Hu PF, Bai LY, Zhao M, Ma KY, Xuan LY, Qi X. Landiolol modulates sodium 1.5 ion and connexin-43 to reduce sepsis ventricular arrhythmias. World J Cardiol 2026; 18(3): 117821 [DOI: 10.4330/wjc.v18.i3.117821]
Corresponding Author of This Article
Xin Qi, Chief Physician, Department of Cardiology, Tianjin Union Medicine Center, The First Affiliated Hospital of Nankai University, No. 190 Jieyuan Road, Hongqiao District, Tianjin 300121, China. qixinx2011@126.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Basic Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 26, 2026 (publication date) through Mar 23, 2026
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Journal Information of This Article
Publication Name
World Journal of Cardiology
ISSN
1949-8462
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Hu PF, Bai LY, Zhao M, Ma KY, Xuan LY, Qi X. Landiolol modulates sodium 1.5 ion and connexin-43 to reduce sepsis ventricular arrhythmias. World J Cardiol 2026; 18(3): 117821 [DOI: 10.4330/wjc.v18.i3.117821]
Peng-Fei Hu, School of Graduate Studies, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
Peng-Fei Hu, Department of Cardiology, Affiliated Hospital of Inner Mongolia Minzu University, Tongliao 028000, Inner Mongolia Autonomous Region, China
Ling-Yu Bai, Ming Zhao, Kui-Ying Ma, Department of Cardiovascular Medicine, Affiliated Hospital of Inner Mongolia Minzu University, Tongliao 028000, Inner Mongolia Autonomous Region, China
Li-Ying Xuan, School of Medicine, Inner Mongolia Minzu University, Tongliao 028000, Inner Mongolia Autonomous Region, China
Xin Qi, Department of Cardiology, Tianjin Union Medicine Center, The First Affiliated Hospital of Nankai University, Tianjin 300121, China
Co-first authors: Peng-Fei Hu and Ling-Yu Bai.
Author contributions: Hu PF and Bai LY conducted the research, formal analysis, and writing - original draft and they contributed equally to this manuscript and are co-first authors; Zhao M and Ma KY conducted the investigation, conceptualization, and methodology; Xuan LY conducted data curation and formal analysis; Qi X designed the research, and contributed to formal analysis, project administration and writing - review and editing. All authors have read and approved the final version to be published.
Supported by Inner Mongolia Natural Science Foundation Project of China, No. 2020MS08031, No. 2021MS08069, and No. 2023 LHMS08082; and Education Institutions in Inner Mongolia Autonomous Region of China, No. NJZY22456.
Institutional animal care and use committee statement: All animal procedures followed the guidelines of the Medical Ethics Committee of Affiliated Hospital of Inner Mongolia Minzu University (No. NM-LL-2024-04-01-04).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Data sharing statement: The author stated that the data of this study can be obtained by contacting the corresponding author under reasonable circumstances.
Corresponding author: Xin Qi, Chief Physician, Department of Cardiology, Tianjin Union Medicine Center, The First Affiliated Hospital of Nankai University, No. 190 Jieyuan Road, Hongqiao District, Tianjin 300121, China. qixinx2011@126.com
Received: December 17, 2025 Revised: January 4, 2026 Accepted: February 9, 2026 Published online: March 26, 2026 Processing time: 96 Days and 17 Hours
Abstract
BACKGROUND
Ventricular arrhythmias in sepsis are life-threatening, and the development of effective treatment is urgent. Landiolol can treat these arrhythmias, and understanding its mechanism is vital for treatment optimization.
AIM
To investigate the electrophysiological effects of landiolol on sepsis rats’ ventricular myocytes and reveal its mechanisms in treating sepsis-induced arrhythmias.
METHODS
Thirty-two Sprague-Dawley male rats aged 6-8 weeks were randomly selected. The control group underwent a sham operation, the sepsis model group underwent cecal ligation puncture, and the sepsis + landiolol group was given a single dose of landiolol, whose total dose is the minimum dose of 0.02 mg/kg/minute × 60 minutes × 24 hours. After 24 hours, tumor necrosis factor-alpha/interleukin-6 levels, electrophysiological changes, pathological changes, connexin-43 (Cx43), and sodium 1.5 ion (Nav1.5) expression were assessed. Data were recorded in Excel and analyzed with SPSS 27.0. One-way analysis of variance was used for multi-group comparisons, and the Bonferroni method was applied for pairwise comparisons.
RESULTS
Sepsis rats demonstrated elevated tumor necrosis factor-alpha and interleukin-6 levels, whereas these levels were reduced in rats treated with landiolol. The control group showed intact myocardial structure, whereas nuclear shrinkage and ventricular muscle tissue disorganization were observed in the sepsis group, with improvements observed in the landiolol group. Immunofluorescence staining showed myocardial fiber proliferation in the sepsis group, which was reduced in the landiolol group. Electrical mapping experiments showed accelerated conduction velocity and increased dispersion in the sepsis group, which was reversed in the landiolol group. Immunohistochemistry and western blot showed increased Cx43 and Nav1.5 channel expression in the sepsis group, which was decreased in the landiolol group.
CONCLUSION
Landiolol reduces ventricular arrhythmias in sepsis rats partly by decreasing Cx43 and Nav1.5 channel expression in the ventricular myocardium.
Core Tip: Landiolol, a beta-blocker, can treat ventricular arrhythmias caused by sepsis. In this study, a rat sepsis model was first established, and the animals then received landiolol. Cardiac electrophysiological experiments and ultrastructural observations of the myocardium were conducted to clarify the electrophysiological effects and mechanisms of landiolol on ventricular myocytes in septic rats. It showed that landiolol could reduce the occurrence of ventricular arrhythmias in sepsis rats through inhibiting inflammatory cells, reducing myocardial fibrosis, reversing ventricular remodeling, and decreasing the expression of connexin-43 and sodium 1.5 ion.
