Journals / SDÜ Tıp Fakültesi Dergisi / 2026 / Cilt: 33 Sayı: 2

Electric Field-Induced Remodeling in Cardiac Tissue: Histopathological and BMP-2 Immunoreactivity Alterations Following High-Voltage Exposure in Rats

Zehra Küçüktepe(SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0009-0005-4485-5574
Mustafa Karabacak(SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0001-6879-5522
Halil Aşçı(SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-1545-035X
Selçuk Çömlekçi(SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0003-1389-6435
Özlem Özmen(BURDUR MEHMET AKİF ERSOY ÜNİVERSİTESİ, VETERİNER FAKÜLTESİ)0000-0002-1835-1082
Pages
136–144
Publication Date
2026-06-29
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These findings suggest BMP-2 may serve as an ear-ly biomarker of cardiac remodeling in electrically active environments or device interfaces, such as pacemaker implantation zones.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective The 10 kV/m electric field, with a repetition frequency of 50 Hz and unidirectional pulsed (DC), which is accepted as the biological interaction limit by the World Health Organization, can also have an effect on cardiac tissues. 10 kV/m electric field exposure (pulsed wave shape) is increasingly seen both in the workplace and clinically.
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Key Findings & Data:This study aimed to evaluate the structural and molecular responses of the heart to graded durations of 10 kV/m electric field (EF) exposure in rats.
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Conclusion & Impact:These findings suggest BMP-2 may serve as an ear-ly biomarker of cardiac remodeling in electrically active environments or device interfaces, such as pacemaker implantation zones.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:BMP-2 · Cardiac remodeling · Electric field

Abstract

Objective The 10 kV/m electric field, with a repetition frequency of 50 Hz and unidirectional pulsed (DC), which is accepted as the biological interaction limit by the World Health Organization, can also have an effect on cardiac tissues. 10 kV/m electric field exposure (pulsed wave shape) is increasingly seen both in the workplace and clinically. This study aimed to evaluate the structural and molecular responses of the heart to graded durations of 10 kV/m electric field (EF) exposure in rats. Material and Method Forty male Sprague-Dawley rats were randomly assigned to five groups (n = 8/group): control (0 min), and EF exposure for 1, 5, 15, or 30 minutes. Animals in the experimental groups were exposed to a pulsed electric field of 10 kV/m generated by a parallel-plate electrode system under standardized conditions.The pulses are unidirectional and have a repetition time of 20 ms (50 Hz). Hearts were harvested post-exposure and examined histopathologically. In addition, Bone Morphogenetic Protein-2 (BMP-2), vascular endothelial growth factor (VEGF), and fibroblast growth factor (FGF) immunohistochemical evaluation were performed, and immunopositivity was scored semi-quantitatively. Results Histopathological evaluation revealed intact myocardial architecture in control, 1-, 5-, and 15-minute groups. However, 30-minute EF exposure induced moderate hyperemia. Immunohistochemistry revealed minimal expression of BMP-2, VEGF, and FGF in early exposure groups, but BMP-2 showed focal upregulation in the 30 min group. VEGF and FGF remained unchanged. Conclusion Prolonged monophasic, high-intensity pulsed electric field exposure induces early signs of microvascular remodeling in cardiac tissue, reflected histologically by hyperemia and molecularly by increased BMP-2 expression. These findings suggest BMP-2 may serve as an ear-ly biomarker of cardiac remodeling in electrically active environments or device interfaces, such as pacemaker implantation zones.

Özet

Objective The 10 kV/m electric field, with a repetition frequency of 50 Hz and unidirectional pulsed (DC), which is accepted as the biological interaction limit by the World Health Organization, can also have an effect on cardiac tissues. 10 kV/m electric field exposure (pulsed wave shape) is increasingly seen both in the workplace and clinically. This study aimed to evaluate the structural and molecular responses of the heart to graded durations of 10 kV/m electric field (EF) exposure in rats. Material and Method Forty male Sprague-Dawley rats were randomly assigned to five groups (n = 8/group): control (0 min), and EF exposure for 1, 5, 15, or 30 minutes. Animals in the experimental groups were exposed to a pulsed electric field of 10 kV/m generated by a parallel-plate electrode system under standardized conditions.The pulses are unidirectional and have a repetition time of 20 ms (50 Hz). Hearts were harvested post-exposure and examined histopathologically. In addition, Bone Morphogenetic Protein-2 (BMP-2), vascular endothelial growth factor (VEGF), and fibroblast growth factor (FGF) immunohistochemical evaluation were performed, and immunopositivity was scored semi-quantitatively. Results Histopathological evaluation revealed intact myocardial architecture in control, 1-, 5-, and 15-minute groups. However, 30-minute EF exposure induced moderate hyperemia. Immunohistochemistry revealed minimal expression of BMP-2, VEGF, and FGF in early exposure groups, but BMP-2 showed focal upregulation in the 30 min group. VEGF and FGF remained unchanged. Conclusion Prolonged monophasic, high-intensity pulsed electric field exposure induces early signs of microvascular remodeling in cardiac tissue, reflected histologically by hyperemia and molecularly by increased BMP-2 expression. These findings suggest BMP-2 may serve as an ear-ly biomarker of cardiac remodeling in electrically active environments or device interfaces, such as pacemaker implantation zones.

