Electro-metabolic coupling in multi-chambered vascularized human cardiac organoids

Mohammad Ghosheh, Avner Ehrlich, Konstantinos Ioannidis, Muneef Ayyash, Idit Goldfracht, Merav Cohen, Amit Fischer, Yoav Mintz, Lior Gepstein, Yaakov Nahmias

Research output: Contribution to journalArticlepeer-review


The study of cardiac physiology is hindered by physiological differences between humans and small-animal models. Here we report the generation of multi-chambered self-paced vascularized human cardiac organoids formed under anisotropic stress and their applicability to the study of cardiac arrhythmia. Sensors embedded in the cardiac organoids enabled the simultaneous measurement of oxygen uptake, extracellular field potentials and cardiac contraction at resolutions higher than 10 Hz. This microphysiological system revealed 1 Hz cardiac respiratory cycles that are coupled to the electrical rather than the mechanical activity of cardiomyocytes. This electro-mitochondrial coupling was driven by mitochondrial calcium oscillations driving respiration cycles. Pharmaceutical or genetic inhibition of this coupling results in arrhythmogenic behaviour. We show that the chemotherapeutic mitoxantrone induces arrhythmia through disruption of this pathway, a process that can be partially reversed by the co-administration of metformin. Our microphysiological cardiac systems may further facilitate the study of the mitochondrial dynamics of cardiac rhythms and advance our understanding of human cardiac physiology.

Original languageAmerican English
Pages (from-to)1493-1513
Number of pages21
JournalNature Biomedical Engineering
Issue number11
StatePublished - Nov 2023


  • Animals
  • Arrhythmias, Cardiac
  • Biochemical Phenomena
  • Humans
  • Myocardial Contraction/physiology
  • Myocytes, Cardiac/metabolism
  • Organoids

All Science Journal Classification (ASJC) codes

  • Bioengineering
  • Biotechnology
  • Biomedical Engineering
  • Medicine (miscellaneous)
  • Computer Science Applications


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