatment with both cyclodextrins significantly increased the pumping capacity of CLVs, as demonstrated by the increased contraction amplitudes by [~]50{+/-}12% and calculated fluid volume displacement by each contraction by [~]35{+/-}11%. Calcium imaging demonstrated that HP{beta}CD increased the amplitude and duration of the large Cav1.2-mediated calcium events (termed calcium flashes. In contrast, cholesterol supplementation by incubation with BODIPY-cholesterol, which presumably incorporates cholesterol into the cell membrane, significantly impaired the contractile activity of CLVs compared to controls by decreasing contraction amplitude (control: 42{+/-}2 {micro}m versus BODIPY-cholesterol: 20{+/-}7{micro}m) and calculated fluid volume displacement (control: 9.2{+/-}3.9nL versus BODIPY cholesterol: 3.3{+/-}1.2nL) which were significantly restored with subsequent cholesterol depletion using HP{beta}CD (amplitude: 36{+/-}11{micro}m, volume displacement: 5.5{+/-}2.4nL). Similarly, treatment with HP{beta}CD significantly improved the contractile capacity of dysfunctional CLVs isolated from hypercholesterolemic ApoEKO mice. In conclusion, changes to cell membrane cholesterol content acutely and significantly altered CLV contractility with depletion improving contractility associated with recruitment of voltage-gated Cav1.2 channels in lymphatic muscle cells (LMCs). Future studies from our lab will determine whether pharmacological depletion of membrane cholesterol can be therapeutic strategy to improve and/or restore lymphatic contractile function in secondary lymphedema, including obesity/hypercholesterolemia-induced and cancer-related lymphedemas.

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Inotropic effects of 3-hydroxybutyrate in a rodent heart: pressure-volume and isolated rat ventricular trabeculae analysis

Kropacek, J.; Nguyen, T. T.; Hajkova, E.; Molnar, M.; Monzo, L.; Miklovic, M.; Melenovsky, V.

2026-09-21 physiology 10.64898/2026.09.15.751359 medRxiv
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An administration of 3 hydroxy-butyrate (3-OHB) in experimental animals or humans is associated with an increase of cardiac output (CO), but whether this hemodynamic benefit reflects direct myocardial inotropy or heart unloading due to peripheral vasodilation remains unclear. It is also unknown if myocardial effects are due to engagement of receptor-mediated inotropic response, or due to improvement of myocardial bioenergetics. To address these questions, we studied integrated cardiovascular response (pressure-volume analysis of the left ventricle) and isolated left ventricular (LV) trabeculae from normotensive male HanSD rats (age 20-30 weeks) after administration of 3-OHB (1 mmol/l) and drugs targeting adrenergic and cAMP-dependent signaling - metoprolol, adenylyl cyclase inhibitor 2,5-dideoxyadenosine and isoprenaline, during Tyrode solution perfusion and 1 Hz pacing. Pressure-volume analysis demonstrated increased left ventricular end-systolic elastance (+34%), improved ventriculo-arterial coupling (+65%) and increased LV efficiency (+28%), indicating direct inotropic effect of 3OHB. In isolated LV trabeculae, 3-OHB increased twitch force in both groups, but increase was greater in healthy hearts (+55.8%) than in the HF group (+35.6%) (p = 0.014). The inotropic effect of 3-OHB was not further augmented by coadministration of isoprenaline and was not attenuated by beta-1 adrenergic blockade or cAMP inhibition. Results suggest that 3-OHB directly improves LV inotropy and by a mechanism that is independent of receptor-mediated beta-adrenergic signaling, most consistent with a direct bioenergetic pathway. These findings support 3-OHB as a candidate inotropic agent with a mechanistic profile distinct from conventional cAMP-dependent inotropes.

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Methodologies for Manipulating Cardiomyocyte Physiology: In Vitro and In Vivo Perspectives

Yang, R.; Liu, D.-H.; Wang, D.-D.; Li, S.-M.; Liu, P.-P.; Li, S.-A.; Kang, J.-S.

