1
|
Méndez-Fernández A, Fernández-Mora Á, Bernal-Ramírez J, Alves-Figueiredo H, Nieblas B, Salazar-Ramírez F, Maldonado-Ruiz R, Zazueta C, García N, Lozano O, Treviño V, Torre-Amione G, García-Rivas G. Distinguishing pathophysiological features of heart failure with reduced and preserved ejection fraction: A comparative analysis of two mouse models. J Physiol 2024. [PMID: 39018163 DOI: 10.1113/jp286410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/25/2024] [Indexed: 07/19/2024] Open
Abstract
Heart failure (HF) is a heterogeneous condition that can be categorized according to the left ventricular ejection fraction (EF) into HF with reduced (HFrEF) or preserved (HFpEF) EF. Although HFrEF and HFpEF share some common clinical manifestations, the mechanisms underlying each phenotype are often found to be distinct. Identifying shared and divergent pathophysiological features might expand our insights on HF pathophysiology and assist the search for therapies for each HF subtype. In this study, we evaluated and contrasted two new murine models of non-ischaemic HFrEF and cardiometabolic HFpEF in terms of myocardial structure, left ventricular function, gene expression, cardiomyocyte calcium handling, mitochondrial polarization and protein acetylation in a head-to-head fashion. We found that in conditions of similar haemodynamic stress, the HFrEF myocardium underwent a more pronounced hypertrophic and fibrotic remodelling, whereas inflammation was greater in the HFpEF myocardium. We observed opposing features on calcium release, which was diminished in the HFrEF cardiomyocyte but enhanced in the HFpEF cardiomyocyte. Mitochondria were less polarized in both HFrEF and HFpEF cardiomyocytes, reflecting similarly impaired metabolic capacity. Hyperacetylation of cardiac proteins was observed in both models, but it was more accentuated in the HFpEF heart. Despite shared features, unique triggering mechanisms (neurohormonal overactivation in HFrEF vs. inflammation in HFpEF) appear to determine the distinct phenotypes of HF. The findings of the present research stress the need for further exploration of the differential mechanisms underlying each HF subtype, because they might require specific therapeutic interventions. KEY POINTS: The mechanisms underlying heart failure with either reduced (HFrEF) or preserved (HFpEF) ejection fraction are often found to be different. Previous studies comparing pathophysiological traits between HFrEF and HFpEF have been conducted on animals of different ages and strains. The present research contrasted two age-matched mouse models of non-ischaemic HFrEF and cardiometabolic HFpEF to uncover divergent and shared features. We found that upon similar haemodynamic stress, the HFrEF heart experienced a more pronounced hypertrophic and fibrotic remodelling, whereas inflammation appeared to be greater in the HFpEF myocardium. Calcium release was diminished in the HFrEF cardiomyocyte and enhanced in the HFpEF cardiomyocyte. Mitochondria were comparably less polarized in both HFrEF and HFpEF myocytes. Hyperacetylation of proteins was common to both models, but stronger in the HFpEF heart. Casting light on common and distinguishing features might ease the quest for phenotype-specific therapies for heart failure patients.
Collapse
Affiliation(s)
- Abraham Méndez-Fernández
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Ángel Fernández-Mora
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Judith Bernal-Ramírez
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
- Institute for Obesity Research, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Hugo Alves-Figueiredo
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Bianca Nieblas
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Felipe Salazar-Ramírez
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Roger Maldonado-Ruiz
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
- Institute for Obesity Research, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Cecilia Zazueta
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología, Ciudad de Mexico, Mexico
| | - Noemí García
- Institute for Obesity Research, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Omar Lozano
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
- Institute for Obesity Research, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Víctor Treviño
- Institute for Obesity Research, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Guillermo Torre-Amione
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
- Institute for Obesity Research, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| | - Gerardo García-Rivas
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
- Institute for Obesity Research, Tecnológico de Monterrey, Hospital Zambrano-Hellion, San Pedro Garza-García, Nuevo León, Mexico
| |
Collapse
|
2
|
Gurler B, Gencay G, Baloglu E. Hypoxia and HIF-1α Regulate the Activity and Expression of Na,K-ATPase Subunits in H9c2 Cardiomyoblasts. Curr Issues Mol Biol 2023; 45:8277-8288. [PMID: 37886965 PMCID: PMC10605391 DOI: 10.3390/cimb45100522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