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Cite This Article

Küçüktepe, Z., Karabacak, M., Aşçı, H., Çömlekçi, S., Özmen, Ö. (2026). Electric Field-Induced Remodeling in Cardiac Tissue: Histopathological and BMP-2 Immunoreactivity Alterations Following High-Voltage Exposure in Rats. SDÜ Tıp Fakültesi Dergisi, Cilt: 33 Sayı: 2, 136–144. https://doi.org/10.17343/sdutfd.1793054

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References (39)

  1. Quinn TA, Kohl P. Cardiac Mechano-Electric Coupling: Acute Effects of Mechanical Stimulation on Heart Rate and Rhythm. Physiol Rev. 2021 Jan 1;101(1):37-92. doi: 10.1152/physrev. 00036.2019. Epub 2020 May 7. PMID: 32380895.
  2. Ye Z, Li Y, Zhao Y, et al. Correction to "Effect of Exogenous Electric Stimulation on the Cardiac Tissue Function in Situ Monitored by Scanning Electrochemical Microscopy". Anal Chem 2023 Jun 6;95(22):8744-8745. doi: 10.1021/acs.analchem. 3c02009. Epub 2023 May 23. Erratum for: Anal Chem. 2023 Mar 14;95(10):4634-4643. doi: 10.1021/acs.analchem. 2c04758. PMID: 37220385.
  3. Katoh K. Effects of Electrical Stimulation of the Cell: Wound Healing, Cell Proliferation, Apoptosis, and Signal Transduction. Med Sci (Basel) 2023;11(1):11. doi: 10.3390/medsci11010011. PMID: 36810478; PMCID: PMC9944882.
  4. Bielfeldt M, Rebl H, Peters K, et al. Sensing of physical factors by cells: electric field, mechanical forces, physical plasma and light—importance for tissue regeneration. Biomedical Materials & Devices. 2023;1(1):146-61.
  5. Kaynak A, N'Guessan KF, Patel PH, et al. Electric Fields Regulate In Vitro Surface Phosphatidylserine Exposure of Cancer Cells via a Calcium-Dependent Pathway. Biomedicines. 2023;11(2):466. doi: 10.3390/biomedicines11020466. PMID: 36831002; PMCID: PMC9953458.
  6. Aguilar AA, Ho MC, Chang E, et al. Permeabilizing Cell Membranes with Electric Fields. Cancers (Basel) 2021 May 10;13(9):2283. doi: 10.3390/cancers13092283. PMID: 34068775; PMCID: PMC8126200.
  7. Hanna H, Andre FM, Mir LM. Electrical control of calcium oscillations in mesenchymal stem cells using microsecond pulsed electric fields. Stem Cell Res Ther 2017 Apr 20;8(1):91. doi: 10.1186/s13287-017-0536-z. PMID: 28424094; PMCID: PMC5397732.
  8. Heng BC, Bai Y, Li X, et al. The bioelectrical properties of bone tissue. Animal Model Exp Med. 2023 Apr;6(2):120-130. doi: 10.1002/ame2.12300. Epub 2023 Mar 1. PMID: 36856186; PMCID: PMC10158952.
  9. Ma L, Lu MF, Schwartz RJ, et al. Bmp2 is essential for cardiac cushion epithelial-mesenchymal transition and myocardial patterning. Development. 2005 Dec;132(24):5601-11. doi: 10.1242/dev.02156. PMID: 16314491.
  10. Rivera-Feliciano J, Tabin CJ. Bmp2 instructs cardiac progenitors to form the heart-valve-inducing field. Dev Biol. 2006 Jul 15;295(2):580-8. doi: 10.1016/j.ydbio.2006.03.043. Epub 2006 Apr 4. PMID: 16730346; PMCID: PMC2680002.
  11. Docshin PM, Karpov AA, Mametov MVet al. Mechanisms of Regenerative Potential Activation in Cardiac Mesenchymal Cells. Biomedicines 2022 May 31;10(6):1283. doi: 10.3390/biomedicines10061283. PMID: 35740305; PMCID: PMC9220771.
  12. Hanna A, Frangogiannis NG. The Role of the TGF-β Superfamily in Myocardial Infarction. Front Cardiovasc Med. 2019 Sep 18;6:140. doi: 10.3389/fcvm.2019.00140. PMID: 31620450; PMCID: PMC6760019.