2026-08-12 cell biology 10.64898/2026.08.11.744256 medRxiv
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Cardiac tissue is primarily made up of cardiomyocytes, which are regulated by the autonomic nervous system. We have used and developed approaches such as patch clamping and electrical stimulation-combined calcium imaging, computer modeling, optogenetics and chemogenetics combining with video-based Short-Time Fourier transformation (STFT) method to study the physiological activities of cardiomyocytes. The action potential of cardiomyocytes was found to be synchronized with calcium signals, which can be grouped into two categories by STFT. A mathematical model was developed to simulate the changes in electrical activities within cardiomyocytes caused by energy depletion, especially for 2-deoxy-D-glucose (2DG) treatment. Optogenetic and chemogenetics tools, such as ChR2(H134R), OptoXR-{beta}2AR and hM3Dq accelerated beating, while GR, ACR1 and hM4Di inhibited cardiomyocytes beating. A video-based STFT method was developed to visualize the beating frequency during these manipulations. An in vitro co-culture method was developed to study the relationship between sympathetic neuronal firing and calcium dynamics in cardiomyocytes. In vivo, electrocardiograph (ECG) measurements showed that Clozapine N-oxide (CNO) caused heart rates increasement in cTnT-hM3Dq virus injected mouse. However, it had no impact on cTnT-hM4Di virus injected mouse. This study provides comprehensive methodologies for studying cardiomyocyte physiology and manipulating heart rates in vitro and in vivo.

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The ACUte effects of SITting time on physiological and psychological function in older adults (ACUSIT): An observational cohort study

Agyapong-Badu, S.; Greig, C.; Bostock, E.; McGee, K. C.; Black, J.; Poses-Ferrer, E.; Jackson, T.; Welch, C.; Chastin, S. F.; Whittaker, A. C.; Skelton, D. A.

2026-09-09 public and global health 10.64898/2026.09.08.26362486 medRxiv
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Introduction: There is accumulating evidence supporting the longer-term detrimental health effects of prolonged bouts of sedentary behaviour (sitting). There is however limited data for acute doses of sitting in older adults. This study aimed to identify key physiological and psychological outcomes influenced by acute periods of inactivity. Methods: Using a randomised cross-over design, participants completed sitting times of 1, 2 and 4 hours on separate days at the same time of day, and were permitted to watch television, knit or read but not to sleep. The sitting times corresponded to a brief control period of sitting (1 hour (h)), moderately sedentary (2-4 h per day) and sedentary (>4 h per day). The primary outcome measure was lower limb power output using the Nottingham Power Rig (Watts (W)/kg). Secondary outcomes included a range of physiological and psychological measures. Assessments were made before and after each period of sitting time in a temperature-controlled room. Differences between the pre and post measurements across each session were analysed using repeated measures ANOVA with post-hoc comparisons to determine between condition differences. Results: Lower limb power output did not change significantly (p = 0.67) following the 1 h (pre: 1.44 {+/-} 0.6, post: 1.461 {+/-} 0.6 W/kg), 2 h (pre 1.42 {+/-} 0.7, post: 1.44 {+/-} 0.6 W/kg) and 4 h (pre: 1.47 {+/-} 0.7, post: 1.44 {+/-} 0.6 W/kg) sitting times. A significant increase in mean systolic and diastolic blood pressure was recorded following the 2h (systolic pre: 137 {+/-} 13, post: 141 {+/-} 6 mmHg; p<0.001; diastolic pre: 74 {+/-} 10, post 76 {+/-} 10mmHg; p<0.001) and 4 h sitting times (systolic pre 137 {+/-} 14, post 147 {+/-} 15 mmHg; p<0.001; diastolic pre 73 {+/-} 10, post 79 {+/-} 10 mmHg; p<0.001). Mean arterial pressure also significantly increased after the 2 h (pre: 95 {+/-} 10, post: 97 {+/-} 11 mmHg; p<0.001) and 4 h (pre: 95 {+/-} 10, post: 102 {+/-} 10 mmHg; p<0.001) periods of sitting. Timed Up & Go performance declined after all sessions of sitting (p=0.01) whereas Digit Symbol Substitution (DSS) scores (p=0.001) and % DSS correct scores (p<0.001) improved. Vitality declined across all sessions, but this was significantly worse after 4 h. Psychological outcome measure (Profile of Mood State; POMS) related to vigour and friendliness showed significant adverse changes across all sessions, although vigour was worst after 4 h sitting. Further, greater and negative fatigue changes were recorded after 2 and 4 h sitting compared to 1 h, with highest post-sitting values after 4 h. In a small subset of participants (n=13), significant increases in bladder volume comparing post with pre-sitting time were found across all 3 sitting periods (p<0.05), however these were not statistically significant. Conclusions: These data show that sitting for 2 h or more may have potentially deleterious effects on cardiovascular biomarkers including blood pressure, as well as increasing the risk of falling. Vitality, vigour and fatigue may also be adversely affected in older adults. These effects appear to increase with continuous sitting time.