The optimal function of the Na,K-ATPase (NKA) pump is essential for the heart. In ischemic heart disease, NKA activity decreases due to the decreased expression of the pump subunits. Here, we tested whether the hypoxia-inducible transcription factor (HIF-1α), the key signaling molecule regulating the adaptation of cells to hypoxia, is involved in controlling the expression and cellular dynamics of α1- and β1-NKA isoforms and of NKA activity in in-vitro hypoxic H9c2 cardiomyoblasts. HIF-1α was silenced through adenoviral infection, and cells were kept in normoxia (19% O2) or hypoxia (1% O2) for 24 h. We investigated the mRNA and protein expression of α1-, β1-NKA using RT-qPCR and Western blot in whole-cell lysates, cell membranes, and cytoplasmic fractions after labeling the cell surface with NHS-SS-biotin and immunoprecipitation. NKA activity and intracellular ATP levels were also measured. We found that in hypoxia, silencing HIF-1α prevented the decreased mRNA expression of α1-NKA but not of β1-NKA. Hypoxia decreased the plasma membrane expression of α1-NKA and β1- NKA compared to normoxic cells. In hypoxic cells, HIF-1α silencing prevented this effect by inhibiting the internalization of α1-NKA. Total protein expression was not affected. The decreased activity of NKA in hypoxic cells was fully prevented by silencing HIF-1α independent of cellular ATP levels. This study is the first to show that in hypoxic H9c2 cardiomyoblasts, HIF-1α controls the internalization and membrane insertion of α1-NKA subunit and of NKA activity. The mechanism behind this regulation needs further investigation.
Collapse
Affiliation(s)
- Beyza Gurler
- Department of Medical Biotechnology, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul 34752, Turkey;
| | - Gizem Gencay
- Department of Molecular and Translational Biomedicine, Institute of Natural and Applied Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul 34752, Turkey;
| | - Emel Baloglu
- Department of Medical Pharmacology, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul 34752, Turkey
| |
Collapse
|
4
|
Wybraniec MT, Orszulak M, Męcka K, Mizia-Stec K. Heart Failure with Improved Ejection Fraction: Insight into the Variable Nature of Left Ventricular Systolic Function. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14400. [PMID: 36361280 PMCID: PMC9656122 DOI: 10.3390/ijerph192114400] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
The progress of contemporary cardiovascular therapy has led to improved survival in patients with myocardial disease. However, the development of heart failure (HF) represents a common clinical challenge, regardless of the underlying myocardial pathology, due to the severely impaired quality of life and increased mortality comparable with malignant neoplasms. Left ventricular ejection fraction (LVEF) is the main index of systolic function and a key predictor of mortality among HF patients, hence its improvement represents the main indicator of response to instituted therapy. The introduction of complex pharmacotherapy for HF, increased availability of cardiac-implantable electronic devices and advances in the management of secondary causes of HF, including arrhythmia-induced cardiomyopathy, have led to significant increase in the proportion of patients with prominent improvement or even normalization of LVEF, paving the way for the identification of a new subgroup of HF with an improved ejection fraction (HFimpEF). Accumulating data has indicated that these patients share far better long-term prognoses than patients with stable or worsening LVEF. Due to diverse HF aetiology, the prevalence of HFimpEF ranges from roughly 10 to 40%, while the search for reliable predictors and genetic associations corresponding with this clinical presentation is under way. As contemporary guidelines focus mainly on the management of HF patients with clearly defined LVEF, the present review aimed to characterize the definition, epidemiology, predictors, clinical significance and principles of therapy of patients with HFimpEF.
Collapse
Affiliation(s)
- Maciej T. Wybraniec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 47 Ziołowa St., 40-635 Katowice, Poland
- Upper-Silesian Medical Center, 40-635 Katowice, Poland
- European Reference Network on Heart Diseases—ERN GUARD-HEART, 1105 AZ Amsterdam, The Netherlands
| | - Michał Orszulak
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 47 Ziołowa St., 40-635 Katowice, Poland
- Upper-Silesian Medical Center, 40-635 Katowice, Poland
| | - Klaudia Męcka
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 47 Ziołowa St., 40-635 Katowice, Poland
- Upper-Silesian Medical Center, 40-635 Katowice, Poland
| | - Katarzyna Mizia-Stec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 47 Ziołowa St., 40-635 Katowice, Poland
- Upper-Silesian Medical Center, 40-635 Katowice, Poland
- European Reference Network on Heart Diseases—ERN GUARD-HEART, 1105 AZ Amsterdam, The Netherlands
| |
Collapse
|