  13. Docshin P, Panshin D, Malashicheva A. Molecular Interplay in Cardiac Fibrosis: Exploring the Functions of RUNX2, BMP2, and Notch. Rev Cardiovasc Med. 2024 Oct 16;25(10):368. doi: 10.31083/j. rcm2510368. PMID: 39484128; PMCID: PMC11522771.
  14. Csiszar A, Lehoux S, Ungvari Z. Hemodynamic forces, vascular oxidative stress, and regulation of BMP-2/4 expression. Antioxid Redox Signal. 2009 Jul;11(7):1683-97. doi: 10.1089/ ars.2008.2401. PMID: 19320562; PMCID: PMC2842584.
  15. Tokola H, Rysä J, Pikkarainen S, Hautala N, et al. Bone morphogenetic protein-2--a potential autocrine/paracrine factor in mediating the stretch activated B-type and atrial natriuretic peptide expression in cardiac myocytes. Mol Cell Endocrinol 2015 Jan 5;399:9-21. doi: 10.1016/j.mce.2014.09.003. Epub 2014 Sep 10. PMID: 25218476.
  16. Howden R. McCann Hartzell K. Gladwell W., et al. Heart Rate and QT Interval Responses to Hyperoxia in Bmp 2 and Bmp 4 Heterozygous Mice (Poster Presentation). American Thoracic Society, Cellular And Molecular Aspects of Acute Lung Injury. 2009; A3567. Am J Respir Crit Care Med, 2009;179:A3567
  17. Hopman LHGA, Beunder KP, Borodzicz-Jazdzyk S, et al. Loss of capture of conduction system pacemaker caused by fibrosis surrounding the lead: a case report. BMC Cardiovasc Disord. 2023 Dec 19;23(1):621. doi: 10.1186/s12872-023-03656-3. PMID: 38114911; PMCID: PMC10729341.
  18. Keiler J, Schulze M, Sombetzki M, et al. Neointimal fibrotic lead encapsulation. Clinical challenges and demands for implantable cardiac electronic devices. J Cardiol. 2017 Jul;70(1):7-17. doi: 10.1016/j.jjcc.2017.01.011. PMID: 28583688.
  19. Crea P, Cocuzza F, Bonanno S, et al. New Diseases Related to Cardiac Implantable Electronic Devices (CIEDs): An Overview. J Clin Med. 2025 Feb 17;14(4):1322. doi: 10.3390/ jcm14041322. PMID: 40004852; PMCID: PMC11856071.
  20. Chen Y, Ye L, Guan L, et al. Physiological electric field works via the VEGF receptor to stimulate neovessel formation of vascular endothelial cells in a 3D environment. Biol Open. 2018 Sep 19;7(9):bio 035204. doi: 10.1242/bio.035204. PMID: 30232195; PMCID: PMC6176943.
  21. Mahaki H, Jabarivasal N, Sardanian K, et al. Effects of Various Densities of 50 Hz Electromagnetic Field on Serum IL-9, IL-10, and TNF-α Levels. Int J Occup Environ Med. 2020 Jan 1;11(1):24-32. doi: 10.15171/ijoem.2020.1572. Epub 2019 Oct 20. PMID: 31647056; PMCID: PMC7024597.
  22. López-Morales GI, Zajac JM, Flick J, et al. Quantum embedding study of strain-and electric-field-induced Stark effects on the NV− center in diamond. Physical Review B. 2024;110(24):245127.
  23. Kos B, Mattison L, Ramirez D, et al. Determination of lethal electric field threshold for pulsed field ablation in ex vivo perfused porcine and human hearts. Front Cardiovasc Med. 2023 Jun 23;10:1160231. doi: 10.3389/fcvm.2023.1160231. PMID: 37424913; PMCID: PMC10326317.
  24. Zhao M, Bai H, Wang E, et al. Electrical stimulation directly induces pre-angiogenic responses in vascular endothelial cells by signaling through VEGF receptors. J Cell Sci. 2004 Jan 26;117(Pt 3):397-405. doi: 10.1242/jcs.00868. Epub 2003 Dec 16. PMID: 14679307; PMCID: PMC1459284.
  25. Docshin P, Bairqdar A, Malashicheva A. Interplay between BMP2 and Notch signaling in endothelial-mesenchymal transition: implications for cardiac fibrosis. Stem Cell Investig. 2023 Sep 28;10:18. doi: 10.21037/sci-2023-019. PMID: 37842185; PMCID: PMC10570623.