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Basolateral localization of Kcnj15 in branchial ionocytes of the seawater pufferfish Takifugu rubripes

Sakamoto, Y.; Kato, A.

2026-09-12 physiology 10.64898/2026.09.05.749310 medRxiv
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In marine teleosts, gill ionocytes play central roles in the excretion of excess monovalent ions (Na+, Cl-, and K+). Basolateral K+ channels are considered essential for sustaining ion secretion by maintaining K+ homeostasis and membrane potential; however, the molecular identity of basolateral K+ channels in teleost gill ionocytes remains incompletely understood. Kcnj15 is a K+ channel expressed in multiple osmoregulatory tissues of the Japanese pufferfish (Takifugu rubripes), and its localization changes depending on tissue type and osmotic conditions; however, its localization in the gills has remained unresolved. Here, we determined the cellular localization of Kcnj15 in the gills and examined its expression in response to changes in environmental salinity. In seawater-acclimated fish, Kcnj15 was localized to the basolateral membrane of Nka- and Nkcc1-positive ionocytes. Following acclimation to hypoosmotic brackish water (1 ppt), transcript levels of cftr, nkcc1, and kcnj1a decreased, whereas kcnj15 expression remained unchanged. Under this condition, Kcnj15 was localized to the basolateral membrane of Nka-positive ionocytes. These results demonstrate that Kcnj15 is localized to the basolateral membrane of gill ionocytes and suggest that it may function as a basolateral K+ leak channel supporting ionocyte homeostasis under both seawater and low-salinity conditions.

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The circadian clock regulates KCNH2 (hERG) promoter activity through daily temperature rhythms.

Rozmus, E. R.; Stumpf, I. G.; Schneider, D. J.; Alimov, A.; Pierce, T. H.; Mirshahi, T.; Delisle, B. P.; Schroder, E. A.

2026-09-29 cell biology 10.64898/2026.09.28.751769 medRxiv
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Background: KCNH2 encodes Kv11.1 channel proteins that conduct the rapidly activating delayed-rectifier K+ current (IKr), which is critical for cardiac repolarization. KCNH2 encodes two functional isoforms, Kv11.1a and Kv11.1b, via alternative transcription start sites. Kv11.1a is the principal determinant of cardiac IKr and ventricular repolarization. The circadian clock, a transcriptional-translational feedback loop that cycles with a period of ~24 hours and drives the circadian expression of many genes, including Kcnh2 in the mouse heart. Because daily body temperature rhythms provide a systemic signal that synchronizes cardiac circadian clocks, we tested whether physiological temperature cycles drive the circadian promoter activity of the cloned human KCNH2 (hKCNH2) promoter. Hypothesis: hKCNH2 is a direct transcriptional target of the circadian clock, with temperature driving its promoter activity through BMAL1:CLOCK acting at a conserved tandem E-box. Methods: We cloned the conserved proximal promoter of KCNH2 (-1631 bp upstream of Kv11.1a exon 1) to generate hKCNH2 promoter luciferase reporter constructs. Constructs were transfected into C2C12 myotubes and synchronized by serum shock (static 37{degrees}C) or temperature cycling (36.5-38.5{degrees}C). Bioluminescence was recorded and assessed for period, phase, and amplitude. BMAL1:CLOCK dependence was tested via dominant-negative CLOCK{Delta}19 co-expression. Results: Temperature cycling did not exhibit the rapid damping characteristic of serum-shock-synchronized oscillations, consistent with continuous entrainment by an external zeitgeber rather than a free-running oscillator. Deletion analysis identified a conserved tandem E-box required for oscillation under both serum shock and temperature cycling, and for BMAL1:CLOCK-dependent transactivation (1.75 {+/-} 0.21 vs. 0.86 {+/-} 0.06 RLU, p = 0.0038). CLOCK{Delta}19 reduced hKCNH2 promoter amplitude under temperature cycling without altering period. Conclusion: The circadian clock regulates KCNH2 promoter activity through daily temperature rhythms.