Cardiac muscle-restricted partial loss of Nos1ap expression has limited impact on electro- and echo-cardiographic features

Genome-wide association studies (GWAS) of QT interval variation have identified common noncoding variants at the NOS1AP gene as the most common genetic regulators of trait variation in the general population. Invoking a cis -regulatory mechanistic hypothesis, we have reported identification of a functional enhancer variant underlying the GWAS signal that influenced human cardiac NOS1AP expression. Functional studies based on in vitro overexpression in murine cardiomyocytes and ex vivo knockdown in zebrafish embryonic hearts, by us and others, have demonstrated that NOS1AP expression levels can alter cellular electrophysiology. Here, to explore the role of NOS1AP in cardiac electrophysiology at an organismal level, we generated and characterized constitutive and heart muscle-restricted Nos1ap knockout mice to assess whether NOS1AP disruption alters the QT interval in vivo . Constitutive loss of Nos1ap led to genetic background-dependent variable lethality at or right before birth. Heart muscle-restricted Nos1ap knockouts generated using cardiac specific alpha-myosin heavy chain promoter-driven tamoxifen-inducible Cre resulted in tissue-level Nos1ap expression reduced by half. This partial loss of expression had no detectable effect on the QT interval, but led to a small yet significant reduction in the QRS interval. Given that challenges associated with defining the end of T wave on murine electrocardiogram can limit identification of subtle effects on QT interval, and that common noncoding NOS1AP variants are also associated with QRS interval, our findings support the role of NOS1AP in regulation of the cardiac electrical cycle.