  26. Humeres C, Venugopal H, Frangogiannis NG. Smad-dependent pathways in the infarcted and failing heart. Curr Opin Pharmacol 2022 Jun;64:102207. doi: 10.1016/j.coph.2022.102207. PMID: 35367786; PMCID: PMC9167749.
  27. Tomida S, Ishima T, Nagai R, et al. T-Type Voltage-Gated Calcium Channels: Potential Regulators of Smooth Muscle Contractility. Int J Mol Sci 2024 Nov 19;25(22):12420. doi: 10.3390/ ijms252212420. PMID: 39596484; PMCID: PMC11594734.
  28. Salvage SC, Habib ZF, Matthews HR, et al. Ca2+-dependent modulation of voltage-gated myocyte sodium channels. Biochem Soc Trans 2021 Nov 1;49(5):1941-1961. doi: 10.1042/ BST20200604. PMID: 34643236; PMCID: PMC8589445.
  29. Vimalraj SA. Concise review of VEGF, PDGF, FGF, Notch, angiopoietin, and HGF signalling in tumor angiogenesis with a focus on alternative approaches and future directions. Int J Biol Macromol. 2022;221;1428-1438.
  30. Cao R, Eriksson A, Kubo H, et al. Comparative evaluation of FGF-2-, VEGF-A-, and VEGF-C-induced angiogenesis, lymphangiogenesis, vascular fenestrations, and permeability. Circ Res. 2004 Mar 19;94(5):664-70. doi: 10.1161/01. RES.0000118600.91698.BB. 2004 Jan 22. PMID: 14739162.
  31. Fletcher-Hall S. Pacemaker-induced cardiomyopathy. JAAPA. 2023 Sep 1;36(9):1-4. doi: 10.1097/01.JAA.0000947080.85880. bb. PMID: 37668488.
  32. George I, Geddis MS, Lill Z, et al. Myocardial function improved by electromagnetic field induction of stress protein hsp70. J Cell Physiol. 2008 Sep;216(3):816-23. doi: 10.1002/jcp.21461. PMID: 18446816; PMCID: PMC3075533.
  33. Wang S, Chen J, Chen MT, et al. Cardiac myocyte excitation by ultrashort high-field pulses. Biophys J. 2009 Feb 18;96(4):1640- 8. doi: 10.1016/j.bpj.2008.11.011. PMID: 19217879; PMCID: PMC2717245.
  34. Guo HD, Wu JH, Wang HJ, et al. Delivery of Stem Cells and BMP-2 With Functionalized Self-Assembling Peptide Enhances Regeneration of Infarcted Myocardium. Stem Cell Rev Rep. 2024 Aug;20(6):1540-1554. doi: 10.1007/s12015-024- 10721-7. Epub 2024 Apr 24. PMID: 38656478.
  35. Andrée B, Duprez D, Vorbusch B, et al. BMP-2 induces ectopic expression of cardiac lineage markers and interferes with somite formation in chicken embryos. Mech Dev. 1998 Jan;70(1-2):119- 31. doi: 10.1016/s0925-4773(97)00186-x. PMID: 9510029.
  36. Wang S, Sun A, Li L, et al. Up-regulation of BMP-2 antagonizes TGF-β1/ROCK-enhanced cardiac fibrotic signalling through activation of Smurf1/Smad6 complex. J Cell Mol Med. 2012 Oct;16(10):2301-10. doi: 10.1111/j.1582-4934.2012.01538.x. PMID: 22283839; PMCID: PMC3823423.
  37. Harakawa S, Hori T, Hiramoto T, et al. Suppression of Glucocorticoid Response in Stressed Mice Using 50 Hz Electric Field According to Immobilization Degree and Posture. Biology (Basel). 2022 Sep 9;11(9):1336. doi: 10.3390/biology11091336. PMID: 36138815; PMCID: PMC9495954.
  38. Katoh K. Effects of Electrical Stimulation of the Cell: Wound Healing, Cell Proliferation, Apoptosis, and Signal Transduction. Med Sci (Basel). 2023 Jan 17;11(1):11. doi: 10.3390/medsci11010011. PMID: 36810478; PMCID: PMC9944882.
  39. Song MY, Yu JZ, Zhao DM, et al. The time-dependent manner of sinusoidal electromagnetic fields on rat bone marrow mesenchymal stem cells proliferation, differentiation, and mineralization. Cell biochem and biophys. 2014;69;47-54.